Preventing Alcohol Misuse among Young Adult Veterans through Brief Online Intervention

通过简短的在线干预防止年轻退伍军人滥用酒精

• 批准号: 10386855
• 负责人: Eric R. Pedersen
• 金额: $ 37.24万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10386855
• 关键词: Address; Affect; Afghanistan; Age; Alcohol abuse; Alcohols; Attention; Behavior; Car Phone; Caring; Chronic; Clinic Visits; Databases; Development; Early treatment; Facebook; Family; Feedback; Female; Gender; Grant; Healthcare; Healthcare Systems; Heavy Drinking; Human Resources; Internet; Intervention; Iraq; Left; Life; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Methodology; Methods; Military Personnel; Moods; Motivation; Outcome; Participant; Pattern; Pilot Projects; Population; Populations at Risk; Post-Traumatic Stress Disorders; Prevention approach; Program Accessibility; Program Sustainability; Public Health; Quality of Care; Randomized; Randomized Controlled Trials; Reporting; Research; Resistance; Risk; Sampling; Subgroup; Symptoms; Tablets; Testing; Time; Treatment Efficacy; Unemployment; United States Department of Veterans Affairs; Veterans; War; Work; alcohol abuse therapy; alcohol comorbidity; alcohol misuse; alcohol misuse prevention; alcohol related consequences; alcohol seeking behavior; alcohol use disorder; attentional control; base; behavioral health; brief intervention; care seeking; college; comorbidity; comparison group; conventional therapy; coping; depressive symptoms; design; deter alcohol use; drinking; efficacy testing; experience; follow-up; health assessment; help-seeking behavior; high risk; intervention effect; intervention participants; male; military veteran; novel; online intervention; outreach; personalized normative feedback; pilot test; post intervention; post-traumatic symptoms; prevent; programs; public database; recruit; screening; sex; social; social media; social stigma; societal costs; therapy design; therapy development; young adult

Project Summary/Abstract Young adult veterans from the wars in Iraq and Afghanistan represent a population at risk for heavy drinking and resulting long-term problems from use. Unfortunately, few seek treatment for alcohol concerns. The objective of this planned research is to more fully test the efficacy of a very brief, inexpensive, single-session, and web-delivered personalized normative feedback (PNF) intervention developed by our team and evaluated in a successful pilot R34 study to prevent alcohol misuse and associated negative consequences, as well as increase behavioral health treatment seeking behaviors among a difficult to reach and treatment resistant veteran population. We expand on our successful pilot work by (1) building a large publicly available database of young veteran drinking and treatment seeking norms, (2) focusing on reaching veterans who have recently separated from the military and drink heavily but who have not recently sought any behavioral health treatment, (3) evaluating how an enhanced intervention offering PNF content specifically related to treatment seeking affects preparatory behaviors and actual treatment initiation, and (4) testing hypothesized mediators and moderators of intervention drinking and treatment initiation outcomes relevant for this population. In Aim 1, we add to our large database of drinking norms for the population by collecting drinking and treatment seeking information from veterans underrepresented in the pilot, such as female veterans (total sample N = 2,500). In Aim 2, we then use these norms in a randomized controlled trial of the PNF intervention designed to reach heavy drinking young veterans who are not currently receiving behavioral health care (N = 800) and test if additional feedback about treatment seeking can help promote treatment initiation among this treatment resistant group. Outcomes at 3, 6, 9, and 12 months are compared for participants receiving an enhanced PNF condition (N = 400) to an attention-only control condition (N = 400). In Aim 3, we test mediators of intervention efficacy on drinking outcomes (i.e., changes in perceived norms, increases in treatment initiation) and explore moderators of outcomes to determine if the brief intervention works better for veteran participants based on age, gender, reasons for drinking (social versus coping), perceived stigma, PTSD and depression symptoms, and solitary drinking. The proposed research offers significant methodological advancements to current PNF approaches by targeting a comorbid population with unmet behavioral health needs. The public health impact of the approach is promising as the intervention is hosted entirely on the Internet and can reach veterans outside of treatment settings. The self-sustaining program uses limited time and personnel and is available on mobile phones and tablets. The intervention can reach a large population resistant to conventional therapies and functions as a stand-alone approach to prevent drinking consequences and promote treatment initiation early, before alcohol misuse and comorbid problems become chronic.

项目概要/摘要 参加过伊拉克和阿富汗战争的年轻成年退伍军人是面临酗酒风险的人群 并导致长期使用问题。不幸的是，很少有人因酒精问题而寻求治疗。这 这项计划研究的目的是更全面地测试一个非常简短、廉价、单次的效果 我们的团队开发并评估了通过网络提供的个性化规范反馈（PNF）干预措施 在一项成功的 R34 试点研究中，旨在防止酒精滥用和相关的负面后果，以及 增加难以接触和抗拒治疗的人群的行为健康治疗寻求行为 退伍军人人口。我们通过 (1) 建立大型公开数据库来扩展我们成功的试点工作 年轻退伍军人饮酒和寻求治疗的规范，(2) 重点关注最近饮酒和治疗的退伍军人 退伍并酗酒但最近没有寻求任何行为健康的人 治疗，(3) 评估如何提供与治疗特别相关的 PNF 内容的增强干预 寻求会影响准备行为和实际治疗开始，以及（4）测试假设的中介因素 以及与该人群相关的干预饮酒和治疗开始结果的调节因素。在目标 1 中， 我们通过收集饮酒和寻求治疗的情况，将人们的饮酒规范添加到大型数据库中 来自试点中代表性不足的退伍军人的信息，例如女性退伍军人（总样本 N = 2,500）。在 目标 2，然后我们在 PNF 干预的随机对照试验中使用这些规范，旨在达到 目前未接受行为健康护理的酗酒年轻退伍军人 (N = 800) 并测试是否 关于寻求治疗的额外反馈可以帮助促进该治疗中的治疗开始 抵抗群体。比较接受增强 PNF 的参与者在 3、6、9 和 12 个月时的结果 条件（N = 400）到仅注意控制条件（N = 400）。在目标 3 中，我们测试干预的中介因素 对饮酒结果的功效（即感知规范的变化、治疗开始的增加）并探索 结果的调节者根据以下情况确定简短的干预是否对退伍军人参与者效果更好 年龄、性别、饮酒原因（社交与应对）、耻辱感、创伤后应激障碍（PTSD）和抑郁症状， 以及独自饮酒。拟议的研究为当前的 PNF 提供了重大的方法论进步 通过针对行为健康需求未得到满足的共病人群来采取方法。公共卫生影响 该方法的前景广阔，因为干预措施完全托管在互联网上，并且可以接触到退伍军人 在治疗环境之外。该自我维持计划使用有限的时间和人员，可在 手机和平板电脑。该干预措施可以覆盖对传统疗法有抵抗力的大量人群 并作为一种独立的方法来预防饮酒后果并促进治疗开始 尽早，在酒精滥用和合并症问题变成慢性之前。

项目成果

Childhood adversity, combat experiences, and military sexual trauma: a test and extension of the stress sensitization hypothesis.

童年逆境、战斗经历和军事性创伤：压力敏化假说的检验和延伸。

• 发表时间: 2023-07
• 影响因子: 6.9
• 作者: Davis, Jordan P;Prindle, John;Saba, Shaddy;Lee, Daniel S;Leightley, Daniel;Tran, Denise D;Sedano, Angeles;Fitzke, Reagan;Castro, Carl A;Pedersen, Eric R
• 通讯作者: Pedersen, Eric R

Changes in perceived stress during the COVID-19 pandemic among American veterans.

COVID-19 大流行期间美国退伍军人感知压力的变化。

• 发表时间: 2022-12
• 作者: Davis, Jordan P;Prindle, John;Saba, Shaddy K;Tran, Denise D;Lee, Daniel S;Sedano, Angeles;Castro, Carl A;Pedersen, Eric R
• 通讯作者: Pedersen, Eric R

Associations between symptoms of posttraumatic stress disorder, pain, and alcohol use disorder among OEF/OIF/OND veterans.

OEF/OIF/OND 退伍军人中创伤后应激障碍、疼痛和酒精使用障碍症状之间的关联。

• 发表时间: 2021
• 影响因子: 4.4
• 作者: Saba, Shaddy K;Davis, Jordan P;Prindle, John J;Castro, Carl Andrew;Pedersen, Eric R
• 通讯作者: Pedersen, Eric R

American Veterans in the Era of COVID-19: Reactions to the Pandemic, Posttraumatic Stress Disorder, and Substance Use Behaviors.

COVID-19 时代的美国退伍军人：对流行病、创伤后应激障碍和药物使用行为的反应。

• 发表时间: 2023
• 作者: Pedersen, Eric R;Davis, Jordan P;Fitzke, Reagan E;Lee, Daniel S;Saba, Shaddy
• 通讯作者: Saba, Shaddy

Applying polyvictimization theory to veterans: Associations with substance use and mental health.

将多重受害理论应用于退伍军人：与药物使用和心理健康的关联。

• 发表时间: 2022-03
• 作者: Davis, Jordan P;Lee, Daniel S;Saba, Shaddy;Fitzke, Reagan E;Ring, Colin;Castro, Carl C;Pedersen, Eric R
• 通讯作者: Pedersen, Eric R