Screening and Brief Intervention in the ED among Mexican-origin Young Adults

墨西哥裔年轻人的急诊科筛查和短暂干预

• 批准号: 8270533
• 负责人: CHERYL J CHERPITEL
• 金额: $ 55.5万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-20 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8270533
• 关键词: 19 year old; 20 year old; Accident and Emergency department; Acute; Address; Admission activity; Adolescent; Adult; Advocate; Affect; Age; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Alcohols; American College of Surgeons; Applications Grants; Area; Attention; Birth; Blinded; Centers for Disease Control and Prevention (U.S.); Cities; Communities; Consent; Country; Coupled; Cultural Characteristics; Data; Development; Disease; Effectiveness; Effectiveness of Interventions; Emergency Medical Technicians; Emergency Medicine; Equation; Esthesia; Ethnic group; Event; Female; Funding; Generations; Guidelines; Health; Health Promotion; Heavy Drinking; High Prevalence; Hispanics; Immigrant; Impulsivity; Individual; Injury; International; Intervention; Intervention Studies; Intervention Trial; Knowledge; Language; Lead; Leadership; Life; Literature; Logistic Regressions; Medical; Mexican; Mexico; NIH Program Announcements; National Institute on Alcohol Abuse and Alcoholism; Nurse Practitioners; Nurses; Outcome; Outcome Assessment; Patient Self-Report; Patients; Physician Assistants; Physicians; Poland; Population; Predictive Value; Prevalence; Primary Health Care; Protocols documentation; Provider; Public Health; Publishing; Quality of life; Randomized; Randomized Controlled Clinical Trials; Readiness; Recommendation; Relative (related person); Reporting; Research; Research Personnel; Risk; Risk-Taking; Screening procedure; Site; Social Characteristics; Source; Staging; Subgroup; Surveys; Techniques; Telephone; Testing; Texas; Time; Training; Translating; Translations; Trauma; Treatment Protocols; Treatment outcome; United States Substance Abuse and Mental Health Services Administration; Visit; Work; World Health Organization; Youth; age group; alcohol abuse therapy; alcohol advertising; alcohol availability; alcohol related problem; alcohol risk; alcohol screening and brief intervention; alcohol use disorder; binge drinking; breath alcohol measurement; brief alcohol intervention; brief intervention; brief motivational intervention; care seeking; convict; cost; disorder prevention; drinking; driving behavior; experience; follow-up; group intervention; hazardous drinking; high risk drinking; impaired driving performance; improved; injured; legal drinking age; male; marijuana user; motivational enhancement therapy; motivational intervention; prototype; recidivism; response; screening and brief intervention; screening, brief intervention, referral, and treatment; standard care; symposium; trauma centers; treatment trial; trial comparing; twelfth grade; young adult

DESCRIPTION (provided by applicant): Screening and Brief Intervention in the ED among Mexican-origin Young Adults The aims of this application "Screening and Brief Alcohol Intervention in Underage and Young Adult Populations" are to: 1) examine the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) among Mexican-origin young adults (age 18-25), using a motivational intervention delivered by a Health Promotion Advocate (promotore), relative to standard care with and without assessment, on a reduction in heavy drinking (drinking days per week, number of drinks per day, maximum number of drinks on an occasion) and alcohol-related problems (RAPS4 and SIPS +6) in the emergency department (ED) at the U.S.- Mexico border; and, 2) identify variables that are related to effectiveness of the intervention and that predict successful treatment outcome. We plan to translate motivational interventions that have been successful in primary care and which were recently implemented in the U.S. 14 Academic Emergency Medicine Collaborative (AEMC) SBIRT study to a population of young adult Mexican-origin ED patients on the Texas border in El Paso; a population which has evidenced a high prevalence of hazardous drinking and alcohol- related problems, in part due to the greater availability of alcohol and at low cost in Mexico border cities. The SBIRT study, funded by NIAAA and SAAMHSA, was the first multi-site, collaborative study of screening, brief intervention and referral for at-risk and dependent drinking in the ED. We will conduct a blinded randomized control brief motivational intervention trial in which both injured and non-injured patients will be screened for at- risk or dependent (using the RAPS4) drinking. Patients screening positive who consent to participate in the study will be randomized into one of three groups: screened only, assessed, and assessed plus brief intervention, with n=312 in each group. Intervention and assessment groups will be followed-up at 3 months and all three groups at 12 months. Modifying variables include drinking in the event, risk-taking disposition, readiness and stage of change, country of birth (U.S. vs. Mexico) and language in which the assessment and intervention were conducted (English vs. Spanish). Outcome data will be analyzed using ANOVA, logistic regression and Generalized Estimating Equations. The interaction of modifying variables on outcomes will also be analyzed. Additionally, the study will examine data relevant to key issues related to the potential translatability and public health impact of the intervention and next steps. Given the paucity of published studies of brief intervention in the ED among young adults in general, or among Mexican-origin adults, and none among Mexican-origin young adults, who may be most vulnerable to alcohol use problems and disorders, especially at the border, work to be undertaken in this application is especially important in determining the effectiveness of AEMC SBIRT protocols (which may serve as a prototype for screening, brief intervention and referral for at-risk and dependent drinking in the ED) in this context of Mexican-origin young adults. PUBLIC HEALTH RELEVANCE: This work is especially relevant to public health in relation to reducing subsequent alcohol-related ED visits and associated costs and increase quality of life among young adults. The project will inform the development and spread of more effective techniques and protocols for addressing at-risk and dependent drinking in the ED in this age group, and provide a better understanding of those factors that influence effectiveness of brief intervention and predict successful patient outcomes across ethnic and cultural groups in the U.S. Additionally, this will be the first randomized controlled clinical trial compared to standard care of brief intervention using promotores in the Mexican-origin community, which may provide a better chance of ongoing implementation of SBIRT in the ED than using ED staff providers.

描述（由申请人提供）：墨西哥裔年轻人中艾德的筛查和短暂干预本申请“未成年人和年轻成年人中的筛查和短暂酒精干预”的目的是：1）检查墨西哥裔年轻人中筛查、短暂干预和转诊治疗（SBIRT）的有效性（18-25岁），使用健康促进倡导者提供的激励干预（promotore），相对于标准护理，评估和不评估，对减少大量饮酒的影响（每周饮酒天数、每天饮酒次数、每次最大饮酒次数）和美国急诊室（艾德）与酒精相关的问题（RAP 4和SIPS +6）-墨西哥边境; 2）确定与干预有效性相关的变量，并预测成功的治疗结果。我们计划将在初级保健中取得成功的激励性干预措施转化为最近在美国14个学术急诊医学合作组织（AEMC）SBIRT研究中实施的激励性干预措施，用于德克萨斯州埃尔帕索边境的年轻墨西哥裔艾德患者人群;一个已经证明危险饮酒和与酒精有关的问题普遍存在的人口，部分原因是墨西哥边境城市的酒精供应量更大，而且价格低廉。SBIRT研究，由NIAAA和SAAMHSA资助，是第一个多站点，合作研究的筛选，短暂的干预和转介的风险和依赖性饮酒在ED。我们将进行一个盲随机对照简短的动机干预试验，受伤和未受伤的患者都将筛选风险或依赖性（使用RAPS 4）饮酒。同意参加研究的筛选阳性患者将随机分为三组：仅筛选组、评估组和评估加简短干预组，每组n=312。干预组和评估组将在3个月时随访，所有三组均在12个月时随访。修改变量包括事件中的饮酒，冒险倾向，准备和变化阶段，出生国（美国与墨西哥）以及进行评估和干预的语言（英语与西班牙语）。将使用ANOVA、logistic回归和广义估计方程分析结局数据。还将分析修正变量对结果的相互作用。此外，该研究将检查与干预措施的潜在可翻译性和公共卫生影响以及后续步骤相关的关键问题相关的数据。鉴于在一般年轻人或墨西哥裔成年人中对艾德进行短暂干预的已发表研究很少，而在墨西哥裔年轻人中没有研究，他们可能最容易受到酒精使用问题和障碍的影响，特别是在边境地区，在这方面开展的工作对于确定AEMC SBIRT方案的有效性尤为重要（这可能作为一个原型，筛选，短暂的干预和转介的风险和依赖性饮酒的艾德）在这种情况下，墨西哥裔年轻人。 公共卫生关系：这项工作与公共卫生特别相关，可以减少随后与酒精相关的艾德就诊和相关费用，并提高年轻人的生活质量。该项目将为开发和传播更有效的技术和方案提供信息，以解决该年龄组艾德中的风险和依赖性饮酒问题，并更好地了解影响短暂干预有效性的因素，并预测美国种族和文化群体的成功患者结局。这将是第一个随机对照临床试验，与在墨西哥裔社区使用促进剂的简单干预的标准护理相比，这可能比使用艾德工作人员提供者提供更好的机会在艾德中持续实施SBIRT。

项目成果

Preparing Mexican-Origin Community Health Advocates (Promotores) to Conduct SBIRT for Problem Drinking in the Emergency Room.

让墨西哥裔社区健康倡导者 (Promotores) 做好准备，在急诊室针对饮酒问题进行 SBIRT。

• DOI: 10.1177/2373379918756425
• 发表时间: 2018
• 期刊: Pedagogy in health promotion
• 作者: Ramos,Rebeca;Cherpitel,CherylJ;Alvarez,Jose;Beltran,Oscar;Woolard,Robert;Villalobos,Susana;Bernstein,Judith;Bernstein,Edward
• 通讯作者: Bernstein,Edward

Brief Intervention for Emergency Department Patients with Alcohol Misuse: Implications for Current Practice.

对急诊科酒精滥用患者的简短干预：对当前实践的影响。

• DOI: 10.1080/07347324.2011.557978
• 发表时间: 2011
• 期刊: Alcoholism treatment quarterly
• 影响因子: 0.9
• 作者: Woolard,Robert;Cherpitel,Cheryl;Kathleen,Thompson
• 通讯作者: Kathleen,Thompson

Smoking Is Associated with Increased Risk of Binge Drinking in a Young Adult Hispanic Population at the US-Mexico Border.

• DOI: 10.1080/08897077.2014.987945
• 发表时间: 2015
• 期刊: Substance abuse
• 影响因子: 3.5
• 作者: Woolard R;Liu J;Parsa M;Merriman G;Tarwater P;Alba I;Villalobos S;Ramos R;Bernstein J;Bernstein E;Bond J;Cherpitel CJ
• 通讯作者: Cherpitel CJ

DRINKING PATTERNS AND DSM-IV ALCOHOL USE DISORDERS' CRITERIA IN ARGENTINEAN EMERGENCY DEPARTMENT PATIENTS.

阿根廷急诊科患者的饮酒模式和 DSM-IV 酒精使用障碍标准。

• 发表时间: 2010
• 期刊: Journal of drug addiction, education, and eradication
• 作者: Cremonte,Mariana;Cherpitel,CherylJ;Borges,Guilherme;Peltzer,RaquelI;Santángelo,PabloR
• 通讯作者: Santángelo,PabloR

Brief Intervention in the Emergency Department Among Mexican-Origin Young Adults at the US-Mexico Border: Outcomes of a Randomized Controlled Clinical Trial Using Promotores.

对美墨边境墨西哥裔年轻人急诊室的简短干预：使用 Promotores 的随机对照临床试验的结果。

• DOI: 10.1093/alcalc/agv084
• 发表时间: 2016
• 期刊: Alcohol and alcoholism (Oxford, Oxfordshire)
• 作者: Cherpitel,CherylJ;Ye,Yu;Bond,Jason;Woolard,Robert;Villalobos,Susana;Bernstein,Judith;Bernstein,Edward;Ramos,Rebeca
• 通讯作者: Ramos,Rebeca