Albright Glenn, Khalid Nikita, Shockley Kristen, Robinson Kelsey, Hughes Kevin, Pace-Danley Bethany
Baruch College Department of Psychology, City University of New York, New York, NY, United States.
The Graduate Center, City University of New York, New York, NY, United States.
JMIR Form Res. 2021 Apr 29;5(4):e27164. doi: 10.2196/27164.
Substance use places a substantial burden on our communities, both economically and socially. In light of COVID-19, it is predicted that as many as 75,000 more people will die from alcohol and other substance use and suicide as a result of isolation, new mental health concerns, and various other stressors related to the pandemic. Public awareness campaigns that aim to destigmatize substance use and help individuals have meaningful conversations with friends, coworkers, or family members to address substance use concerns are a timely and cost-effective means of augmenting existing behavioral health efforts related to substance use. These types of interventions can supplement the work being done by existing public health initiatives.
This pilot study examines the impact of the One Degree: Shift the Influence role play simulation, designed to teach family, friends, and coworkers to effectively manage problem-solving conversations with individuals that they are concerned about regarding substance use.
Participants recruited for this mixed methods study completed a presurvey, the simulation, and a postsurvey, and were sent a 6-week follow-up survey. The simulation involves practicing a role play conversation with a virtual human coded with emotions, a memory, and a personality. A virtual coach provides feedback in using evidence-based communication strategies such as motivational interviewing.
A matched sample analysis of variance revealed significant increases at follow-up in composite attitudinal constructs of preparedness (P<.001) and self-efficacy (P=.01), including starting a conversation with someone regarding substance use, avoiding upsetting someone while bringing up concerns, focusing on observable facts, and problem solving. Qualitative data provided further evidence of the simulation's positive impact on the ability to have meaningful conversations about substance use.
This study provides preliminary evidence that conversation-based simulations like One Degree: Shift the Influence that use role play practice can teach individuals to use evidence-based communication strategies and can cost-effectively reach geographically dispersed populations to support public health initiatives for primary prevention.
物质使用给我们的社区带来了巨大的经济和社会负担。鉴于新冠疫情，预计将有多达75000人因隔离、新出现的心理健康问题以及与疫情相关的各种其他压力源，死于酒精和其他物质使用及自杀。旨在消除对物质使用的污名化，并帮助个人与朋友、同事或家庭成员进行有意义的对话以解决物质使用问题的公众意识运动，是增强现有与物质使用相关的行为健康努力的及时且具有成本效益的手段。这类干预措施可以补充现有公共卫生举措正在开展的工作。
本试点研究考察了“一度：转变影响”角色扮演模拟的效果，该模拟旨在教会家人、朋友和同事有效地与他们关心的有物质使用问题的人进行解决问题的对话。
招募参加这项混合方法研究的参与者完成了一项预调查、模拟以及一项后调查，并收到了一份为期6周的随访调查。该模拟包括与一个编码了情绪、记忆和个性的虚拟人进行角色扮演对话练习。一名虚拟教练会就使用动机性访谈等循证沟通策略提供反馈。
方差匹配样本分析显示，随访时在准备度（P<0.001）和自我效能感（P=0.01）的综合态度构念方面有显著提高，包括与某人就物质使用展开对话、在提出担忧时避免让对方不安、关注可观察到的事实以及解决问题。定性数据进一步证明了该模拟对就物质使用进行有意义对话的能力产生的积极影响。
本研究提供了初步证据，表明像“一度：转变影响”这样基于对话的模拟，通过角色扮演练习，可以教会个人使用循证沟通策略，并且能够以具有成本效益的方式覆盖地域分散的人群，以支持初级预防的公共卫生举措。
