Review of the AA Literature: Clinical and Research Implications

描述（由申请人提供）：此修订后的申请响应PA-10-069。匿名戒酒会（AA）是针对有酒精相关问题的人的最受欢迎的自助计划，基于AA原则和实践的12步疗法是美国流行的酒精治疗模式。因此，可以理解的是，已经开展了数百项基于社区的AA调查，并且最近对这一实证文献的叙述性评论相对普遍。叙述性综述的价值有限，因为它们往往只回顾“统计上显著”的发现，它们不提供影响程度的估计，而且由于不提供这种估计，这些综述错过了提醒研究人员注意未来研究最肥沃领域的机会。为了克服这些限制，我们建议使用先进的元分析技术对经验AA文献（1993- 2009）进行全面回顾。上一次这样的综合评价（Emrick et al., 1993）已经过去19年了，在这段时间里，大约有450-500篇AA同行评议的论文发表。本综述主要有三个目的：(1)对1993-2009年的AA文献进行综述，重点关注AA的归属概况和AA相关利益的大小和性质。与1993年和1996年的meta分析综述相比，我们将采用更完善的程序和统计方法来进行研究。(2)我们将回顾AA研究的三个新领域，这是由于1993年以来AA研究的激增而使meta分析综合成为可能。这些领域包括：(a) AA的变化机制；(b)特殊人群和AA； (c) AA的长期关系和结果。这些新领域的总结将为从业者和研究人员提供一个独特的视角，以了解AA如何以及对谁有帮助。与此相关，我们计划识别、编码和分析非aa自助同行评议论文。(3)我们将向高影响力期刊传播元分析论文，向研究者提供数据集，并免费分发一张包含PDF文件的CD，其中包含在元分析搜索中确定的所有定性和定量论文的参考文献，并在版权法允许的情况下附带PDF复制文章。

DESCRIPTION (provided by applicant): This revised application responds to PA-10-069. Alcoholics Anonymous (AA) is the most popular self-help program for persons with alcohol-related problems, and 12-step therapy, based on AA doctrine and practice, is the prevailing alcohol treatment model in the United States. Understandably, then, hundreds of investigations on community-based AA have been conducted, and recent narrative reviews of this empirical literature are relatively common. Narrative reviews are of limited value as they tend to review only "statistically significant" findings, they do not provide estimates of the magnitude of effects and, by not providing such estimates, these reviews miss the opportunity to alert researchers to the most fertile areas for future investigations. To overcome these limitations we propose to do a comprehensive review of the empirical AA literature (1993- 2009) using advanced meta-analytic techniques. It has been 19 years since the last comprehensive review of this kind (Emrick et al., 1993), and in that time about 450-500 AA peer- reviewed papers have been published. This review has three aims: (1) we will summarize the AA literature from 1993-2009 focusing on AA affiliation profiles and the magnitude and nature of AA- related benefit. We will do this with much improved procedural and statistical approaches relative to our 1993 and 1996 meta-analytic reviews, (2) we will review three new areas of AA research, a meta-analytic synthesis made possible because of the surge of AA research since 1993. The areas are: (a) mechanisms of change in AA, (b) special populations and AA, and (c) long-term AA affiliation and outcome. Summaries of these new areas will provide practitioners and researchers with a unique perspective in understanding how, and for whom, AA may be helpful. Related, we plan to identify, code, and analyze non-AA self-help peer-reviewed papers. (3) We will disseminate meta-analytic papers to high impact journals, make available the data set to investigators, and distribute, free of charge, a CD that contains a PDF file with the references for all qualitative and quantitative papers identified in the meta-analytic search, with accompanying PDF reproduced articles when copyright laws permit. PUBLIC HEALTH RELEVANCE: This project will apply advanced meta-analytic techniques to review and summarize the AA-based research literature from 1993 to 2009. We will review English and Spanish peer-reviewed papers, and we will also include non-12 step self-help papers. In addition to identifying AA affiliation profiles and the nature and magnitude of AA-related benefit, this comprehensive review will synthesize findings in three new areas of AA research that have proliferated since 1993: (1) mechanisms of change in AA, (2) special populations and AA, and (3) long-term AA careers and outcome. Findings will provide both: (1) evidence-based recommendations to clinicians about who does and does not benefit from AA, and (2) clear recommendations to researchers about the most fertile areas for future mutual-help investigations.