Testing the long-term efficacy of a proactive expert system intervention to prevent alcohol use in the population

酒精筛查和短暂干预是一种重要的公共卫生方法。它首先接触尽可能多的人进行筛查，这通常会产生相对于干预措施的高成本。然而，绝大多数接触者通常被排除在以下简短干预之外，例如饮酒过少或过多的人。潜力没有得到充分利用。例如，在低风险饮酒的人群中，饮酒行为的轻微减少甚至维持可以在人口水平上产生巨大影响。因此，人口影响的ASBI可以大大增加接近所有人的人口（而不是一个选定的高风险人群只），而成本的干预仍然几乎相同。开发和测试的综合预防和干预（PRINT）计划，以支持低风险酒精使用的人口的功效。PRINT将基于专家系统软件。针对酒精使用和动机变量的评估数据，软件为每个人单独生成与一般人群数据相比的反馈。参与者将通过普通邮件收到个性化的反馈信。PRINT的目的是（1）减少有饮酒风险的人的饮酒量，（2）维持低饮酒风险的人的饮酒量。根据预先研究的结果，将修改一个久经考验的专家系统软件，以测试酒精使用和动机变量的测量（N = 150）。因此，反馈将根据一个人的具体需求与他/她的动机状态和饮酒模式。PRINT的有效性将在一项随机对照试验中进行测试，该试验在年龄在18至64岁之间的注册办公室客户中进行12个月的随访（N = 1648）。预期影响：我们希望提供一种基于计算机的简短酒精干预，适用于各种人群，无论他们的饮酒和风险状况如何。干预措施可能有可能以低成本减少人群中的危险酒精使用和酒精相关问题。

Alcohol screening and brief Intervention is an important public health approach. It starts with contacting as many persons of a population as possible for screening, which usually produces high costs relative to the intervention. However, the vast majority of the contacted persons is typically excluded from the following brief intervention, e.g. people drinking too little or too heavily. The full potential is not exploited. E.g. among persons with low-risk alcohol use, marginal reductions or even the maintenance of the drinking behavior can produce large effects on a population level. Thus, the population impact of ASBI could be increased considerably by approaching all persons of a population (rather than a selected high-risk population only), while the costs for the intervention remain almost identical.To develop and test the efficacy of an integrative PRevention and INTervention (PRINT) program to support low-risk alcohol use in the population. PRINT will be based on expert system software. In response to assessment data on alcohol use and motivational variables, feedback in comparison to general population data is generated individually by the software for each person. Participants will receive individualized feedback letters by ordinary mail. PRINT aims to result in (1) drinking reductions among persons with at-risk alcohol use and (2) maintenance of the drinking among persons with low-risk alcohol use.A well-tried expert system software will be modified based on results from a pre-study to test measures for alcohol use and motivational variables (N = 150). As a result, feedback will be tailored to a person`s specific needs associated with his/ her motivation status and drinking pattern. The efficacy of PRINT will be tested in a randomized controlled trial with 12-month follow-up among registry office clients aged between 18 and 64 years (N = 1648).EXPECTED IMPACT: We expect to provide a computer-based brief alcohol intervention that is appropriate for a wide range of people regardless of their drinking and risk status. The intervention may have the potential to decrease at-risk alcohol use and alcohol-related problems on a population level at low costs.