Testing a Couple-based Program for Alcohol Risk Reduction in the National Guard

在国民警卫队中测试以夫妻为基础的降低酒精风险计划

• 批准号: 9223619
• 负责人: Elizabeth Ellen Epstein
• 金额: $ 24.08万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-20 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9223619
• 关键词: Address; Alcohol consumption; Alcohols; Attitude; Behavioral; Belief; Caring; Collaborations; Complex; Conflict (Psychology); Coping Skills; Couples; Couples Therapy; Depression and Suicide; Ensure; Family; Freedom; Geography; Goals; Health; Health Promotion; Health Services Research; Heavy Drinking; Human Resources; Institute of Medicine (U.S.); Instruction; Internet; Intervention Studies; Learning; Manuals; Massachusetts; Measures; Mediator of activation protein; Mental Health; Military Personnel; Monitor; Outcome; Persons; Pharmaceutical Preparations; Population; Prevention; Prevention Protocols; Prevention approach; Prevention program; Prevention strategy; Preventive Intervention; Problem Solving; Protocols documentation; Public Health; Randomized Controlled Trials; Readiness; Recommendation; Relapse; Research; Research Project Grants; Risk; Risk Factors; Risk Reduction; Secondary Prevention; Services; Spouses; Support System; Symptoms; System; Testing; United States National Institutes of Health; Work; alcohol misuse; alcohol risk reduction; alcohol use disorder; analog; base; behavior change; binge drinking; cohort; design; drinking; drinking behavior; evidence base; field study; fitness; hazardous drinking; healthy lifestyle; high risk drinking; indicated prevention; member; operation; primary outcome; programs; protocol development; psychologic; public health relevance; resilience; response; secondary outcome; service member; stem; telehealth; uptake; use alcohol to cope

DESCRIPTION (provided by applicant): Rates of binge drinking in the military currently hover at 47% and constitute a "public health crisis" (IOM, 2012), with few evidence-based prevention programs in place to stem the tide. Hazardous drinking among service members is directly detrimental to psychological fitness and military readiness, and is also a risk factor for several overlapping problems, including alcohol use disorder (AUD), use of other drugs, depression, suicide, and relationship conflict. This R34, "Testing A Couple-based Program for Alcohol Risk Reduction in the National Guard," in line with PAR-12-279, aims to develop and test an indicated, secondary prevention intervention to harness marital support and health promoting endeavors such as relationship enhancement and problem solving to replace use of alcohol to cope with reintegration challenges. Up to 81% of military members are married or in a committed relationship and the integration of couple-based prevention programs into military service settings has been identified as a promising but underutilized health promotion strategy. National Guard (NG) members and their families are a special needs population due to high rates of heavy drinking, mental health, and family problems, paired with geographic challenges that limit access to military heath care support systems. The proposed "indicated secondary prevention" project targets hazardous drinking NG members who have not yet developed AUD. Aim 1 is to modify our efficacious Alcohol Behavioral Couple Therapy (ABCT) manual into a brief indicated secondary prevention protocol called Alcohol Behavioral Couple Prevention (ABCP), available for in-person or telehealth delivery by professionals or paraprofessionals in military settings. The goal of the new ABCP is for couples to learn to work together to minimize hazardous drinking in order to then begin to effectively address other problems often present among returning service members. Aim 2 is to field test an in-person delivery platform of the protocol (ABCP_P) with 6 couples, refine, and then field test a telehealth delivery platform (ABCP_T) for the refined protocol with 6 new couples. Aim 3 is to conduct a small randomized controlled trial with 22 couples in each condition: (1) "Prevention as usual" (PAU) which includes annual briefings and a limited monitoring system currently in place in the NG; (2) PAU plus ABCP_P, and (3) PAU plus ABCP_T. Primary outcome variables include alcohol use, marital functioning and coping skills. Candidate mediators of health promotion behavior change, including attitudes and beliefs about drinking will be tracked. This project is in accord with IOM (2013) recommendations; it aims to fill a gap in prevention strategies for hazardous drinking and associated risks among service members, with an evidence-based risk reduction protocol to support overall force readiness while strengthening the family unit. Further, it includes a teleheath delivery platform to address geographic challenges and lower barriers to accessible services for the armed forces.

描述（由申请人提供）：目前军队中的酗酒率徘徊在 47%，构成了一场“公共卫生危机”（IOM，2012 年），但几乎没有基于证据的预防计划来遏制这一趋势。军人中的危险饮酒直接损害心理健康和军事准备，也是导致酒精使用障碍（AUD）、使用其他药物、抑郁、自杀和关系冲突等多种重叠问题的风险因素。 R34，“测试国民警卫队中以夫妇为基础的降低酒精风险计划”，与 PAR-12-279 一致，旨在开发和测试指示性二级预防干预措施，以利用婚姻支持和健康促进工作，例如加强关系和解决问题，以取代饮酒来应对重返社会的挑战。高达 81% 的军人已婚或处于稳定的关系中，将基于夫妇的预防计划纳入军事服务环境已被认为是一种有前景但未得到充分利用的健康促进策略。由于酗酒、心理健康和家庭问题的发生率较高，再加上地理条件限制了获得军事医疗保健支持系统的机会，国民警卫队 (NG) 成员及其家人属于特殊需求人群。拟议的“指示二级预防”项目针对的是尚未发展为 AUD 的危险饮酒 NG 成员。目标 1 是将我们有效的酒精行为夫妻治疗 (ABCT) 手册修改为简短的二级预防方案，称为酒精行为夫妻预防 (ABCP)，可供军事环境中的专业人员或辅助专业人员进行面对面或远程医疗服务。新 ABCP 的目标是让夫妇学会共同努力，尽量减少危险饮酒，以便开始有效解决回国服役人员中经常出现的其他问题。目标 2 是对 6 对夫妇现场测试协议 (ABCP_P) 的现场交付平台，进行改进，然后对 6 对新夫妇对改进后的协议的远程医疗交付平台 (ABCP_T) 进行现场测试。目标 3 是对每种情况下的 22 对夫妇进行一项小型随机对照试验：(1)“照常预防”(PAU)，其中包括年度简报和 NG 中目前实施的有限监测系统； (2) PAU 加 ABCP_P，以及 (3) PAU 加 ABCP_T。主要结果变量包括饮酒、婚姻功能和应对技巧。将跟踪健康促进行为改变的候选调解者，包括对饮酒的态度和信念。该项目符合 IOM (2013) 建议；它的目的是通过基于证据的风险降低协议来填补军人中有害饮酒和相关风险预防战略的空白，以支持部队的整体战备状态，同时加强家庭单位。此外，它还包括一个远程医疗交付平台，以解决地理挑战并降低武装部队获得服务的障碍。