Project THRIVE: Testing an app-based early intervention to reduce alcohol use and PTSD after sexual assault

Project THRIVE：测试基于应用程序的早期干预措施，以减少性侵犯后的饮酒和创伤后应激障碍

• 批准号: 10562029
• 负责人: Emily Raphael Dworkin
• 金额: $ 73.28万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-10 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10562029
• 关键词: Address; Alcohol consumption; Attention; Award; Behavioral; Caring; Cognitive; Early Intervention; Elements; Enrollment; Ensure; Evaluation; Feedback; Female; Frequencies; Future; Gender; Institution; Intervention; Intoxication; Mobile Health Application; Monitor; Participant; Patient Self-Report; Persons; Phase; Post-Traumatic Stress Disorders; Preparation; Randomized; Randomized, Controlled Trials; Risk; Schedule; Services; Students; Survivors; System; Testing; Time; Trauma; Universities; Work; alcohol misuse; college; coping; critical period; design; drinking; effective intervention; efficacy trial; ethnic minority; experience; high risk; mHealth; member; men; multiphase optimization strategy; pilot test; pilot trial; post intervention; post-trauma; post-traumatic stress; prevent; preventive intervention; prototype; racial minority; randomized trial; reduced alcohol use; sexual assault; telephone coaching; trauma exposure; university student; usability

PROJECT SUMMARY Sexual assault is highly prevalent among college students and is associated with high risk for alcohol misuse and co-occurring posttraumatic stress in survivors of all genders. These conditions are associated with significant strain on campus service systems and substantial short- and long-term consequences for students. Although effective preventative interventions (i.e., implemented within the months following trauma exposure) exist for these conditions, college student survivors often do not seek or successfully access in-person care, especially among men and racial/ethnic minorities. Mobile health (i.e., mHealth) interventions are a promising strategy to increase low-barrier access to preventative interventions among college students. We developed and pilot tested a multi-component mHealth preventative intervention prototype, THRIVE, to reduce posttraumatic stress and alcohol misuse in recent survivors of sexual assault. THRIVE was effective in reducing both posttraumatic stress and alcohol misuse, making it the first post-trauma mHealth intervention with evidence of efficacy in reducing alcohol misuse. In the current study, we propose to conduct an optimization trial to identify the most effective, efficient, and low-burden version of THRIVE for college students. Prior to conducting the trial, we will revise THRIVE using the real-time user feedback collected in the pilot trial (Aim 1). Revisions will maintain the core elements of THRIVE while increasing usability. Revisions will be selected by reviewing the app and pilot user feedback in partnership with user experience/interface designers, our advisory board of experts in cultural adaptations of interventions, and our advisory board of college student survivors. This will maximize usability with attention to the needs of diverse student survivors. Using the revised app, we will then conduct a 2x2x2 factorial randomized trial to test the unique effects of the 3 core THRIVE components (i.e., in-app activity scheduling, in-app cognitive restructuring, phone coaching) on alcohol misuse and posttraumatic stress (Aim 2), as well as the added benefit of coaching to activity scheduling and cognitive restructuring (Aim 3). N=464 college students with past-12-week sexual assault, elevated drinking, and PTSD will be enrolled. All participants will receive an onboarding call and non-core app elements (i.e., self-monitoring, encouraging statements banner, referrals), and will be randomized to additionally receive combinations of the 3 core elements. Participants will complete self-report assessments at baseline, daily during the intervention, post-intervention, and 3, 6, 9, and 12 months. Results will be used to select an optimized version of THRIVE. Our design will ensure that future testing and dissemination of THRIVE reflects maximally inclusive, efficient, and effective intervention elements. If effective, THRIVE would represent a highly-scalable strategy that could be directly implemented by campus service systems to reduce the substantial burden of PTSD and alcohol misuse on students.

项目摘要 性侵犯在大学生中非常普遍，并且与滥用酒精的高风险有关 以及所有性别幸存者的创伤后应激。这些条件与 校园服务系统的重大压力以及对学生的巨大短期和长期影响。 尽管有效的预防性干预措施（即在创伤暴露后的几个月内实施） 在这些条件下，大学生幸存者通常不会寻求或成功获得面对面的护理， 特别是在男人和种族/族裔少数民族中。移动健康（即MHealth）干预措施是一种有希望的 策略以增加级别的大学生预防干预措施的策略。我们开发了 并试点测试了多组分MHealth预防性干预原型，以减少 最近的性侵犯幸存者创伤后压力和滥用酒精。蓬勃发展是有效的 减少创伤后压力和滥用酒精，使其成为第一个创伤后MHealth干预措施 具有减少酒精滥用功效的证据。在当前的研究中，我们建议进行 优化试验，以确定大学蓬勃发展的最有效，最有效和低负荷的版本 学生。在进行试验之前，我们将使用收集的实时用户反馈来修订 试点试验（AIM 1）。修订将维持蓬勃发展的核心要素，同时提高可用性。修订将 通过与用户体验/界面合作查看应​​用程序和飞行员用户反馈来选择 设计师，我们的文化改编专家顾问委员会，我们的顾问委员会 大学生幸存者。这将最大程度地提高可用性，并注意各种学生幸存者的需求。 然后，我们将使用修订的应用程序进行2x2x2阶乘随机试验，以测试3的独特效果 在 酗酒和创伤后压力（AIM 2），以及教练的额外好处 调度和认知重组（AIM 3）。 n = 464名过去12周的性侵犯的大学生， 饮酒升高，PTSD将被招募。所有参与者都将收到一个入职通话和非核心应用程序 元素（即自我监控，鼓励陈述横幅，推荐），并将被随机分配给 另外，接收3个核心元素的组合。参与者将完成自我报告评估 基线，干预期间每天，干预后以及3、6、9和12个月。结果将用于 选择“蓬勃发展”的优化版本。我们的设计将确保将来的测试和传播 反映最大包含，高效且有效的干预要素。如果有效，蓬勃发展将代表 校园服务系统可以直接实施的一种高度估计的策略来减少 PTSD的重大负担和滥用学生。