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: 10020882
• 负责人: Paul A Gilbert
• 金额: $ 49.03万
• 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/10020882
• 关键词: Abstinence; Address; Adult; Alcohol abuse; Alcohol consumption; Alcohols; Baseline Surveys; Behavioral; Behavioral Mechanisms; Capital; 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; Lead; Maintenance; Minority; Modeling; Nature; Outcome; Pathway interactions; Probability Samples; Process; Psyche structure; Questionnaires; Race; Recovery; Reporting; Research; Resources; Respondent; Services; Spirituality; Spontaneous Remission; Stimulus; Subgroup; Surveys; Telephone Interviews; Testing; Thinking; Tobacco use; Variant; alcohol abuse therapy; alcohol exposure; alcohol intervention; alcohol services; alcohol use disorder; behavior change; behavior influence; cost effective; drinking; follow-up; medical specialties; member; novel; peer; population survey; quantum; racial and ethnic disparities; response; service utilization; 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.

项目摘要/摘要 普通人口调查经常发现，不到终生饮酒的成年人不到四分之一 疾病（AUD）曾经获得治疗；然而，大多数具有AUD的人将在 有点。这种未经处理的恢复现象（也称为自然恢复，自发缓解， 长期以来，量子变化）已被认识到，但知之甚少。例如，几十年 研究证实了它的存在，甚至确定了相关性。但是，促进的干预措施 治疗以外的恢复产生了模棱两可的结果或适度的结果 差距，例如对恢复含义的了解很少，行为机制在 传统治疗服务。在Stall和Biernacki的自发缓解概念模型的指导下 强迫行为和整合跨理论模型的变化过程，这是拟议的研究 将使用混合定量质量方法来识别与恢复相关的过程 处理和测试恢复定义与这些过程和恢复结果的关系。具体目的是： （1）通过治疗暴露来表征恢复定义； （2）识别没有的恢复过程 治疗; （3）估计持续恢复的可能性并确定可修改的相关性 恢复;并在探索性目的（4）中研究亚组的变化。首先，在线详细 问卷将向1,500名成年人管理，从知识中得出有问题的饮酒 小组（IPSOS公共事务； Norwalk CT），这是一个现有的国家概率样本。受访者会 分类为处理的恢复（使用的专业服务，有或没有12步组），辅助恢复 （使用了12步组，但没有专业服务）或独立恢复（从未使用过专业服务或12-- 步骤组），这将允许通过干预暴露水平进行对比（即独立与辅助和 治疗的恢复组）。在AIM 1下，我们将使用Kaskutas及其同事的多维 使用横截面基线调查数据（n = 1,500）来量化恢复概念的恢复量表。 在AIM 2下，我们将对有目的的子集（n = 80）进行定性访谈。 独立恢复以调查恢复的含义，是什么指导了决定不寻求治疗的决定， 以及受访者如何启动和维持行为变化。在AIM 3下，一部分受访者早期 恢复（<5年; n = 270）将在另外3年进行，完成年度定量调查 建立恢复的稳定性，并确定与逐组成功维持恢复相关的因素。 我们的长期目标是扩大对饮酒问题的反应的曲目。调查结果可用于发展 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。