Implementing a Screening and Brief Intervention in the EAP for At-Risk Drinkers

在 EAP 中对高危饮酒者实施筛查和简短干预

• 批准号: 7921690
• 负责人: Karen Chan Osilla
• 金额: $ 27万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7921690
• 关键词: Absenteeism; Accidents; Address; Administrator; Affect; Alcohol abuse; Caring; Client; Control Groups; Counseling; Data; Dependence; Dimensions; Early Diagnosis; Effectiveness; Eligibility Determination; Employee; Employee Assistance Program (Health Care); Employee Health; Face; Facilities and Administrative Costs; Family; Feedback; Female; Focus Groups; Future; Health; Health Benefit; Health Services Research; Heavy Drinking; Individual; Intervention; Mental Depression; Methods; Modeling; Nature; Occupational; Occupations; Outcome; Parents; Pharmaceutical Preparations; Population; Prevalence; Prevention; Primary Health Care; Process; Productivity; Protocols documentation; Publishing; Randomized; Recovery; Recruitment Activity; Relative (related person); Research; Research Design; Risk; Services; Telephone; Time; Training; Treatment Efficacy; Work; Workplace; adverse outcome; alcohol intervention; alcohol screening and brief intervention; alcohol use disorder; college; cost; cost effectiveness; drinking; drinking behavior; experience; follow-up; high risk drinking; improved; innovation; male; medical specialties; motivational enhancement therapy; pilot trial; prevent; public health relevance; randomized trial; research study; screening and brief intervention; standard care

DESCRIPTION (provided by applicant): Employee assistance programs (EAPs) offer short-term counseling and long-term referrals to employees as part of a health benefits package. The EAP setting presents a unique opportunity to conduct screening and brief interventions (SBIs) for at-risk drinking. Using an EAP to address at-risk drinking and to prevent more serious alcohol problems from developing may be critical to reducing the prevalence of these issues among employed individuals. Unfortunately, the majority of at-risk drinkers are not identified by clinicians through EAPs, nor are they provided services through EAPs for their drinking if identified. The main objective of this two-year services research study is to understand how to implement SBIs for at-risk drinking in a standard EAP setting. Substantial evidence supports the effectiveness of SBIs in other settings such as primary care and college settings. However, only a few published studies have examined the feasibility of implementing SBIs into workplace populations. These SBI interventions typically last about 20-30 minutes and utilize a Motivational Interviewing approach. The brief nature of these interventions may make it feasible to integrate, but there may be several barriers specific to the EAP from an organization and staff perspective that would make it challenging to implement. In the current study, we will first conduct focus groups with EAP staff to determine the barriers and facilitating factors associated with implementing and recruiting for a SBI for at-risk drinking within the EAP. Using this information, we will conduct a randomized trial of the SBI as an add-on to standard EAP care compared to standard EAP care alone. EAP Clinicians will deliver both the SBI intervention and EAP sessions. The intervention will be an add-on to the client's second session. Upon entering the EAP, clients will be screened for at-risk drinking using the AUDIT-C. Male clients scoring five or higher and female clients scoring three or higher on the AUDIT-C will be randomly assigned to either the intervention (n=50) or control (n=50) group. To assess the efficacy of the intervention, we will examine drinking and health outcomes at 3- and 6-month follow-ups. Finally, we will gather basic cost data associated with adding the SBI to standard EAP care and explore the feasibility of gathering administrative data for a future cost-effectiveness study. This R21 represents our first critical step in understanding potential barriers to bringing alcohol interventions into the workplace and examining potential efficacy and costs associated with this type of intervention. Results from this pilot trial have significant potential to influence standards of care for identifying and intervening with at-risk drinkers in the EAP setting. PUBLIC HEALTH RELEVANCE: Widely implementing SBIs in standard EAP care has a great potential for decreasing the prevalence of alcohol use disorders in the workplace as well as decreasing the costs of occupational, societal, and health problems associated with untreated at-risk drinking. To date, few studies have examined the implementation of an SBI in an EAP setting, and very little is known about the barriers that would be encountered. Results from this pilot trial have significant potential to influence standards of care for identifying and intervening with at-risk drinkers in the EAP setting.

描述（由申请人提供）：员工援助计划（eap）为员工提供短期咨询和长期推荐，作为一揽子健康福利的一部分。EAP的设置提供了一个独特的机会进行筛查和简短干预（sbi）的高危饮酒。使用EAP来解决高危饮酒问题并防止更严重的酒精问题的发展，对于减少这些问题在就业人员中的流行可能至关重要。不幸的是，大多数高危饮酒者并没有被临床医生通过eap识别出来，即使他们被识别出来，也没有通过eap为他们提供服务。这项为期两年的服务研究的主要目的是了解如何在标准的EAP环境中对高危饮酒实施sbi。大量证据支持sbi在其他环境中的有效性，如初级保健和大学环境。然而，只有少数已发表的研究报告审查了在工作场所人口中实施sbi的可行性。这些SBI干预通常持续约20-30分钟，并利用动机性访谈方法。这些干预措施的简短性质可能使其集成可行，但是从组织和员工的角度来看，可能存在一些特定于EAP的障碍，这将使其具有挑战性。在目前的研究中，我们将首先与EAP的工作人员进行焦点小组讨论，以确定在EAP内实施和招募高危饮酒的SBI相关的障碍和促进因素。利用这些信息，我们将进行一项随机试验，将SBI作为标准EAP治疗的附加治疗与单独的标准EAP治疗进行比较。EAP临床医生将提供SBI干预和EAP会话。干预将是客户第二次会话的附加内容。进入EAP后，客户将使用AUDIT-C对有饮酒风险的客户进行筛查。男性客户在AUDIT-C上得分5分或更高，女性客户在AUDIT-C上得分3分或更高，将被随机分配到干预组（n=50）或对照组（n=50）。为了评估干预的效果，我们将在3个月和6个月的随访中检查饮酒和健康结果。最后，我们将收集与将SBI添加到标准EAP护理相关的基本成本数据，并探索收集行政数据的可行性，以用于未来的成本效益研究。这份R21报告是我们在了解将酒精干预措施引入工作场所的潜在障碍以及检查与此类干预措施相关的潜在功效和成本方面迈出的关键一步。这项试点试验的结果对EAP环境中高危饮酒者的识别和干预的护理标准具有重要的影响。