Augmenting Brief Interventions for Adolescent Marijuana Users: The Impact of Motivational Check-Ins
Augmenting Brief Interventions for Adolescent Marijuana Users: The Impact of Motivational Check-Ins
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DOI：
10.1037/ccp0000094
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发表时间：
2016-11-01
影响因子：
5.9
通讯作者：
Roffman, Roger A.
中科院分区：
文献类型：
--
作者：
Walker, Denise D.;Stephens, Robert S.;Roffman, Roger A.
目的：在学校为青少年大麻使用者提供简短的干预措施，以达到不会出现在治疗中的使用者。目前的研究是建立在先前以学校为基础的两期动机增强疗法（MET）干预试验的基础上，通过增加定期的、简短的动机检查来加强收益和增强动机。方法：青少年参与者被随机分配到动机登记（MCI, n = 128）或仅评估登记（ACI, n = 124）比较条件。两组患者均接受2次MET治疗。MCI条件下的参与者在基线后4、7和10个月参加了3次基于met的检查，而ACI条件下的参与者在相同的时间点参加了仅评估的检查。在两种情况下，根据需要，可选择认知行为疗法（CBT），从基线开始持续12个月。结果：基线后6、9、12和15个月评估结果。参与者（59%白种人，68%男性，平均年龄15.84岁）报告在过去60天中平均有37次使用大麻，70%符合大麻使用障碍的诊断标准。这两种情况都与减少使用和持续15个月的负面后果有关。在6个月的随访中，MCI状况导致了更大的减少，但在后来的随访中没有发现不同情况之间的差异，并且MCI参与并没有像预期的那样增加CBT的参与。结论：结果重复了短暂干预对青少年大麻使用的效果，并提供了关于增加重复检查会话的效用的混合证据。这项研究的公共卫生意义是什么？大麻是美国使用最广泛的非法物质，去年大约有2500万人至少使用过一次大麻。据估计，曾经使用过大麻的人中有10%会成为日常使用者，终身大麻依赖率估计占总人口的4%，是所有非法药物中最高的。鉴于绝大多数有一种或更多大麻使用障碍症状的成年人报告说他们在18岁之前开始吸烟，对青少年，特别是那些大量使用大麻的青少年的早期干预努力，成为一项重要的公共卫生目标，以防止以后的问题。
Objective: Brief interventions for adolescent marijuana users offered in schools reach users who would not otherwise present for treatment. The current study builds on previous trials of a school-based, 2-session motivational enhancement therapy (MET) intervention by adding periodic, brief motivational check-ins to reinforce gains and bolster motivation. Method: Adolescent participants were randomly assigned to a motivational check-in (MCI; n = 128) or assessment-only check-in (ACI; n = 124) comparison condition. Both conditions received 2 sessions of MET. Participants in the MCI condition then attended 3 MET-based check-in sessions at 4, 7, and 10 months after baseline, whereas the ACI condition participants attended assessment-only check-ins at the same time points. Optional cognitive behavior therapy (CBT) sessions were available as needed for 12 months from baseline in both conditions. Results: Outcomes were assessed at 6, 9, 12, and 15 months after baseline. Participants (59% Caucasian; 68% male; mean age = 15.84) reported using marijuana on an average of 37 of the last 60 days, and 70% met diagnostic criteria for a marijuana use disorder. Both conditions were associated with reduced use and negative consequences that were sustained throughout the 15 months of follow-up. The MCI condition resulted in greater reductions at the 6 months follow-up, but differences between conditions were not found at later follow-ups, and MCI participation did not increase engagement in CBT as predicted. Conclusions: Results replicated the efficacy of the brief intervention for adolescent marijuana use and provided mixed evidence on the utility of adding repeated check-in sessions.What is the public health significance of this study?Marijuana is the most widely used illicit substance in the United States, with approximately 25 million people having used marijuana at least once in the past year. An estimated 10% of persons who have ever used marijuana will become daily users, with lifetime marijuana dependence rates estimated at 4% of the general population, the highest of any illicit drug. Given that the great majority of adults with 1 or more marijuana use disorder symptoms report they began smoking before age 18, early intervention efforts with adolescents, particularly those who are using heavily, becomes an important public health objective in order to prevent later problems.