CBT by Phone to Promote Use of Alcohol Related Care and Reduce Drinking

摘要 已经开发出许多基于证据的酒精使用障碍 (AUD) 治疗方法，并且研究 研究表明，获得酒精专业护理的个人饮酒结果有所改善，并且更有可能 康复，但一小部分 AUD 患者获得了治疗。筛选的使用，简介 干预和转诊治疗 (SBIRT) 干预措施是增加治疗的潜在策略 寻求，但几乎没有证据表明这些干预措施增加了对酒精相关护理的参与，并且 缺乏证据表明这种护理可以作为改善饮酒结果的机制。目前的 通过电话进行一次干预的随机对照试验 (RCT) 旨在解决这些问题 证据上的空白。具体目标是表明 18 岁及以上持有 AUD 的研究志愿者 与信息控制条件相比，分配给干预措施的人更有可能引发酒精 专业护理（目标 1），减少饮酒频率（以戒酒天数百分比衡量），并且 饮酒强度（以每天饮酒量衡量）（目标 2），以及治疗参与度 作为改善饮酒结果的中介（目标 3）。创新包括使用 SBIRT 基于计划行为理论和认知行为治疗原则的干预 干预措施从一开始就是为电话管理而制定的，其明确目的是促进 治疗参与度。该项目是为了响应 PA-15-299，酒精使用障碍：行为 治疗、服务和康复研究。它建立在一个较小的功效试验的基础上，该试验表明 干预导致人们更多地参与与酒精相关的护理（Stecker 等，2012）并扩展了这一点 通过多种方式进行研究，包括通过使用先验测试来确定干预措施的有效性 改善饮酒结果，并且治疗参与是改善结果的中介。

Abstract Numerous evidence based treatments for alcohol use disorder (AUD) have been developed, and research shows that individuals who obtain alcohol specialty care have improved drinking outcomes and are more likely to recover, yet a small percentage of individuals with AUD obtain treatment. Use of Screening, Brief Intervention, and Referral to Treatment (SBIRT) interventions is a potential strategy to increase treatment seeking, yet there is little evidence that these interventions increase participation in alcohol-related care and a lack of evidence that such care serves as a mechanism for improved drinking outcomes. The current randomized controlled trial (RCT) of a one session intervention delivered by telephone seeks to address these gaps in evidence. The specific aims are to show that research volunteers ages 18 and older with AUD who are assigned to the intervention compared to an information control condition are more likely to initiate alcohol specialty care (aim 1), have decreased frequency of alcohol use (as measured by percent days abstinent) and intensity of alcohol use (as measured by drinks per drinking day) (aim 2), and that treatment engagement serves as a mediator of the improved drinking outcomes (aim 3). Innovations include the use of an SBIRT intervention based on the theory of planned behavior and cognitive behavioral treatment principles and that the intervention was developed for phone administration from the onset and was explicitly designed to promote treatment engagement. The project is in response to PA-15-299, Alcohol Use Disorders: Behavioral Treatment, Services, and Recovery Research. It builds on a smaller efficacy trial that showed that the intervention leads to increased engagement in alcohol-related care (Stecker et al., 2012) and extends that study in several ways including through the use of a priori tests to determine efficacy of the intervention to improve drinking outcomes and that treatment engagement serves as a mediator of the improved outcomes.