Project CHOICE: Choosing Healthy Options in Coping with Emotions, a Personalized-Feedback EMA/EMI Study for Emerging Adults Leaving Psychiatric Partial Hospitalization

项目 CHOICE：选择健康的应对情绪的选择，一项针对摆脱精神病部分住院治疗的新兴成年人的个性化反馈 EMA/EMI 研究

• 批准号: 10599317
• 负责人: Ana M Abrantes
• 金额: $ 21.28万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-05 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10599317
• 关键词: Address; Affect; Alcohol abuse; Alcohol consumption; Alcohols; Anxiety; Caring; Clinical; Coping Skills; Data; Day Care; Development; Ecological momentary assessment; Effectiveness of Interventions; Emotions; Feedback; Focus Groups; Future; Heavy Drinking; Hospitalization; Individual; Intention; Intervention; Intervention Studies; Knowledge; Mental Depression; Mental Health; Methods; Modification; Monitor; Mood Disorders; Moods; Motivation; Outcome; Participant; Pattern; Perception; Persons; Phase; Pilot Projects; Protocols documentation; Psychiatric therapeutic procedure; Randomized; Randomized, Controlled Trials; Recurrence; Reporting; Research Personnel; Risk; Risk Assessment; Risk Reduction; Series; Site; Specific qualifier value; Study Subject; Suggestion; Technology; Testing; Time; Treatment Efficacy; alcohol abuse therapy; alcohol comorbidity; alcohol intervention; alcohol related problem; cognitive function; comorbidity; coping; drinking; effective intervention; emerging adult; emerging adulthood; experience; group intervention; high risk; improved; interest; intervention delivery; intervention refinement; multi-site trial; negative affect; normative feedback; novel; personalized normative feedback; physical conditioning; pilot test; programs; psychiatric comorbidity; psychiatric symptom; randomized, clinical trials; response; satisfaction; substance use; suicidal risk; symptomatology; tailored messaging; tailored text messaging; treatment arm; treatment trial; usability

ABSTRACT Emerging adulthood represents a common time for problematic mental health issues, particularly affective disorders such as anxiety and depression, and problematic patterns of alcohol use. Heavy alcohol use can lead to negative mental health, academic, physical health, and cognitive functioning outcomes. In particular, individuals who use alcohol are more likely to have psychiatric comorbidity and have poorer clinical outcomes. Comorbidity is associated with more risk than psychiatric symptomatology or alcohol use alone, yet is rarely targeted in mental health settings. Using substances for the motive of coping with negative affect compounds risks, as those who use to cope experience the most problems. As such, it is important to target alcohol use, particularly in EA with affective disorders who use to cope. Typical treatment for alcohol is brief, motivationally-based, and provides normative feedback. We propose to enhance our existing interventions with EA in psychiatric care with affective disorders who use alcohol to cope, which capitalized on technology. Technology allows for assessment of high-risk situations in real time through Ecological Momentary Assessment (EMA) and delivery of interventional content by Ecological Momentary Intervention (EMI). The delivery of tailored, just-in-time risk reduction message paired with personalized normative feedback may impact problematic use and depression/anxiety outcomes by reducing the likelihood of use and negative outcomes of use. We propose to enhance our existing pilot intervention by integrating participant feedback and protocol refinement. In Phase 1, we will (1) make changes to the pilot PFIcope+EMI, based on participant and researcher experience; (2) evaluate the refined intervention through a series of focus groups. In Phase 2, we will test our refined intervention (PFIcope+EMI) and in a randomized, controlled treatment trial as compared to personalized normative feedback only, delivered at baseline (PNF). The PFIcope+EMI consists of: 1) an in-person personalized feedback session to present normative information, discuss the individual's use, and generate risk reduction messages to be used in EMI; 2) EMA to monitor affect, use intention, actual alcohol use, coping motives, and alternate coping skills utilization; and 3) tailored messages (EMI) based on EMA (i.e., normative feedback plus individualized risk reduction messages when individuals report negative affect and use intention). The PNF condition will receive 1) an in-person personalized feedback session to present normative information, discuss the individual's use, delivered at baseline. We anticipate that this project will lead to the development of a well-specified, novel, technology- supported, real-time intervention for EA with comorbid alcohol and depression/anxiety that can be later tested in a multi-site fully-powered RCT.

抽象的 新兴的成年是有问题的心理健康问题的常见时间，特别是情感 焦虑和抑郁以及饮酒的有问题的模式等疾病。大量饮酒可以 导致心理健康，学术，身体健康和认知功能的负面影响。尤其， 使用酒精的人更有可能患有精神病合并症，并且临床结果较差。 合并症与精神病症状学或仅使用酒精的风险相关，但 很少针对心理健康环境。使用物质来应对负面影响的动机 化合物冒险，因为那些用来应付的人会遇到最大的问题。因此，针对目标很重要 饮酒，特别是在EA中具有用于应对的情感障碍。 酒精的典型治疗方法是简短的，基于动机的，并提供了规范性的反馈。我们建议 为了增强我们在精神病护理中使用EA的现有干预措施，并通过使用酒精的情感障碍 COPE，资本利用技术。技术可以实时评估高风险情况 通过生态瞬时评估（EMA）和通过生态提供介入的含量 瞬时干预（EMI）。量身定制的，即时降低风险的消息与 个性化的规范反馈可能会通过减少来影响有问题的使用和抑郁/焦虑症状 使用的可能性和使用的负面结果。我们建议通过 集成参与者的反馈和协议改进。在第1阶段，我们将（1）更改飞行员 Pficope+EMI，基于参与者和研究人员的经验； （2）通过 一系列焦点小组。在第2阶段，我们将测试我们的精制干预措施（Pficope+EMI），并在随机的， 与仅在基线（PNF）交付的个性化规范反馈相比，受控治疗试验。 Pficope+EMI包括：1）面对面的个性化反馈会议，以介绍规范 信息，讨论个人的使用，并产生降低风险的信息，以在EMI中使用； 2）ema to 监视影响，使用意图，实际饮酒，应对动机以及替代应对技能利用； 3） 基于EMA的量身定制消息（EMI）（即规范反馈以及个性化风险降低消息 当个人报告负面影响和使用意图时）。 PNF条件将接收1）面对面的 个性化的反馈会议以介绍规范信息，讨论个人的用途，交付 基线。我们预计该项目将导致开发一个明确的，新颖的技术 - 通过合并酒精和抑郁/焦虑的EA的支持，实时干预，可以在以后进行测试 在多站点全功率的RCT中。