An Adaptive Preventive Intervention to Optimize the Transition from Universal to Indicated Resources for College Student Alcohol Use

适应性预防干预措施，优化大学生饮酒从通用资源到指定资源的过渡

• 批准号: 9794637
• 负责人: Megan E. Patrick
• 金额: $ 44.29万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9794637
• 关键词: Acute; Address; Alcohol consumption; Alcoholic beverage heavy drinker; Brief Alcohol Screening and Intervention for College Students; Counseling; Electronic Mail; Frequencies; Health; Health Promotion; Heavy Drinking; Human; Injury; Institution; Internet; Intervention; Mental Health Services; Monitor; National Institute on Alcohol Abuse and Alcoholism; Perception; Persons; Population; Prevention approach; Preventive Intervention; Public Health; Randomized; Reporting; Research Project Grants; Resources; Risk; Services; Students; Technology; Training; Treatment Efficacy; Woman; alcohol consequences; alcohol poisoning; alcohol related consequences; alcohol use disorder; base; binge drinking; brief intervention; brief motivational intervention; college; college drinking; cost; cost effective; cost effectiveness; design; drinking; evidence base; experience; falls; follow-up; health service use; heavy drinking college student; heavy drinking students; high risk; men; novel strategies; peer influence; personalized intervention; personalized normative feedback; primary outcome; randomized trial; response; secondary outcome; service intervention; service programs; trial design; universal prevention; university student; web site; young adult; young adult alcohol use

College student alcohol use and associated negative consequences are public health problems. In particular, first-year students transitioning to college are at increased risk. Scarce intervention resources must be used as wisely as possible to address these concerns. One way to address heavy drinking while conserving resources is to first utilize universal interventions, identify students at high risk who do not respond well, and then motivate them to engage in indicated intervention. This approach to prevention is `adaptive' because information about the student in the course of the intervention (e.g., response status) is used to determine whether more resources should be invested to motivate the student to transition to indicated services. The purpose of the proposed project is to implement adaptive preventive intervention (API) that employs cost- effective, technology-based brief interventions to do the following. First, provide a universal personalized normative feedback (PNF) intervention followed by student self-monitoring (SM). Second, motivate students who continue to drink heavily (i.e., 2+ reports of 4/5+ drinks for women/men, or 1 report of 8/10+ drinks for women/men) to transition to additional intervention resources. To optimize the efficacy of this intervention, we will investigate the best timing for delivering the initial universal PNF+SM intervention (i.e., as an inoculation before moving to college vs. once they are experiencing the college context during their first semester). Additionally, we will examine how best to motivate heavy-drinking students to pursue indicated intervention (i.e., via automated emails vs. online interaction with a personal health coach using mBridge). A sequential multiple assignment randomized trial (SMART) design (N=700) will be used to address these questions. College students will be randomized to receive PNF either before college begins (2 weeks before classes start) or during the beginning of the first semester (about 3 weeks after they arrive on campus), followed by SM every two weeks during the first semester; these SM assessments will be used to identify heavy-drinking students who remain at risk. Once heavy drinking is identified, the student will be re-randomized to either an automated email or mBridge coach to offer indicated intervention resources. The specific aims are to examine: (1) the efficacy of the API compared to an assessment-only control, (2) whether the API can be optimized by altering the timing of the universal intervention and/or the type of message to motivate seeking indicated intervention, and (3) moderators of these effects (e.g., pre-college drinking intentions, high-intensity [compared to binge] drinking during the start of college). Frequency of heavy drinking, alcohol-related consequences, and health services utilization will be assessed prior to the start of classes, and at each follow-up point (the end of the semester, the end of the year, and the following fall). The API to be refined through this project will offer a novel strategy for mitigating both the acute negative health consequences (e.g., injury, alcohol poisoning) and long-term health consequences (e.g., alcohol use disorders) of young adult alcohol use.

大学生饮酒和相关的负面后果是公共卫生问题。尤其， 过渡到大学的一年级学生面临的风险更大。必须利用稀缺的干预资源 尽可能明智地解决这些问题。在节约资源的同时解决酗酒问题的一种方法 是首先利用普遍干预措施，识别出反应不佳的高风险学生，然后 激励他们参与指定的干预。这种预防方法是“适应性的”，因为 干预过程中有关学生的信息（例如，反应状态）用于确定 是否应该投入更多资源来激励学生过渡到指定服务。这 拟议项目的目的是实施适应性预防干预（API），该干预采用成本- 有效的、基于技术的简短干预措施可以做到以下几点。一、提供通用的个性化 规范反馈（PNF）干预，然后是学生自我监控（SM）。二、激发学生的积极性 继续大量饮酒的人（即女性/男性有 2 份以上饮酒量超过 4/5 的报告，或女性/男性有 1 份报告饮酒量超过 8/10 的人） 女性/男性）过渡到额外的干预资源。为了优化这种干预措施的效果，我们 将调查提供初始普遍 PNF+SM 干预措施的最佳时机（即作为接种 在进入大学之前与他们在第一学期体验大学环境后相比）。 此外，我们将研究如何最好地激励酗酒的学生进行指示性干预 （即通过自动电子邮件与使用 mBridge 与个人健康教练在线互动）。一个连续的 将使用多重分配随机试验 (SMART) 设计 (N=700) 来解决这些问题。 大学生将在大学开学前（开课前 2 周）随机接受 PNF 或在第一学期开始时（到达校园后约 3 周），然后是 SM 第一学期每两周一次；这些 SM 评估将用于识别酗酒者 仍处于危险之中的学生。一旦发现酗酒，学生将被重新随机分配到 自动电子邮件或 mBridge coach 提供指示的干预资源。具体目标是检查： (1) 与仅评估对照相比 API 的功效，(2) 是否可以通过以下方式优化 API 改变普遍干预的时间和/或信息类型以激发寻求指示 干预，以及（3）这些影响的调节因素（例如，大学前饮酒意图、高强度[相比 大学开始时酗酒）。酗酒的频率、酒精相关的后果，以及 将在课程开始之前以及每个后续时间点（课程结束时）评估卫生服务的利用率 学期、年底和接下来的秋季）。通过该项目完善的 API 将提供 减轻急性负面健康后果（例如受伤、酒精中毒）和 年轻人饮酒的长期健康后果（例如，酒精使用障碍）。