Recovery Definitions and Behavior Change Processes in Recovery outside of Treatment

治疗外恢复中的恢复定义和行为改变过程

• 批准号: 10685993
• 负责人: Paul A Gilbert
• 金额: $ 36.92万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10685993
• 关键词: Abstinence; Address; Adult; Alcohol abuse; Alcohol consumption; Alcohols; Baseline Surveys; Behavioral; Behavioral Mechanisms; Capital; Classification; Complement; Compulsive Behavior; Conscious; Data; Dimensions; Disease remission; Elements; Ethnic Origin; Evaluation; Exposure to; Gender; General Population; Goals; Institute of Medicine (U.S.); Intervention; Interview; Investigation; Knowledge; Maintenance; Minority; Modeling; Nature; Outcome; Pathway interactions; Persons; Probability Samples; Process; Psyche structure; Questionnaires; Race; Recovery; Recovery Support; Reporting; Research; Resources; Respondent; Services; Spirituality; Spontaneous Remission; Stimulus; Subgroup; Surveys; Telephone Interviews; Testing; Theoretical model; Thinking; Tobacco use; Variant; alcohol abuse therapy; alcohol exposure; alcohol intervention; alcohol services; alcohol use disorder; behavior change; behavior influence; cost effective; drinking; ethnic disparity; follow-up; gender disparity; medical specialties; member; novel; peer; population survey; quantum; racial disparity; response; service utilization; sustained recovery; treatment disparity; treatment services; uptake

PROJECT SUMMARY/ABSTRACT General population surveys have regularly found that less than one-quarter of adults with a lifetime alcohol use disorder (AUD) ever obtain treatment; nevertheless, the majority of those with AUD will achieve remission at some point. This phenomenon of untreated recovery (also known as natural recovery, spontaneous remission, and quantum change) has been long recognized but remains poorly understood. For example, several decades of research have confirmed its existence and even identified correlates; however, interventions to promote recovery outside of treatment have yielded equivocal or modest results, which are likely the result of unaddressed gaps, such as little knowledge of the meaning of recovery and the mechanisms of behavior change outside of traditional treatment services. Guided by Stall and Biernacki's conceptual model of spontaneous remission from compulsive behaviors and integrating processes of change from the Transtheoretical Model, the proposed study will use mixed quantitative-qualitative approaches to identify the processes associated with recovery outside of treatment and test how recovery definitions relate to those processes and recovery outcomes. Specific aims are: (1) to characterize recovery definitions by treatment exposure; (2) to identify the processes of recovery without treatment; (3) to estimate the likelihood of sustained recovery and identify modifiable correlates to support recovery; and in an exploratory aim (4) to investigate variation by subgroups. First, a detailed online questionnaire will be administered to 1,500 adults with resolved problematic drinking drawn from Knowledge Panel (Ipsos Public Affairs; Norwalk CT), a pre-existing national probability sample. Respondents will be classified as in treated recovery (used specialty services, with or without 12-step groups), assisted recovery (used 12-step groups but not specialty services), or independent recovery (never used specialty services or 12- step groups), which will permit contrasts by level of intervention exposure (i.e., independent vs. assisted and treated recovery groups). Under Aim 1, we will use Kaskutas and colleagues' multi-dimensional What Is Recovery scale to quantify conceptualizations of recovery using cross-sectional baseline survey data (n=1,500). Under Aim 2, we will conduct qualitative interviews with a purposive sub-set (n=80) of respondents in assisted and independent recovery to investigate the meaning of recovery, what guides the decision not to seek treatment, and how respondents initiate and maintain behavior change. Under Aim 3, a subset of respondents in early recovery (<5 years; n=270) will be followed for 3 additional years, completing annual quantitative surveys to establish stability of recovery and identify factors associated with successful maintenance of recovery by group. Our long-term goal is to expand the repertoire of responses to problem drinking. Findings may be used to develop and test novel low-threshold interventions to promote recovery among people who are unable or unwilling to seek specialty treatment services.

项目概要/摘要 一般人口调查经常发现，只有不到四分之一的成年人一生饮酒 疾病（AUD）曾经接受过治疗；尽管如此，大多数 AUD 患者将在 某个点。这种未经治疗的恢复现象（也称为自然恢复、自发缓解、 和量子变化）早已被认识到，但仍然知之甚少。比如说几十年 的研究已证实其存在，甚至确定了相关性；然而，干预措施促进 治疗之外的恢复产生了模棱两可或适度的结果，这可能是由于未解决的结果 差距，例如对恢复的含义以及外界行为改变的机制知之甚少 传统治疗服务。以 Stall 和 Biernacki 的自发缓解概念模型为指导 强迫行为和跨理论模型的整合变化过程，拟议的研究 将使用混合定量-定性方法来确定与外部恢复相关的过程 治疗并测试恢复定义与这些过程和恢复结果之间的关系。具体目标是： (1) 通过治疗暴露来描述恢复定义； (2) 识别恢复过程，无需 治疗; (3) 估计持续恢复的可能性并确定可修改的相关因素以支持 恢复;并以探索性目标 (4) 调查亚组的变异。首先网上有详细的 将对来自 Knowledge 的 1,500 名已解决饮酒问题的成年人进行问卷调查 小组（益普索公共事务部；诺沃克 CT），预先存在的国家概率样本。受访者将 分类为治疗康复（使用专业服务，有或没有 12 步组）、辅助康复 （使用过 12 步组，但未使用过专业服务），或独立恢复（从未使用过专业服务或 12- 步骤组），这将允许按干预暴露水平进行对比（即独立与辅助和 治疗恢复组）。在目标 1 下，我们将使用 Kaskutas 和同事的多维 What Is 使用横截面基线调查数据（n=1,500）量化恢复概念的恢复量表。 根据目标 2，我们将有目的地对受援助的受访者子集 (n=80) 进行定性访谈 和独立康复来调查康复的意义，是什么指导了不寻求治疗的决定， 以及受访者如何发起和维持行为改变。在目标 3 下，早期的一部分受访者 恢复情况（<5 年；n=270）将再跟踪 3 年，完成年度定量调查以 建立恢复的稳定性并确定与按组成功维持恢复相关的因素。 我们的长期目标是扩大针对饮酒问题的应对措施。研究结果可用于开发 并测试新颖的低阈值干预措施，以促进无法或不愿意的人的康复 寻求专业治疗服务。

项目成果

Strategies to maintain recovery from alcohol problems during the COVID-19 pandemic: Insights from a mixed-methods national survey of adults in the United States.

COVID-19 大流行期间保持酒精问题恢复的策略：来自美国成年人混合方法全国调查的见解。

• 发表时间: 2023
• 影响因子: 3.7
• 作者: Gilbert, Paul A;Soweid, Loulwa;Holdefer, Paul J;Kersten, Sarah;Mulia, Nina
• 通讯作者: Mulia, Nina

Gender differences in lifetime and current use of online support for recovery from alcohol use disorder.

一生中的性别差异以及目前使用在线支持从酒精使用障碍中恢复的情况。

• 发表时间: 2022-06
• 作者: Gilbert, Paul A;Saathoff, Elizabeth;Russell, Alex M;Brown, Grant
• 通讯作者: Brown, Grant