Treatment seeking as a mechanism of change in a randomized controlled trial of a mobile health intervention to support recovery from alcohol use disorders.
Treatment seeking as a mechanism of change in a randomized controlled trial of a mobile health intervention to support recovery from alcohol use disorders.
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DOI：
10.1016/j.jsat.2017.03.011
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发表时间：
2017-06
影响因子：
3.9
通讯作者：
Shah D
中科院分区：
文献类型：
--
作者：
Glass JE;McKay JR;Gustafson DH;Kornfield R;Rathouz PJ;McTavish FM;Atwood AK;Isham A;Quanbeck A;Shah D
我们估计了成瘾综合健康促进支持系统（A-CHESS）在增加成瘾服务使用方面的有效性，并研究了这种服务的使用在多大程度上介导了A-CHESS对危险饮酒日和戒酒的影响。我们对A-CHESS随机对照试验进行了次要数据分析。招募发生在五个住宅治疗方案由两个成瘾治疗组织。参与者是349名患有酒精使用障碍的成年人，他们在出院前两周从住院治疗中招募。我们为干预组参与者提供了智能手机、A-CHESS应用程序和8个月的服务计划。对照组受试者照常接受治疗。在4个月，8个月和12个月的随访电话访谈评估了过去一个月的危险饮酒日，过去一个月的禁欲，出院后的服务利用（过去一个月的门诊成瘾治疗和过去一周的互助，包括酗酒者匿名和麻醉品匿名）。使用混合效应潜变量模型，我们估计了A-CHESS对饮酒结果的间接影响（由出院后服务利用率介导）。大约50.5%的参与者报告了门诊成瘾治疗，75.5%的参与者在随机化后的一年中的任何随访访谈中报告了互助。分配到A-CHESS干预与随访期间门诊成瘾治疗的几率增加相关，但不是相互帮助。这种使用门诊成瘾治疗介导的影响，A-国际象棋的危险饮酒日，但不禁欲。通过门诊成瘾治疗的A-CHESS效果似乎使随访期间的风险饮酒天数减少了11%。移动的健康干预措施促进了门诊成瘾治疗的使用，这似乎有助于其减少危险饮酒的功效。未来的研究应该调查移动医疗干预措施如何将患者与所需的治疗服务联系起来，并促进这些服务的持续使用。
We estimated the efficacy of the Addiction-Comprehensive Health Enhancement Support System (A-CHESS) in increasing the use of services for addiction and examined the extent to which this use of services mediated the effects of A-CHESS on risky drinking days and abstinence from drinking. We conducted secondary data analyses of the A-CHESS randomized controlled trial. Recruitment occurred in five residential treatment programs operated by two addiction treatment organizations. Participants were 349 adults with alcohol use disorders recruited two weeks before discharge from residential treatment. We provided intervention arm participants with a smartphone, the A-CHESS application, and an 8-month service plan. Control arm participants received treatment as usual. Telephone interviews at 4, 8, and 12-month follow-ups assessed past-month risky drinking days, past-month abstinence, and post-discharge service utilization (past-month outpatient addiction treatment and past-week mutual help including Alcoholics Anonymous and Narcotics Anonymous). Using mixed effects latent variable models, we estimated the indirect effects of A-CHESS on drinking outcomes, as mediated by post-discharge service utilization. Approximately 50.5% of participants reported outpatient addiction treatment and 75.5% reported mutual help at any follow-up interview in the year following randomization. Assignment to the A-CHESS intervention was associated with an increased odds of outpatient addiction treatment across follow-ups, but not mutual help. This use of outpatient addiction treatment mediated the effect of A-CHESS on risky drinking days, but not abstinence. The effect of A-CHESS through outpatient addiction treatment appeared to reduce the expected number of risky drinking days across follow-ups by 11%. The mobile health (mHealth) intervention promoted the use of outpatient addiction treatment, which appeared to contribute to its efficacy in reducing risky drinking. Future research should investigate how mHealth interventions could link patients to needed treatment services and promote the sustained use of these services.
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影响因子：
25.8
作者：
Gustafson, David H.;McTavish, Fiona M.;Chih, Ming-Yuan;Atwood, Amy K.;Johnson, Roberta A.;Boyle, Michael G.;Levy, Michael S.;Driscoll, Hilary;Chisholm, StevenM.;Dillenburg, Lisa;Isham, Andrew;Shah, Dhavan
通讯作者：
Shah, Dhavan
影响因子：
4.2
作者：
Killeen, TK;Brady, KT;Simpson, KN
通讯作者：
Simpson, KN
影响因子：
7.9
作者：
Gustafson, David H.;Hawkins, Robert;Serlin, Ronald C.
通讯作者：
Serlin, Ronald C.
影响因子：
4.4
作者：
Gustafson, DH;McTavish, FM;Hawkins, R
通讯作者：
Hawkins, R
影响因子：
4.2
作者：
Glass, Joseph E.;Bucholz, Kathleen K.
通讯作者：
Bucholz, Kathleen K.