A randomized clinical trial of mobile phone motivational interviewing for alcohol use problems in Kenya.
A randomized clinical trial of mobile phone motivational interviewing for alcohol use problems in Kenya.
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DOI：
10.1111/add.14903
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发表时间：
2020-06
期刊：
影响因子：
--
通讯作者：
Mutiso VN
中科院分区：
文献类型：
--
作者：
Harder VS;Musau AM;Musyimi CW;Ndetei DM;Mutiso VN
旨在测试使用手机对有酗酒问题的成年人进行动机访谈 (MI) 干预的有效性。一项针对移动 MI 和标准面对面 MI 的随机临床试验，并进行 1 个月和 6 个月的随访，包括一个月的候补名单对照，然后进行移动 MI。肯尼亚农村的一个初级保健中心。 300 名酒精使用问题筛查呈阳性的成年人被随机分配，并在未接受治疗一个月后接受立即移动 MI (n=89)、面对面 MI (n=65) 或延迟移动 MI (n=76) 作为候补对照，其中 70 人无法联系到干预。一次 MI 课程要么立即通过手机亲自在健康中心提供，要么延迟一个月然后通过手机提供。使用酒精使用障碍识别测试 (AUDIT) 和较短的 AUDIT-C 反复评估酒精使用问题。主要结局是等待名单控制未干预后 1 个月与移动 MI 后 1 个月酒精评分的差异。次要结果是当面 MI 与移动 MI 的酒精评分在 MI 后 1 个月和 6 个月的差异。对于我们的主要结局，等待名单对照在没有干预一个月后的平均 AUDIT-C 分数比干预后一个月的移动 MI 高出近 3 分（差异 = 2.88，95% CI：2.11，3.66）。次要结果的结果支持一个月时现场 MI 和移动 MI 之间没有差异的零假设（贝叶斯因子=.22），但在六个月时没有结论（贝叶斯因子=.41）。基于手机的动机访谈可能是治疗肯尼亚初级保健成年人饮酒问题的有效方法。提供移动动机访谈可能有助于农村地区的临床医生接触到需要治疗酗酒问题的患者。
To test the effectiveness of a motivational interviewing (MI) intervention using the mobile phone among adults with alcohol use problems. A randomized clinical trial of mobile MI and standard in-person MI with 1- and 6-month follow-up, including a one-month waitlist control followed by mobile MI. A primary health center in rural Kenya. Three hundred adults screening positive for alcohol use problems were randomized and received immediate mobile MI (n=89), in-person MI (n=65), or delayed mobile MI (n=76) for waitlist controls one month after no treatment, with 70 unable to be reached for intervention. One MI session was provided either immediately by mobile phone, in-person at the health center, or delayed by one month and then provided by mobile phone. Alcohol use problems were repeatedly assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the shorter AUDIT-C. The primary outcome was difference in alcohol score one month after no intervention for waitlist control vs. one month after MI for mobile MI. The secondary outcomes were difference in alcohol score for in-person MI vs. mobile MI one and six months after MI. For our primary outcome, average AUDIT-C scores were nearly three points higher (Difference=2.88, 95% CI: 2.11, 3.66) for waitlist controls after one month of no intervention vs. mobile MI one month after intervention. Results for secondary outcomes supported the null hypothesis of no difference between in-person and mobile MI at one month (Bayes Factor=.22) but were inconclusive at six months (Bayes Factor=.41). Mobile phone-based motivational interviewing may be an effective treatment for alcohol use problems among adults visiting primary care in Kenya. Providing mobile motivational interviewing may help clinicians in rural areas reach patients needing treatment for alcohol use problems.
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