Identifying Factors Influencing Alcohol Use after Bariatric Surgery: An Ecological Momentary Assessment

确定减肥手术后影响饮酒的因素：生态瞬时评估

• 批准号: 10439039
• 负责人: Lisa Matero
• 金额: $ 19.22万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-05 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10439039
• 关键词: Affect; Alcohol abuse; Alcohol consumption; Alcohols; Anger; Anxiety; Area; Behavior; Behavioral; Data; Development; Distal; Eating; Eating Behavior; Ecological momentary assessment; Emotional; Emotions; Enrollment; Feedback; Food; Frequencies; Future; Goals; Grant; Heavy Drinking; Hormones; Incidence; Individual; Intervention; Interview; Knowledge; Measurement; Measures; Mental Depression; Metabolic; Metabolism; Methods; Mission; Moods; Morbid Obesity; Operative Surgical Procedures; Participant; Pathway interactions; Patients; Phase; Physiological; Population; Prevalence; Protocols documentation; Public Health; Randomized; Recording of previous events; Reporting; Research; Research Design; Research Project Grants; Rewards; Risk; Surveys; Symptoms; Time; United States National Institutes of Health; absorption; acceptability and feasibility; alcohol effect; alcohol risk; alcohol use disorder; alcohol use initiation; bariatric surgery; coping; coping mechanism; design; deter alcohol use; drinking; effective intervention; effective therapy; emotional eating; experience; follow-up; hazardous drinking; high risk; improved; innovation; meetings; negative mood; patient engagement; patient population; prevent; prospective; recruit; reduced alcohol use; response; retention rate; substance use; weight loss intervention

Bariatric surgery is the most effective weight loss treatment for patients who are severely obese; however, 1 in 5 patients develop an alcohol use disorder (AUD) after undergoing surgery. After surgery, changes in metabolism, hormone levels, and behaviors alter the rewarding effects of alcohol while concurrently changing its absorption rate, putting patients at significantly elevated risk of hazardous drinking. To better understand the development of AUDs after bariatric surgery, we must first identify factors leading to re-initiation of alcohol use and escalation to heavy drinking. Promising areas include mood and eating behaviors. The purpose of the proposed study is to identify the distal and proximal factors that contribute to re-initiation and episodic alcohol use following bariatric surgery. We will use an exploratory sequential mixed methods approach and first obtain qualitative data to inform the quantitative phase. In the qualitative phase, we will conduct interviews of patients who are between 6 months and 3-years post-bariatric surgery (N= 30) to identify the reasons they consumed alcohol after bariatric surgery. We will also inquire about the frequency, amount, and the antecedents and consequences of episodic alcohol use (i.e., mood, eating behaviors). This information will be used to inform the quantitative data phase (i.e., finalize the constructs to assess, how and when to measure these variables, and the frequency of assessment). In the quantitative phase, patients (N= 100) will also be recruited between 6 months and 3-years post-surgery. Participants will complete measures of substance use, mood, and eating behaviors at baseline and at 6- and 12-weeks post-baseline to capture longer-term data to identify distal factors associated with alcohol use. Within the 12-week study period, participants will also be randomly assigned a 3-week period in which they will complete an ecological momentary assessment (EMA) design. The EMA design consists of brief, daily morning and evening assessments in “real-time” regarding emotions and behaviors (i.e., substance use, affect, and eating behaviors), which will allow us to identify the factors contributing to episodic alcohol use (i.e., proximal factors). We will also examine intended and unintended drinking. Our long-term goal is to better understand the progression from re-initiation of alcohol use, to heavy use, to development of an AUD, which will assist in targeting interventions to prevent AUDs. In addition to being the first study to examine distal and proximal factors of post-surgical alcohol use, this project contains multiple innovative components including an EMA design which allows for the examination of unintended drinking. Further, given participants will have varying histories of alcohol use prior to surgery, we will explore whether distal and proximal predictors are differentially predictive of drinking among those with and without a history of heavy drinking prior to surgery. The proposed line of research is significant and relevant to NIH’s mission because it will lead to tailored, effective interventions to reduce alcohol use and prevent the development of an alcohol use disorder among patients at high risk (i.e., those who undergo bariatric surgery).

然而，对于严重肥胖的患者来说，减肥手术是最有效的减肥治疗方法； 5 名患者在手术后出现酒精使用障碍 (AUD)。 新陈代谢、激素水平和行为会改变酒精的奖励效果，同时改变 它的吸收率，使患者的危险饮酒风险显着升高。 减肥手术后出现 AUD，我们必须首先确定导致重新开始饮酒的因素 和升级到大量饮酒的目的包括情绪和饮食行为。 拟议的研究旨在确定导致重新开始和发作性酒精的远端和近端因素 在减肥手术后使用我们将使用探索性顺序混合方法并首先获得。 定性数据为定量阶段提供信息 在定性阶段，我们将对患者进行访谈。 减肥手术后 6 个月至 3 年之间的人 (N= 30) 以确定他们消费的原因 我们还会询问减肥手术后饮酒的频率、量以及前因后果。 偶尔饮酒的后果（即情绪、饮食行为）。 定量数据阶段（即最终确定评估结构、如何以及何时测量这些变量，以及 在定量阶段，患者（N = 100）也将在 6 之间招募。 手术后几个月和三年，参与者将完成药物使用、情绪和饮食的测量。 基线以及基线后 6 周和 12 周的行为，以捕获长期数据来识别远端 在 12 周的研究期内，参与者也将被随机分配。 他们将被分配 3 周的时间来完成生态瞬时评估 (EMA) 设计。 EMA 设计包括关于情绪和情绪的简短、每日早晚“实时”评估。 行为（即物质使用、情感和饮食行为），这将使我们能够识别因素 我们还将检查有意和无意的饮酒。 我们的长期目标是更好地了解从重新开始饮酒到酗酒的过程。 制定 AUD，这将有助于制定预防 AUD 的干预措施。 作为第一项检查术后饮酒的远端和近端因素的研究，该项目包含 多个创新组件，包括 EMA 设计，可用于检查意外情况 此外，鉴于手术前有不同的饮酒史，我们将探讨。 远端和近端预测因子是否对有或没有饮酒的人有不同的预测作用 手术前的酗酒史 拟议的研究路线具有重要意义并且与 NIH 相关。 使命，因为它将带来量身定制的有效干预措施，以减少饮酒并预防 高危患者（即接受减肥手术的患者）出现酒精使用障碍。