Perceived Risk of Harm Mediates the Effects of Primary Care Alcohol Use Screening and Brief Advice in Adolescents.
Perceived Risk of Harm Mediates the Effects of Primary Care Alcohol Use Screening and Brief Advice in Adolescents.
复制标题
DOI：
10.1016/j.jadohealth.2021.09.029
复制
发表时间：
2022-03
影响因子：
7.6
通讯作者：
Harris, Sion K.
中科院分区：
文献类型：
--
作者：
Byregowda, Himani;Flynn, Amy L.;Knight, John R.;Harris, Sion K.
关键词：
先前的一项试验发现，与常规治疗（TAU）相比，接受计算机辅助筛选和提供者简要建议（cSBA）的青少年初级保健患者在随访期间饮酒风险较低。我们测试了这种影响是否由酒精相关的感知伤害风险（PRoH）介导。我们分析了9个新英格兰诊所12- 18岁患者的cSBA试验数据（n = 2，096，58%为女性）。该试验采用准实验前后设计，实践是自己的对照（TAU，然后是cSBA）。因为先前的饮酒经历可能会改变效应，我们根据过去12个月的饮酒基线进行分层分析。在基线不饮酒者中，我们在3个月和12个月的随访中测试了“尝试酒精”作为饮酒效应中介的PRoH基线至3个月的轨迹。同样，在那些有饮酒史的人中，我们检查了基线到3个月的PRoH轨迹，即“每周狂饮”作为饮酒和狂饮的效应中介。我们使用了海耶斯系数调解方法的产品。在基线不饮酒者（n = 1，449）中，cSBA与TAU相比，“尝试酒精”的PRoH更高，而更高的PRoH反过来与更低的后续饮酒风险相关。PRoH在12个月时介导其cSBA效应，但在3个月时不介导。在既往饮酒的青少年中（n = 647），cSBA对于“每周狂饮”具有较高的PRoH，这与两次随访时较低的饮酒风险以及3个月时较低的狂饮风险相关。PRoH在两次随访中介导了cSBA对饮酒的影响，并在3个月时介导了酗酒。一个计算机辅助的初级保健干预提高了青少年的感知酒精的风险，这反过来又与较低的饮酒风险。
A previous trial found lower alcohol use risk during follow-up among adolescent primary care patients receiving computer-facilitated Screening and provider Brief Advice (cSBA) compared to treatment-as-usual (TAU). We tested whether the effect was mediated by alcohol-related perceived risk of harm (PRoH). We analyzed data from the cSBA trial on 12- to 18-year-old patients at 9 New England practices (n = 2,096, 58% females). The trial used a quasi-experimental pre–post design with practices being their own controls (TAU followed by cSBA). Because prior alcohol experience could modify effects, we stratified analyses by baseline past 12-month drinking. Among baseline nondrinkers, we tested baseline to 3-month trajectories in PRoH of “trying alcohol” as an effect mediator for drinking at 3- and 12-month follow-up. Similarly, among those with prior drinking, we examined baseline to 3-month trajectories in PRoH of “weekly binge drinking” as an effect mediator for drinking and binge drinking. We used the Hayes product of coefficients mediation approach. Among baseline nondrinkers (n = 1,449), cSBA had higher PRoH compared to TAU for “trying alcohol,” and higher PRoH in turn was associated with lower follow-up drinking risk. PRoH mediated their cSBA effect at 12 months, but not 3 months. Among adolescents with prior drinking (n = 647), cSBA had higher PRoH for “weekly binge drinking,” which was associated with lower drinking risk at both follow-ups, and lower binge drinking risk at 3 months. PRoH mediated their cSBA effect on drinking at both follow-ups, and binge drinking at 3 months. A computer-facilitated primary care intervention enhanced adolescents’ perceived alcohol risks which in turn was associated with lower drinking risk.
登录
查看更多内容
影响因子：
4.2
作者：
Prince, Mark A.;Swaim, Randall C.;Conner, Bradley T.
通讯作者：
Conner, Bradley T.
影响因子：
5.9
作者：
D'Amico EJ;Parast L;Shadel WG;Meredith LS;Seelam R;Stein BD
通讯作者：
Stein BD
影响因子：
2
作者：
Grevenstein, Dennis;Nagy, Ede;Kroeninger-Jungaberle, Henrik
通讯作者：
Kroeninger-Jungaberle, Henrik
影响因子：
7.6
作者：
Louis-Jacques, Jennifer;Knight, John R.;Harris, Sion K.
通讯作者：
Harris, Sion K.
影响因子：
26.1
作者：
Adams, Sally H.;Park, Jane;Irwin, Charles E., Jr.
通讯作者：
Irwin, Charles E., Jr.