Mechanisms of Change for an Effective Alcohol Text Message Intervention

有效酒精短信干预的变革机制

• 批准号: 9035519
• 负责人: Tammy Chung
• 金额: $ 32.37万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-20 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9035519
• 关键词: Accident and Emergency department; Address; Age; Alcohol abuse; Alcohols; Algorithms; Attention; Attitude; Behavior; Cereals; Cognition; Collection; Cues; Data; Development; Effectiveness; Emergency Department patient; Emergency department visit; Feedback; Goals; Impulsivity; Individual; Individual Differences; Informal Social Control; Intention; Intervention; Knowledge; Lead; Mediating; Mediator of activation protein; Meta-Analysis; Modeling; Monitor; Motivation; Neurocognition; Outcome; Participant; Patient Self-Report; Patients; Pattern; Phase; Planning Theory; Process; Randomized; Recruitment Activity; Research; Role; Severities; Subgroup; Techniques; Testing; Text; Time; Work; age group; alcohol exposure; alcohol intervention; alcohol related consequences; alcohol use disorder; arm; base; behavior change; binge drinking; computerized; design; discounting; drinking; drinking behavior; effective intervention; follow-up; hazardous drinking; improved; innovation; intervention effect; mHealth; public health relevance; randomized trial; responders and non-responders; response; theories; treatment response; trial design; willingness; young adult

 DESCRIPTION (provided by applicant): Young adults ages 18-25 have high rates of hazardous alcohol use and alcohol-related consequences, but are rarely exposed to alcohol interventions. The Emergency Department (ED) setting provides an important opportunity to identify young adult hazardous drinkers who could benefit from an alcohol intervention. Among young adult hazardous drinkers seen in the ED, a text message (TM) intervention has demonstrated effectiveness in reducing hazardous alcohol use (binge drinking) through 9-month follow-up. However, the "active ingredients" (TM strategies that facilitate reductions in binge drinking) and "mechanisms of change" (processes occurring in the individual that lead to reduced binge drinking) of TM intervention for binge drinking remain unclear, and impede progress in constructing mobile interventions with maximum impact and durability. To address this gap, a dismantling design is needed to determine the TM intervention's component effects, and to identify the mechanisms through which components operate, which will have broad implications for the design of mobile interventions and informing theories of behavior change. This project will determine whether TM intervention "active ingredients" involve the critical combination of "goal prompt" (i.e., TM prompt to commit to a low drinking quantity goal), "feedback" (e.g., real-time TM feedback on willingness to set a drinking goal), and "cued self-monitoring" or each of the three components separately. TM intervention is a methodological innovation in research on mechanisms of behavior change because of high fidelity of intervention delivery via computerized algorithm, and collection of real-time data on response to specific intervention components. Young adult (ages 18-25) ED patients who screen positive for hazardous drinking/AUD (N=1,875) will be recruited to participate in a randomized trial of a 12-week TM intervention to reduce binge drinking. Patients will be randomized to one of five conditions: (1) "Cued Self-Monitoring" (TM control condition), (2) "Goal Prompt", (3) "Feedback", (4) all 3 TM components combined, and (5) Assessment Only (control condition). All participants complete assessments at baseline (ED visit), 3- and 6-months post-randomization. Participants in the four TM arms complete weekly TM queries during the intervention phase to track changes in drinking behavior and proposed mediators of intervention effects (intention, motivation, implicit cognitions) in order to determine component-specific change mechanisms. We also will examine individual differences (e.g., baseline alcohol severity) associated with intervention effects, to identify "for whom" treatment has effects. Determining "how" and "for whom" TM intervention has effects will be used to revise TM intervention content to maximally impact identified mechanisms, and has broader implications in terms of determining key components to include in mobile interventions more generally. Further, fine-grained data on response to intervention collected in real time will enable a paradigm shift based on the development of a more dynamic model of behavior change.

 描述（由适用提供）：18-25岁的年轻成年人的危险性饮酒和与酒精有关的后果较高，但很少暴露于酒精干预措施。急诊科（ED）设置提供了一个重要的机会，可以识别可能从酒精干预中受益的年轻成人危险饮酒者。在ED中看到的年轻成人危险饮酒者中，一条短信（TM​​）干预表明，在减少危险饮酒（暴饮暴食）到9个月的随访中有效。但是，“活跃的侵害量”（有助于减少暴饮暴食的TM策略）和“变化机制”（在个人中发生的过程，导致暴饮暴食的饮酒）用于暴饮暴食，尚不清楚，并阻碍了具有最大影响和耐用性和耐用性和耐用性的移动干预措施的进展。为了解决这一差距，需要拆卸设计来确定TM干预的组件效应，并确定组件运行的机制，这将对移动干预的设计和为行为改变理论提供广泛影响。该项目将确定TM干预“有效成分”是否涉及“目标提示”的关键组合（即TM提示提示低饮酒量目标），“反馈”（例如，对设定饮酒目标的意愿实时TM反馈）和“提示自我监控”或三个组成部分的每个组成部分。 TM干预是对行为改变机制的方法论创新，这是由于通过计算机化算法的高度保真提供了干预措施，并收集了有关对特定干预组件的响应的实时数据。筛选危险饮酒/AUD阳性的年轻成人（18-25岁）的ED患者将招募到参与者的危险性饮酒（n = 1,875），将被随机分为五个条件之一：（1）“提示自我监测”（TM对照条件），（2）“目标提示”，“目标提示”，（3）“反馈”，（4）所有3 TM组成的条件仅评估和（5）控制和（5）控制。所有参与者在基线（ED访问），3个月和6个月后完成评估。在干预阶段，四个TM ARM的参与者每周完成TM查询，以跟踪饮酒行为的变化和拟议的干预效果介体（意图，动机，隐性认知），以确定组成部分特定的变化机制。我们还将检查与干预效应相关的个体差异（例如基线酒精的严重程度），以确定“为谁”治疗具有影响。确定TM干预效果的“如何”和“如何”修改TM干预内容以最大程度地影响确定的机制，并且在确定要在移动干预措施中包括在内的关键组件的含义更大。此外，基于更具动态的行为变化模型的发展，实时收集的对干预措施的响应的细粒度数据将实现范式转移。