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Exploring the Teachable Moment for Alcohol Reduction in Breast Clinics: Formative Work to Inform Intervention Design, Development, Process Evaluation

探索乳腺诊所减少饮酒的可教学时刻：为干预设计、开发、过程评估提供信息的形成性工作

基本信息

批准号：
MR/P016960/1
负责人：
Julia Sinclair
金额：
$ 19.3万
依托单位：
University of Southampton
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2017
资助国家：
英国
起止时间：
2017 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FP016960%2F1
关键词：
Exploring Teachable Moment Alcohol Reduction

项目摘要

The Chief Medical Officers have recently announced updates to the national alcohol guidelines reflecting new scientific evidence that risks of alcohol on health are dose-dependent, and there is no 'safe' level of alcohol consumption. There is now a need to increase public awareness of this recent evidence to all types of alcohol consumers, whether light or heavy drinkers, in order to reduce alcohol intake across the whole population. There is relatively little research as to whether providing alcohol brief interventions for moderate drinkers (who are still at increased risk of cancer including breast cancer) is either acceptable or feasible.Evidence tends to show that patients and the wider public are both more receptive to health improvement advice and more open to make positive changes in their lifestyle when facing significant health events, for instance pregnancy or a visit to an Emergency Department, this has been described as 'readiness to change'. Many opportunistic brief interventions use these health service encounters to increase the effectiveness of public health advice.We propose an early phase study to determine the information about alcohol needed by women attending these clinics, how tailored and supportive feedback can be provided, and what tools may help develop this into a long-term intrinsic motivation to reduce alcohol consumption. We propose to explore the acceptability and feasibility of an opportunistic alcohol brief intervention (ABI) delivered electronically to women during health care attendances related to breast cancer, when women maybe particularly alert to breast health initiatives. Every year, approximately 275,000 women in England are referred urgently to clinics for suspected breast cancer, and a further 4.4 million women take up a mammography as part of the NHS Breast Screening Programme. Our recent Cancer Research UK-funded pilot study found that less than 20% of women attending these appointments identified alcohol as a risk factor for breast cancer, despite now well-established evidence that this is the case.The proposed formative work is driven by what women in clinics would find most useful and acceptable. It aims to identify the most appropriate means to empower women to better understand their own alcohol consumption, and the benefits of reduction, capitalising on the heightened receptivity provided by the context of breast clinic waiting areas. We will do this using a range of research methods (survey, semi structured interviews, and focus groups), the results of which will feed into each other to give us the most appropriate format to share alcohol risk information and health improvement advice that addresses women referred to these clinics information needs in a positive and empowering way. We will also explore the acceptability of spreading the ABI to the family and friends of participants, where appropriate.Finally, we will test the prototype intervention with clinic attendees. Results will show whether enough patients engage with the intervention, accept and understand the advice, and ultimately feel a determination to act upon it. All these would confirm sufficient potential to justify a future main study assessing the efficacy of the intervention on alcohol reduction.

首席医疗官最近宣布了国家酒精指南的更新，反映了新的科学证据，即酒精对健康的风险是剂量依赖的，并且没有“安全”的酒精消费水平。现在有必要向所有类型的饮酒者，无论是轻度饮酒者还是重度饮酒者，提高公众对这一最新证据的认识，以减少整个人口的酒精摄入量。对于为适度饮酒者（他们仍然有更高的癌症风险，包括乳腺癌）提供短暂的酒精干预是否可以接受或可行，目前的研究相对较少。有证据表明，患者和广大公众在面临重大健康事件（例如怀孕或去急诊室）时，更容易接受改善健康的建议，更愿意积极改变他们的生活方式，这被称为“准备改变”。许多机会主义的简短干预措施利用这些卫生服务接触来提高公共卫生咨询的有效性。我们建议进行一项早期研究，以确定参加这些诊所的妇女所需的酒精信息，如何提供量身定制的支持性反馈，以及哪些工具可以帮助将其发展为减少酒精消费的长期内在动机。我们建议探讨在乳腺癌相关的保健护理期间，当妇女可能特别注意乳房健康倡议时，通过电子方式向妇女提供机会性酒精短暂干预（ABI）的可接受性和可行性。每年，英格兰大约有27.5万名妇女因疑似乳腺癌被紧急转诊到诊所，另有440万名妇女接受乳房x光检查，这是NHS乳房筛查计划的一部分。我们最近由英国癌症研究中心资助的试点研究发现，尽管现在有确凿的证据证明这一点，但参加这些预约的女性中，只有不到20%的人认为酒精是乳腺癌的危险因素。拟议的形成性工作是由诊所妇女认为最有用和可接受的东西驱动的。它的目的是确定最适当的手段，使妇女能够更好地了解自己的酒精消费，以及减少酒精消费的好处，利用乳房诊所候诊区提供的更高的接受度。为此，我们将采用一系列研究方法（调查、半结构化访谈和焦点小组），这些研究结果将相互反馈，为我们提供最适当的形式，以分享酒精风险信息和改善健康的建议，以积极和赋权的方式解决转介到这些诊所的妇女的信息需求。在适当的情况下，我们亦会探讨向参加者的家人和朋友推广保险合约的可接受性。最后，我们将在临床参与者中测试干预原型。结果将显示是否有足够的患者参与干预，接受和理解建议，并最终决定采取行动。所有这些都将证实有足够的潜力来证明未来评估干预措施对减少酒精的有效性的主要研究。