Optimizing the length and reliability of measures of mechanisms of change to support measurement-based care in alcohol use disorder treatment.
Optimizing the length and reliability of measures of mechanisms of change to support measurement-based care in alcohol use disorder treatment.
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DOI：
10.1037/ccp0000643
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发表时间：
2021-04
影响因子：
5.9
通讯作者：
Cook, Sharon
中科院分区：
文献类型：
--
作者：
Hallgren, Kevin A;Holzhauer, Cathryn G;Epstein, Elizabeth E;McCrady, Barbara S;Cook, Sharon
接受酒精使用障碍 (AUD) 治疗的客户会经历不同的结果。使用标准化措施（即基于测量的护理）来测量治疗期间的临床进展可以帮助表明临床改善是否正在发生。行为改变机制（MOBC）的测量可能特别适合基于测量的护理；然而，如果测量更加简短，并且如果能够更好地阐明它们检测个体客户可靠变化的能力，那么测量 MOBC 将更加可行且信息丰富。在一项针对 AUD 女性的为期 12 周的认知行为治疗随机试验中，每周进行三项假设 MOBC 的简短测量（戒断自我效能、应对策略、焦虑）和第四项完整测量（抑郁）。心理测量分析估计了每种测量方法区分人内变化与人际差异和测量误差的可靠性。对每个工具的模拟简短版本（即比已经简化的工具具有更少项目的工具）估计了可靠性系数，并且对每个测量的可靠改善和可靠恶化的比率进行了估计。所有四项指标对于检测人体内的变化都具有良好的可靠性 (0.86-0.90)。许多参与者 (41.4–62.5%) 从第一次治疗到最后一次治疗，MOBC 确实得到了改善。 MOBC 的可靠改善与 3、9 和 15 个月随访中饮酒天数百分比的减少有关。每个工具的模拟简短版本在检测变化方面保持了良好的可靠性，只有 3 个（自我效能）、11 个（应对策略）、5 个（焦虑）或 10 个项目（抑郁）。简短的 MOBC 测量可以检测 AUD 治疗中个体的可靠变化。定期测量 MOBC 可能有助于监测临床进展。
Clients who receive alcohol use disorder (AUD) treatment experience variable outcomes. Measuring clinical progress during treatment using standardized measures (i.e., measurement-based care) can help indicate whether clinical improvements are occurring. Measures of mechanisms of behavioral change (MOBCs) may be particularly well-suited for measurement-based care; however, measuring MOBCs would be more feasible and informative if measures were briefer and if their ability to detect reliable change with individual clients was better articulated. Three abbreviated measures of hypothesized MOBCs (abstinence self-efficacy, coping strategies, anxiety) and a fourth full-length measure (depression) were administered weekly during a 12-week randomized trial of cognitive-behavioral therapy for women with AUD. Psychometric analyses estimated how reliably each measure distinguished within-person change from between-person differences and measurement error. Reliability coefficients were estimated for simulated briefer versions of each instrument (i.e., instruments with fewer items than the already-abbreviated instruments) and rates of reliable improvement and reliable worsening were estimated for each measure. All four measures had good reliability (.86-.90) for detecting within-person change. Many participants (41.4–62.5%) reliably improved on MOBCs from first to last treatment session. Reliable improvement on MOBCs was associated with reductions in percentage of drinking days at 3, 9, and 15-month follow-ups. Simulated briefer versions of each instrument retained good reliability for detecting change with only 3 (self-efficacy), 11 (coping strategies), 5 (anxiety), or 10 items (depression). Brief MOBC measures can detect reliable change for individuals in AUD treatment. Routinely measuring MOBCs may help with monitoring clinical progress.
影响因子：
2.9
作者：
Drapkin M;Epstein EE;McCrady B;Eddie D
通讯作者：
Eddie D