School of Public Health, University of North Texas Health Science Center, Ft. Worth, Texas, USA.
University of Texas Health Science Center School of Public Health, Austin, Texas, USA.
Alcohol Clin Exp Res. 2022 Sep;46(9):1732-1741. doi: 10.1111/acer.14908. Epub 2022 Aug 7.
Adults experiencing homelessness have much higher rates of alcohol misuse than housed individuals. This study describes the development and preliminary effectiveness of a smartphone-based, just-in-time adaptive intervention (JITAI) to reduce alcohol use among adults experiencing homelessness.
We conducted a pilot trial (N = 41; mean age [SD] = 45.2 [11.5]; 19.5% women) of the Smart-T Alcohol JITAI where participants completed brief ecological momentary assessments (EMAs) each day, received personalized treatment messages following each EMA, and accessed on-demand intervention content for 4 weeks. The prediction algorithm and treatment messages were developed based on an independent but similar sample as part of the trial. We examined three drinking outcomes: daily drinking (yes/no), drinks per day, and heavy episodic drinking, controlling for scores on the Alcohol Use Disorders Identification Test (AUDIT) at baseline, age, and sex using quadratic growth curve models.
Over the 4-week period, participants showed a decline in all alcohol use outcomes. Participants also reported high levels of satisfaction with the JITAI.
Use of the Smart-T Alcohol JITAI was well received and provided encouraging evidence that it may reduce any drinking, drinks per day, and heavy episodic drinking among adults experiencing homelessness.
无家可归的成年人酗酒率远高于有房成年人。本研究描述了一种基于智能手机的即时自适应干预（JITAI）的开发和初步有效性，以减少无家可归成年人的饮酒量。
我们对 Smart-T 酒精 JITAI 进行了一项试点试验（N=41；平均年龄[标准差] = 45.2[11.5]；19.5%女性），参与者每天完成简短的生态瞬间评估（EMA），在每次 EMA 后收到个性化的治疗信息，并在 4 周内访问按需干预内容。预测算法和治疗信息是根据独立但类似的样本作为试验的一部分开发的。我们使用二次增长曲线模型，针对基线时的酒精使用障碍识别测试（AUDIT）评分、年龄和性别，检查了三种饮酒结果：每日饮酒（是/否）、每日饮酒量和重度饮酒事件。
在 4 周的时间里，参与者的所有饮酒结果都有所下降。参与者还报告对 JITAI 高度满意。
使用 Smart-T 酒精 JITAI 受到欢迎，并提供了令人鼓舞的证据，表明它可能减少无家可归成年人的任何饮酒、每日饮酒量和重度饮酒事件。
