A Technology-based Intervention to Reduce Alcohol Use after Bariatric Surgery

减肥手术后减少饮酒的基于技术的干预措施

• 批准号: 10470842
• 负责人: Jordan Michel Braciszewski
• 金额: $ 21.63万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 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 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10470842
• 关键词: Abstinence; Address; Adoption; Aftercare; Alcohol abuse; Alcohol consumption; Alcohols; Behavior; Behavioral; Blood alcohol level measurement; Body Weight decreased; Caring; Cellular Phone; Clinical Trials; Control Groups; Coping Skills; Data; Development; Ecological momentary assessment; Education; Enrollment; Ethanol Metabolism; Evidence based intervention; Feedback; Food; Freezing; Gastrectomy; Gastric Bypass; Goals; Grant; Guidelines; Hormones; Hour; Incidence; Individual; Intervention; Intervention Trial; Interview; Length; Low Prevalence; Mental Health; Metabolic hormone; Metabolism; Methods; Mission; Modeling; Morbid Obesity; Observational Study; Operative Surgical Procedures; Outcome; Participant; Patient Preferences; Patients; Persons; Phase; Physiological; Pilot Projects; Plant Roots; Population; Population Intervention; Populations at Risk; Prevalence; Prevention; Procedures; Public Health; Questionnaires; Randomized; Readiness; Recommendation; Reporting; Research; Rewards; Risk; Surveys; System; Techniques; Technology; Testing; Text Messaging; Time; Treatment Efficacy; United States; United States National Institutes of Health; absorption; acceptability and feasibility; alcohol abstinence; alcohol effect; alcohol prevention; alcohol use disorder; alcohol use initiation; bariatric surgery; base; brief intervention; clinical practice; clinically significant; computerized; coping mechanism; cost; cost effective; deter alcohol use; disorder later incidence prevention; drinking; evidence base; experience; feasibility testing; food consumption; group intervention; hazard; hazardous drinking; innovation; intervention delivery; mHealth; meetings; motivational enhancement therapy; novel; patient population; physical conditioning; post intervention; preference; prevent; preventive intervention; primary outcome; programs; psychoeducation; recruit; reduced alcohol use; response; retention rate; satisfaction; service delivery; skills; smoking cessation; substance use; surgical risk; tailored messaging; therapy design; traditional therapy; treatment as usual; weight loss intervention

Despite bariatric surgery being the most effective weight loss intervention for patients who are severely obese, as many as 1 in 5 patients will develop an alcohol use disorder after their surgery. Changes in metabolism, hormone levels, and behavior as a result of bariatric surgery alter the rewarding effects of alcohol while concurrently changing its absorption rate, putting patients at significantly elevated risk of hazardous drinking. Simply providing education to this vulnerable patient population about post-surgical risks has not been sufficient to reduce alcohol use, yet comprehensive in-person interventions are met with significant challenges, including hours-long distances between patients and their bariatric surgery programs. Thus, our long-term goal is to increase access to an empirically-supported intervention for reducing alcohol use among patients who undergo bariatric surgery by leveraging technology. Our intervention, rooted in motivational interviewing and the transtheoretical model, is a two-session computerized brief intervention (CBI), supplemented by six months of tailored text messaging based on participants’ CBI results and subsequent fluctuations in their readiness to change. The purpose of the proposed study is to optimize this technology-based intervention for patients who undergo bariatric surgery and to examine feasibility and acceptability of the intervention. In the first phase, patient interviews (n= 20) will be utilized to identify preferences for intervention content and treatment delivery. Ten patients will then participate in an open trial of the intervention, which will be subsequently revised based on feedback from these patients. In Phase 2, patients (N = 60) will be recruited between 3 and 6 months following bariatric surgery and randomized to the intervention or treatment as usual control group. All patients will complete baseline questionnaires and at 1, 3, 6, and 9 month post-assessments. We expect that this intervention will be both feasible and acceptable to patients. Results will be used as preliminary data to inform a large, fully-powered clinical trial to test the larger efficacy of this intervention. Although primary outcomes focus on feasibility and acceptability, we also expect that patients assigned to the intervention will have a longer time to their first post-surgical drink, report more days of abstinence, fewer drinks per drinking day, and a lower prevalence of alcohol use disorder after bariatric surgery compared to controls. This project is innovative because it expands upon existing interventions for bariatric surgery patients by implementing evidence-based strategies for alcohol use. By utilizing a technology-based approach, we can also reach a larger number of patients to prevent initiation of drinking, reduce current alcohol use, and facilitate better engagement in care, should individuals opt into traditional treatment approaches. The proposed line of research is significant and relevant to NIH’s mission because the intervention is expected to reduce the likelihood that patients will develop an alcohol use disorder following bariatric surgery. Given the potential of wide dissemination at low cost, the proposed study has high potential public health and clinical significance.

尽管减肥手术是对严重肥胖患者最有效的减肥干预措施， 多达五分之一的患者在手术后会出现酒精使用障碍， 激素水平和减肥手术导致的行为会改变酒精的奖励作用，而 同时改变其吸收率，使患者危险饮酒的风险显着升高。 仅仅向这些脆弱的患者群体提供有关术后风险的教育还不够。 足以减少饮酒，但全面的面对面干预措施遇到了重大挑战， 包括患者及其减肥手术计划之间长达数小时的距离，这就是我们的长期目标。 的目的是增加获得经验支持的干预措施的机会，以减少以下患者的饮酒情况： 通过利用技术进行减肥手术。我们的干预植根于动机访谈和 跨理论模型是一个为期两次的计算机化简短干预（CBI），辅以六个月 根据参与者的 CBI 结果以及随后的准备情况波动定制短信 拟议研究的目的是针对以下患者优化这种基于技术的干预措施。 进行减肥手术并检查干预措施的可行性和可接受性。 将利用患者访谈（n = 20）来确定对干预内容和治疗实施的偏好。 然后，十名患者将参加干预措施的公开试验，随后将根据情况进行修订 根据这些患者的反馈，将在 3 至 6 个月内招募患者 (N = 60)。 减肥手术后并随机分为干预组或照常治疗对照组的所有患者。 将完成基线调查问卷以及 1、3、6 和 9 个月的后评估。 干预措施既可行又为患者所接受，结果将用作初步数据以供参考。 一项大型、功能齐全的临床试验，以测试这种干预措施的更大功效，尽管主要结果。 关注可行性和可接受性，我们还期望分配到干预的患者将有一个 术后首次饮酒的时间更长，报告禁欲天数更长，每个饮酒日的饮酒量更少，以及 与对照组相比，减肥手术后酒精使用障碍的患病率较低。 创新是因为它通过实施对减肥手术患者的现有干预措施进行了扩展 通过利用基于技术的方法，我们还可以达成一个基于证据的饮酒策略。 大量患者防止开始饮酒、减少当前饮酒量并促进更好的治疗 个人是否应该选择传统的治疗方法来参与护理。 研究对于 NIH 的使命具有重要意义和相关性，因为干预措施预计会减少 鉴于减肥手术的潜力，患者出现酒精使用障碍的可能性。 所提出的研究以低成本广泛传播，具有很高的潜在公共卫生和临床意义。