Making Alcoholics Anonymous Easier: A Group TSF Approach

描述（由申请人提供）：此拨款申请响应NIAAA PA 02-167，寻求对提供者优先考虑的合作治疗和服务研究，并强调对管理护理和少数群体有效的团体治疗。该应用程序提出了一项健康服务试验，以测试一种手册指导的、以团体为导向的12步促进干预，称为MAAEZ（使匿名戒酒者更容易）。基于AA可以增强治疗效果的证据，本干预旨在帮助以团体为导向的治疗方案使来访者参与AA。到目前为止，还没有测试或提供给治疗项目的12步促进小组手册。MAAEZ以Ajzen的计划行为理论为基础，专注于影响患者对AA参与的态度、主观规范和控制感。MAAEZ的6个会议帮助参与者欣赏他们在AA遇到的人、意见和会议的多样性；找到他们喜欢的方便会议；并在AA建立联系，引导参与者在会议上与AA成员交谈，打电话给他们，并要求某人成为临时担保人。拟议的试验（n=630）将在三个Kaiser门诊诊所进行。在招募的前10周，site 1、2和3的参与者将接受常规治疗（OFF状态）。在接下来的10周内，站点1和站点2的新队列将接受6次MAAEZ治疗，代替6次常规护理（ON），而站点3的新队列将继续接受OFF治疗，以便研究可以排除MAAEZ影响的历史记录。新站点3的参与者将在第三个为期10周的招募期间获得MAAEZ。参与者将在基线、基线后6周、6个月和12个月接受访谈。调查措施包括参与嗜酒者互诫会；态度、主观规范、知觉控制和意图；以及饮酒结果（主要是戒酒）。自我报告的酒精和药物使用情况将通过尿检来证实。本研究旨在测试MAAEZ是否会增加AA参与和戒酒，确定MAAEZ对其最有效的亚群，并评估MAAEZ对AA参与和饮酒结果影响的相关作用机制。分析将包括混合模型ANCOVA和线性回归。与PA的目标一致，Kaiser项目主管和临床医生一直参与研究问题，并将积极合作，从实施到传播。如果有效，MAAEZ应该引起提供者的广泛兴趣，因为它可以迅速纳入现有方案，为群体导向治疗的简短干预提供简洁的手册。

DESCRIPTION (provided by applicant): This grant application responds to NIAAA PA 02-167 seeking collaborative treatment and services studies of high priority to providers, and emphasizing group therapies effective for managed care and minority populations. The application proposes a health services trial to test a manual-guided, group-oriented 12-step facilitation intervention called MAAEZ (Making Alcoholics Anonymous Easier). Based on evidence that AA can potentiate treatment effects, this intervention aims to help group-oriented treatment programs engage clients in AA. To this point, no group format manual for 12-step facilitation has been tested and made available to treatment programs. MAAEZ is grounded in Ajzen's Theory of Planned Behavior, and focuses on influencing patient attitudes, subjective norms, and sense of control regarding AA involvement. MAAEZ's 6 sessions help participants to appreciate the diversity of people, opinions and meetings that they encounter at AA; find convenient meetings that they like; and make connections at AA, walking participants through the process of talking to AA members at meetings, calling them on the telephone, and asking someone to be a temporary sponsor. The proposed trial (n=630) will be undertaken in three Kaiser outpatient clinics. For the first 10 weeks of recruitment, participants at Sites 1, 2 and 3 will receive usual treatment (OFF condition). During the next 10 weeks, a new cohort at Sites 1 and 2 will receive 6 weekly MAAEZ sessions in place of 6 usual care sessions (ON), while OFF continues for the new Site 3 cohort so that the study can rule out historical accounts of MAAEZ's effects. New Site 3 participants will receive MAAEZ during a third 10-week recruitment period. Participants will be interviewed at baseline, and at 6 weeks, 6 months, and 12 months post-baseline. Survey measures include AA involvement; attitudes, subjective norms, perceived control, and intentions regarding AA involvement; and drinking outcomes (primarily abstinence). Self-reported alcohol and drug use will be validated by urine testing. The study aims to test whether MAAEZ increases AA involvement and abstinence, to identify subgroups for whom MAAEZ is most effective, and to evaluate mechanisms of action associated with MAAEZ's influence on AA involvement and drinking outcomes. Analyses will include mixed-model ANCOVA's and linear regressions. Consistent with the PA goals, Kaiser program directors and clinicians have been involved in the research questions and will actively collaborate from implementation through dissemination. If effective, MAAEZ should be of wide interest to providers, as it can be rapidly incorporated into existing programs, offering a succinct manual for brief interventions in group-oriented treatment.