Mindfulness-Based Relapse Prevention as Video Conferencing Continuing Care to Promote Long Term Recovery from Alcohol Use Disorder

基于正念的复发预防作为视频会议持续护理，促进酒精使用障碍的长期康复

• 批准号: 10753350
• 负责人: Katie A Witkiewitz
• 金额: $ 68.17万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10753350
• 关键词: Abstinence; Address; Adult; Affect; Alcohol consumption; Alcoholics Anonymous; Behavioral Mechanisms; Biochemical; Caring; Clinical; Communities; Data; Disease remission; Drug usage; Emotional; Goals; Harm Reduction; Health; Health Benefit; Health Services Accessibility; Heavy Drinking; Individual; Intervention; Life; Measures; Methods; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Neurobiology; Outcome; Participant; Personal Satisfaction; Persons; Pharmaceutical Preparations; Population Study; Public Health; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recovery; Reporting; Sampling; Self Efficacy; Smoking Prevention; Support Groups; Testing; Videoconferencing; Work; addiction; alcohol abuse therapy; alcohol and other drug; alcohol use disorder; behavior change; behavioral response; chronic pain; cost; craving; cue reactivity; design; drinking; effectiveness evaluation; effectiveness testing; effectiveness/implementation design; evidence base; executive function; experience; future implementation; health professional shortage areas; improved; incentive salience; innovation; interest; long term recovery; medically underserved; mindfulness; mortality; multi-site trial; negative affect; neuroadaptation; opioid use disorder; pharmacologic; pilot trial; population based; process evaluation; programs; prospective test; psychosocial; relapse prevention; remote delivery; response; social health determinants; tool; translational study; underserved area

PROJECT SUMMARY Alcohol use disorder (AUD) is prevalent and costly, and associated with significant morbidity and mortality. Effective pharmacological and psychosocial treatments for AUD exist, although many individuals do not receive medications and most are treated via mutual support group participation. Alcoholics Anonymous and other mutual support programs have been shown to be highly effective in supporting abstinence, and they are a tremendously valuable option for those interested in abstinence-based recovery. Yet, approximately 80% of individuals with AUD never seek treatment and not wanting to stop drinking is a common barrier to seeking treatment. AA and other mutual support programs are often abstinence-based, yet programs that focus on reductions in drinking have been shown to be as effective at reducing harms related to alcohol use. Recent studies in population-based and clinical samples indicate significant health benefit from drinking reductions, without total abstinence. Aligned with these findings, the National Institute on Alcohol Abuse and Alcoholism has proposed a new operational definition of recovery defined as: remission from AUD, cessation of heavy drinking, and improvements in functioning and well-being. Expanding the definition of recovery to include non- abstinent outcomes could increase treatment seeking among those with AUD who are not willing to abstain but are willing to reduce drinking, and reduce the public health burden of untreated AUD. One program that has considerable promise for promoting AUD recovery is mindfulness-based relapse prevention (MBRP). Efficacy of MBRP for reducing heavy drinking has been shown in several trials. Further, MBRP explicitly targets neurobiologically-informed domains of addiction: inhibitory control over behavioral responses (executive function); craving and cue reactivity (incentive salience); and negative affect (negative emotionality). MBRP may also be more effective than existing continuing care options in targeting broader health and life functioning. MBRP also has the potential to be broadly accessible via video conferencing. The goal of this study is to examine the effectiveness of MBRP groups delivered via video conferencing in promoting whole- person recovery from AUD up to three years following an attempt to change or stop drinking via treatment or self-change, as compared to referral to online mutual support groups. This study will also examine how MBRP affects mechanisms of behavior change based on neurobiologically-informed addiction cycle domains. We will use an effectiveness-implementation design to prospectively test the effectiveness of MBRP, as well as identify barriers and facilitators of MBRP group participation to inform future implementation of MBRP continuing care. The ultimate goal of this work is to evaluate MBRP via video conferencing as a continuing care option that supports whole-person recovery and targets addiction cycle domains in supporting long-term recovery from AUD in communities nationwide, including a focus on underserved areas. Availability of effective, evidence- based continuing care interventions may reduce the public health burden of AUD.

项目概要 酒精使用障碍 (AUD) 普遍存在且成本高昂，并且与显着的发病率和死亡率相关。 存在针对 AUD 的有效药物和心理社会治疗方法，尽管许多人不这样做 接受药物治疗，大多数通过互助小组参与进行治疗。戒酒互诫协会和 其他相互支持计划已被证明在支持禁欲方面非常有效，而且它们是 对于那些对禁欲康复感兴趣的人来说，这是一个非常有价值的选择。然而，大约 80% 患有 AUD 的人从不寻求治疗，并且不想戒酒是寻求治疗的常见障碍 治疗。 AA 和其他互助计划通常以禁欲为基础，但计划重点关注 事实证明，减少饮酒对于减少与饮酒相关的危害同样有效。最近的 基于人群和临床样本的研究表明，减少饮酒对健康有显着益处， 没有完全禁欲。根据这些发现，国家酒精滥用和酒精中毒研究所 提出了恢复的新操作定义，定义为：AUD 缓解、重度运动停止 饮酒，以及功能和福祉的改善。扩大恢复的定义以包括非 戒酒结果可能会增加那些不愿意戒酒但又患有 AUD 的人寻求治疗的机会 愿意减少饮酒，并减轻未经治疗的澳元造成的公共健康负担。一个程序有 基于正念的复发预防 (MBRP) 是促进 AUD 恢复的重要希望。功效 MBRP 减少酗酒的效果已在多项试验中得到证实。此外，MBRP 明确针对 成瘾的神经生物学领域：对行为反应的抑制控制（执行 功能）;渴望和提示反应性（激励显着性）；和负面影响（负面情绪）。 MBRP 在针对更广泛的健康和生活方面也可能比现有的持续护理选择更有效 发挥作用。 MBRP 还具有通过视频会议广泛普及的潜力。此举的目标 这项研究的目的是检验通过视频会议提供的 MBRP 小组在促进整体发展方面的有效性。 尝试通过治疗改变或停止饮酒后三年内从澳元恢复，或 与推荐在线互助小组相比，自我改变。本研究还将探讨 MBRP 如何 影响基于神经生物学信息的成瘾周期域的行为改变机制。我们将 使用有效性实施设计前瞻性地测试 MBRP 的有效性，并确定 MBRP 小组参与的障碍和促进因素，为未来实施 MBRP 持续护理提供信息。 这项工作的最终目标是通过视频会议评估 MBRP 作为一种持续护理选项， 支持整个人的康复并针对成瘾周期领域，以支持长期康复 澳元在全国范围内的社区，包括重点关注服务不足的地区。有效证据的可用性- 基于持续护理干预措施可能会减轻 AUD 的公共卫生负担。