Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial
Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial
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DOI：
10.1542/peds.2015-1260
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发表时间：
2015-10-01
期刊：
影响因子：
8
通讯作者：
Walton, Maureen A.
中科院分区：
文献类型：
--
作者：
Cunningham, Rebecca M.;Chermack, Stephen T.;Walton, Maureen A.
目的：本研究探讨了基于急诊科（艾德）的简短抽象干预（BI）的有效性，由计算机或治疗师提供，有或没有后艾德会议，对酒精消费和后果超过12个月。（年龄14-20岁）危险饮酒筛查阳性的受试者被随机分为：BI组（n = 277）、治疗师BI组（n = 278）或对照组（n = 281）。3个月随访后，参与者随机接受ED后BI治疗或对照治疗。通过动机访谈，BI解决了酒精消费和后果，包括酒后驾车（DUI），酒精相关伤害以及其他伴随药物使用。计算机BI是一个离线的，Facebook风格的program.Results：在4389例患者筛选，1054例患者报告危险饮酒和836人参加了随机对照试验。回归模型检查了干预条件（与对照组相比）和交互作用（艾德条件3后艾德条件）对主要结局的主要影响。治疗师和计算机BI在3个月时显著减少了消费，在3个月和12个月时减少了后果，在12个月时减少了处方药的使用;计算机BI在12个月时减少了DUI的频率;治疗师BI在12个月时减少了酒精相关损伤的频率。后艾德会议减少酒精的后果在6个月，受益于那些谁没有收到BI在艾德。结论：一个单一的会话BI，由计算机或治疗师在艾德提供，显示未成年饮酒者的承诺。考虑到未来实施的便利性，全自动独立计算机BI的研究结果特别有吸引力。
OBJECTIVES: This study examined the efficacy of emergency department (ED)-based brief abstract interventions (BIs), delivered by a computer or therapist, with and without a post-ED session, on alcohol consumption and consequences over 12 months.METHODS: Patients (ages 14-20 years) screening positive for risky drinking were randomized to: BI (n = 277), therapist BI (n = 278), or control (n = 281). After the 3-month follow-up, participants were randomized to receive a post-ED BI session or control. Incorporating motivational interviewing, the BIs addressed alcohol consumption and consequences, including driving under the influence (DUI), and alcohol-related injury, as well as other concomitant drug use. The computer BI was an offline, Facebook-styled program.RESULTS: Among 4389 patients screened, 1054 patients reported risky drinking and 836 were enrolled in the randomized controlled trial. Regression models examined the main effects of the intervention conditions (versus control) and the interaction effects (ED condition 3 post-ED condition) on primary outcomes. The therapist and computer BIs significantly reduced consumption at 3 months, consequences at 3 and 12 months, and prescription drug use at 12 months; the computer BI reduced the frequency of DUI at 12 months; and the therapist BI reduced the frequency of alcohol-related injury at 12 months. The post-ED session reduced alcohol consequences at 6 months, benefiting those who had not received a BI in the ED.CONCLUSIONS: A single-session BI, delivered by a computer or therapist in the ED, shows promise for underage drinkers. Findings for the fully automated stand-alone computer BI are particularly appealing given the ease of future implementation.