Adaptive Text Messaging Intervention for Risky Drinking in Postpartum Women

针对产后女性危险饮酒的自适应短信干预

• 批准号: 10265557
• 负责人: SARAH E. DAUBER
• 金额: $ 24.33万
• 依托单位: PARTNERSHIP TO END ADDICTION
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10265557
• 关键词: Address; Adult; Age; Alcohol consumption; American; Behavior Therapy; Behavioral; Cellular Phone; Child; Child Abuse; Child Abuse and Neglect; Child Health; Child Welfare; Cognitive; Cognitive Therapy; Coping Skills; County; Data; Data Collection; Development; Distal; Ecological momentary assessment; Engineering; Evaluation; Evidence based intervention; Excision; Feedback; Female of child bearing age; Focus Groups; Fright; Future; Goals; Health Services Accessibility; Impairment; Individual; Infant Care; Infrastructure; Intake; Intention; Intervention; Interview; Life; Literature; Methods; Modeling; Mothers; Motivation; National Institute on Alcohol Abuse and Alcoholism; New Jersey; Outcome; Patient Recruitments; Pattern; Population; Postpartum Period; Postpartum Women; Pregnancy; Preparation; Public Health; Reporting; Research Support; Risk; Risk Factors; Self Efficacy; Services; Specific qualifier value; Stress; System; Technology; Testing; Text; Text Messaging; Theoretical model; Time; Woman; Work; acceptability and feasibility; alcohol abuse therapy; base; behavior change; binge drinking; child protective service; coping; cost; design; disorder later incidence prevention; drinking; drinking behavior; evidence base; high risk; high risk drinking; innovation; interest; mHealth; motherhood; motivational enhancement therapy; motivational intervention; multiphase optimization strategy; negative mood; perinatal women; poor sleep; prenatal health; prepregnancy; prevent; randomized trial; relapse risk; reproductive; response; screening program; sleep quality; social stigma; substance use; targeted treatment; text messaging intervention; theories

Abstract The proposed R34 will develop a theory-driven, adaptive text messaging intervention (TMI) for risky drinking in postpartum women. Risky drinking is prevalent among women of reproductive age, and more than half of women who reduce their alcohol use during pregnancy return to pre-pregnancy levels by three months postpartum. Postpartum risky drinking can impair a mother’s ability to care for her baby, and is associated with increased risk for child abuse and neglect and involvement with the child welfare system, as well as poor long- term child outcomes. Most adults who engage in risky drinking do not seek treatment, and postpartum women may be especially unlikely to seek formal treatment due to stigma and fears of child protective services involvement. Text messaging is a promising strategy for reaching non-treatment-seeking risky drinkers that may be particularly suitable for postpartum women, as it is convenient and anonymous. This approach also has wide scalability potential, as it is capable of reaching large numbers of people at relatively low cost. The proposed study will apply the Multiphase Optimization Strategy (MOST) framework, an engineering-inspired approach for developing efficient and scalable mobile health interventions, to develop the first adaptive TMI specifically designed for risky drinking in postpartum women. The proposed study will refine a theoretical model to inform the TMI that is based on the Relapse Prevention model and specifies the temporal relations of stress, negative mood, and maternal self-efficacy with intention to drink and daily drinking behavior in postpartum women, and their daily fluctuations in response to triggers that are unique to the postpartum period (sleep quality and baby irritability). The proposed TMI will include behavior change interventions based on motivational interviewing and cognitive behavioral therapy that target coping skills and motivation to avoid drinking, and that are adaptively tailored to fluctuations in stress, negative mood, and self-efficacy. Specific aims are to (1) test and refine the proposed theoretical model via Ecological Momentary Assessment with 30 women for 14 days to determine daily fluctuations in stress, negative mood, and self-efficacy in response to triggers and their impact on drinking intentions; (2) develop the content and decision rules for the TMI via iterative cycles of user feedback collected via focus groups with 30 postpartum women; and (3) conduct a pilot micro-randomized trial (MRT) with 50 women to assess feasibility of design and methods and obtain preliminary proof-of-concept data to prepare for a future fully-powered optimization trial. Study products will be a set of preliminary TMI components for postpartum risky drinking, ready for optimization and evaluation in a future larger scale R01, and a set of piloted EMA and MRT methods for the population of postpartum risky drinkers.

抽象的 拟议的R34将开发一种理论驱动的自适应文本消息干预（TMI），以供风险饮酒 产后妇女。在生殖年龄的女性中，风险饮酒普遍存在，超过一半 怀孕期间降低饮酒的妇女恢复了三个月 产后。产后危险饮酒会损害母亲照顾婴儿的能力，并且与 增加虐待儿童，忽视儿童的风险，并参与儿童福利制度以及差的长期风险 儿童成果。大多数从事风险饮酒的成年人都不寻求治疗，产后妇女 由于污名和对儿童保护服务的恐惧，可能尤其不可能寻求正式治疗 参与。文本消息传递是一种有前途的策略，用于吸引非治疗的风险饮酒者 由于方便而匿名，可能特别适合产后女性。这种方法也是如此 具有广泛的可扩展性潜力，因为它能够以相对较低的成本吸引大量人。这 拟议的研究将应用多相优化策略（大多数）框架，这是一种以工程为灵感的 开发高效且可扩展的移动健康干预措施的方法，以开发第一个自适应TMI 专为产后妇女的危险饮酒而设计。拟议的研究将完善理论 告知基于预防复发模型的TMI的模型，并指定了临时关系 压力，负面情绪和孕产妇自我效能感，有意喝酒和日常饮酒行为 产后妇女及其每日波动，以应对产后独有的触发因素 （睡眠质量和婴儿烦躁）。拟议的TMI将包括基于行为改变干预措施 动机访谈和认知行为疗法以应对技巧和动力避免 饮酒，并且是针对压力，负面情绪和自我效能感的波动而适应的。具体的 目的是（1）通过生态时刻评估测试和完善所提出的理论模型。 妇女持续14天，以确定应对压力，负面情绪和自我效能的每日波动 触发及其对饮酒意图的影响； （2）通过通过 通过焦点小组收集的用户反馈的迭代周期，有30个产后妇女； （3）进行飞行员 与50名妇女的微型试验（MRT）评估设计和方法的可行性并获得 初步概念验证数据，为将来的全力优化试验做准备。研究产品将是 一组可用于产后风险饮酒的初步TMI组件，准备优化和评估 未来的较大规模R01，以及一套针对产后风险人群的试验EMA和MRT方法 饮酒者。