Web Intervention for OEF/OIF Veterans With Problem Drinking and PTSD Symptoms: A Randomized Clinical Trial
Web Intervention for OEF/OIF Veterans With Problem Drinking and PTSD Symptoms: A Randomized Clinical Trial
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DOI：
10.1037/a0033697
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发表时间：
2013-10-01
影响因子：
5.9
通讯作者：
Rosenbloom, David
中科院分区：
文献类型：
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作者：
Brief, Deborah J.;Rubin, Amy;Rosenbloom, David
目的：曾在持久自由行动（OEF）和伊拉克自由行动（OIF）中服役的退伍军人在从战区返回后通常会出现酒精滥用和创伤后应激障碍（PTSD）症状。我们进行了一项随机临床试验，以评估新开发的8模块自我管理网络干预（VetChange）的有效性，该干预基于动机和认知行为原则，以减少饮酒，酒精相关问题和创伤后应激障碍症状。方法：通过定向Facebook广告招募的600名参与者被随机分配到初始干预组（IIG; n = 404）或延迟干预组（DIG; n = 196），等待8周才能访问VetChange。主要结果指标是每天饮酒量，平均每周饮酒量，重度饮酒天数百分比和PTSD症状。意向治疗分析比较了IIG和DIG之间随时间推移的结局指标变化以及组内变化。结果如下：IIG参与者在基线和干预结束之间的饮酒（每项测量p <0.001）和PTSD症状（p = 0.009）比DIG参与者在基线和等待期结束之间的减少更大。DIG参与者在参与VetChange后表现出与IIG相似的改善。在基线和3个月随访之间，每组的酒精问题也有所减少。结论：结果表明，VetChange在减少OIF/OEF退伍军人的饮酒和PTSD症状方面是有效的。需要对VetChange进行进一步研究，以评估基于网络的招募和保留方法，并确定VetChange在返回退伍军人的人口统计和临床亚群中的有效性。
Objective: Veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) commonly experience alcohol misuse and symptoms of posttraumatic stress disorder (PTSD) following their return from deployment to a war zone. We conducted a randomized clinical trial to evaluate the efficacy of a newly developed, 8-module, self-management web intervention (VetChange) based on motivational and cognitive-behavioral principles to reduce alcohol consumption, alcohol-related problems, and PTSD symptoms in returning combat veterans. Method: Six hundred participants, recruited through targeted Facebook ads, were randomized to either an Initial Intervention Group (IIG; n = 404) or a Delayed Intervention Group (DIG; n = 196) that waited 8 weeks for access to VetChange. Primary outcome measures were Drinks per Drinking Day, Average Weekly Drinks, Percent Heavy Drinking Days, and PTSD symptoms. Intent-to-treat analyses compared changes in outcome measures over time between IIG and DIG as well as within-group changes. Results: IIG participants demonstrated greater reductions in drinking (p < .001 for each measure) and PTSD symptoms (p = .009) between baseline and end-of-intervention than did DIG participants between baseline and the end of the waiting period. DIG participants showed similar improvements to those in IIG following participation in VetChange. Alcohol problems were also reduced within each group between baseline and 3-month follow-up. Conclusions: Results indicate that VetChange is effective in reducing drinking and PTSD symptoms in OIF/OEF veterans. Further studies of VetChange are needed to assess web-based recruitment and retention methods and to determine VetChange's effectiveness in demographic and clinical sub-populations of returning veterans.