Review of the AA Literature: Clinical and Research Implications

描述（由申请人提供）：本修订申请响应PA-10-069。匿名戒酒会（AA）是针对酒精相关问题的人最受欢迎的自助计划，基于AA理论和实践的12步疗法是美国流行的酒精治疗模式。可以理解的是，那么，数以百计的调查，以社区为基础的AA已经进行，最近的叙述性评论，这方面的实证文献是比较常见的。叙述性审查的价值有限，因为它们往往只审查“统计上显著”的发现，它们不提供对影响程度的估计，而且由于不提供这种估计，这些审查错过了提醒研究人员注意未来研究最肥沃领域的机会。为了克服这些局限性，我们建议使用先进的荟萃分析技术对经验AA文献（1993- 2009）进行全面回顾。自上一次这类全面审查以来已经有19年了（Emrick等人，1993），在这段时间内，大约有450-500篇AA同行评审的论文已经发表。这次审查有三个目标：（1）我们将总结1993-2009年的AA文献，重点关注AA隶属关系概况以及AA相关益处的程度和性质。相对于我们1993年和1996年的元分析综述，我们将采用改进的程序和统计方法来做到这一点。（2）我们将回顾AA研究的三个新领域，由于1993年以来AA研究的激增，元分析综合成为可能。这些领域是：（a）AA的变化机制，（B）特殊人群和AA，以及（c）AA的长期联系和结果。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。相关的，我们计划识别，编码和分析非AA自助同行评审论文。(3)我们将把荟萃分析论文分发给高影响力的期刊，向研究者提供数据集，并免费分发一张CD，其中包含一个PDF文件，其中包含荟萃分析检索中识别的所有定性和定量论文的参考文献，以及在版权法允许的情况下附带的PDF复制文章。 公共卫生相关性：本研究将应用先进的元分析技术，对1993年至2009年基于AA的研究文献进行回顾和总结。我们将审查英语和西班牙语同行评审的论文，我们也将包括非12步自助论文。除了确定AA的关系概况和AA相关的利益的性质和幅度，这一全面的审查将综合研究结果在三个新的领域AA的研究，自1993年以来激增：（1）机制的变化AA，（2）特殊人群和AA，（3）长期AA的职业生涯和结果。调查结果将提供：（1）向临床医生提供关于谁从AA中受益和不受益的循证建议，以及（2）向研究人员提供关于未来互助调查最肥沃领域的明确建议。

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.