Change Plan as an Active Ingredient of Brief Motivational Interventions for Reducing Negative Consequences of Drinking in Hazardous Drinking Emergency-Department Patients
Change Plan as an Active Ingredient of Brief Motivational Interventions for Reducing Negative Consequences of Drinking in Hazardous Drinking Emergency-Department Patients
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DOI：
10.15288/jsad.2010.71.726
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发表时间：
2010-09-01
影响因子：
3.4
通讯作者：
Woolard, Robert
中科院分区：
文献类型：
--
作者：
Lee, Christina S.;Baird, Janette;Woolard, Robert
目的：很少有研究探讨简短的动机干预成分（例如变更计划的完成）对治疗结果的影响。对急诊科随机招募的危险饮酒者样本进行二次分析，探讨了在考虑治疗前准备情况后，与酒精相关的改变计划对治疗结果的潜在预测作用。书面变更计划经过独立评估。方法：中介分析框架使用线性回归测试了治疗前准备情况、改变计划和治疗结果之间的定向假设。在所有分析中，基线总饮酒者后果清单 (DrInC) 评分均与 12 个月 DrInC 总评分相关。完成了简短的动机干预和变革计划的参与者被纳入其中（N = 333）。结果：治疗前准备度与 12 个月时的酒精后果呈负相关，beta = -.09，t(254) = -2.07，p < .05，以及高质量的改变计划，beta = .18，t(320) = 4.37，p < .001。当变更计划和准备情况处于同一模型中时，准备情况和治疗结果之间的关系变得不显着，但变更计划仍然是预期方向上治疗结果的显着预测因子，beta = -.17，t(254) = -2.89，p < .01。包括交互项（变革计划和治疗前准备度）的后续广义线性模型显示，那些准备度高且制定了高质量变革计划的人与那些准备度低且变革计划质量差的人相比，无论是准备度还是单独的变革计划，其结果都好于预测。结论：研究结果表明，简短动机干预中的改变计划可能是治疗的一个积极成分，与治疗前准备情况的影响之外的更好结果相关。 （酒精药物研究杂志，71, 726-733, 2010）
Objective: Few studies have examined the effects of brief motivational intervention components, such as change-plan completion, on treatment outcomes. This secondary analysis of an opportunistically recruited emergency-department sample of hazardous injured drinkers examines the potential predictive role of an alcohol-related change plan on treatment outcomes after accounting for pretreatment readiness. Written change plans were independently rated. Method: A mediational analysis framework tested directional hypotheses between pretreatment readiness, change plan, and treatment outcomes using linear regressions. The baseline total Drinker Inventory of Consequences (DrInC) score was covaried on 12-month DrInC total score, in all analyses. Participants who completed a brief motivational intervention and a change plan were included (N = 333). Results: Pretreatment readiness was negatively associated with alcohol consequences at 12 months, beta = -.09, t(254) = -2.07, p < .05, and good-quality change plans, beta = .18, t(320) = 4.37, p < .001. With change plan and readiness in the same model, the relationship between readiness and treatment outcomes became nonsignificant, but change plan remained a significant predictor of treatment outcomes in the expected direction, beta = -.17, t(254) = -2.89, p < .01. Follow-up generalized linear modeling including an interaction term (change plan and pretreatment readiness) revealed that those with high readiness and a good-quality change plan versus those with low readiness and a poor-quality change plan had better-than-predicted outcomes for either readiness or change plan alone. Conclusions: Study findings suggest that the change plan in brief motivational intervention may be an active ingredient of treatment associated with better outcomes over and above the influence of pretreatment readiness. (J. Stud. Alcohol Drugs, 71, 726-733, 2010)