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Family Intervention for Teen Drinking and Alcohol-related Crises in the ER

急诊室青少年饮酒和酒精相关危机的家庭干预

基本信息

批准号：
8270524
负责人：
CYNTHIA Lyn ROWE
金额：
$ 65.54万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-05-01 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8270524
关键词：
Abstinence Accident and Emergency department Acute Address Adolescence Adolescent Adult Aftercare Age Alcohol abuse Alcohol consumption Alcohol dependence Alcohol or Other Drugs use Alcoholism Alcohols American Area Automobile Driving Behavior Behavior Therapy Caring Chronic Clinical Communities Continuity of Patient Care Costs and Benefits Development Diagnostic Distress Drug abuse Drug usage Effectiveness Emergency Situation Enrollment Etiology Family Family Relationship Family Research Family member Family psychotherapy Foundations Functional disorder Growth Health Healthcare Home environment Hospitals Hour Injury Intake Intervention Knowledge Link Mediator of activation protein Medical Mental Health Mental disorders Methods Modeling Motivation National Institute on Alcohol Abuse and Alcoholism Outcome Parenting behavior Parents Participant Pattern Pediatric Hospitals Pharmaceutical Preparations Policy Maker Preventive Intervention Provider Public Health Randomized Randomized Controlled Trials Recommendation Relapse Relative (related person)Reporting Research Research Personnel Research Priority Risk Risk Behaviors Risk Factors Risk-Taking Role Sampling Schools Services Societies Surgeon System Techniques Teenagers Testing Therapeutic Time United States Substance Abuse and Mental Health Services Administration Universities Visit Vulnerable Populations Youth adolescent alcohol adolescent alcohol abuse adolescent drug abuse adolescent substance abuse alcohol abuse therapy alcohol expectancy alcohol intervention alcohol measurement alcohol relapse alcohol research alcohol services base binge drinking control trial coping cost cost effective design drinking effective intervention effective therapy family influence follow-up group intervention improved innovation intervention effect medical specialties meetings motivational enhancement therapy parental influence peer prevent problem drinker reduced alcohol use response standard care substance abuse treatment trauma centers trauma units treatment center treatment duration treatment effect treatment program underage drinker underage drinking underage drinking reduction

项目摘要

DESCRIPTION (provided by applicant): Alcohol continues to be the drug of choice among American youth and teen drinking remains one of the nation's most serious public health problems. Yet in the Surgeon General's recent "Call to Action to Prevent and Reduce Underage Drinking" (USDHHS, 2007), he asserted that "underage drinking is not inevitable, and schools, parents, and other adults are not powerless to stop it." Accordingly, in line with scientific recommendations and NIAAA's (2006) research priorities, we propose to further develop and rigorously test two family interventions for adolescent alcohol problems, Multidimensional Family Therapy (MDFT) and a Family Motivational Interviewing Intervention (FMII). Family interventions have strong research and clinical traditions in the treatment of adult alcoholism and adolescent drug abuse, but little research has focused on family interventions for teen drinking. In this controlled trial, 250 youth ages 12 to 18 with alcohol-related crises in the ER or trauma center will be randomized to one of these two family interventions or to standard care. Both family interventions, MDFT and FMII, aim to potentiate the influence of the family to motivate and help youth to change, but they rely on different theoretical foundations and clinical techniques. Both family interventions provide 2 initial engagement sessions in the homes of participants within 72 hours of the ER visit. Youth in MDFT will then be engaged into a full course (3 months) of this family-centered treatment, and FMII youth will be enrolled into 3 months of behaviorally oriented 12-step group treatment. Standard care participants will be referred to the same group treatment as youth in FMII, but will receive no engagement or family sessions. We propose a randomized controlled trial with five aims: 1. To investigate the engagement potential and effectiveness of a family-centered intervention (MDFT) and Family Motivational Interviewing Intervention (FMII)/group for teens with alcohol-related crises; 2. To explore differential treatment effects with comorbid adolescents; 3. To examine the role of motivation and family factors as treatment mediators; 4. To examine long-term abstinence, patterns and predictors of relapse up to 18 months follow-up; and 5. To compare the total and net monetary benefits to society of MDFT, FMII/group, and standard care. A multiple time point (intake, 3, 6, 9, 12, and 18 month follow-up), multiple domain and method assessment approach will be used to compare the interventions on their engagement and retention rates, clinical outcomes, and total and net monetary benefits to society. Latent growth curve modeling and other state-of-the-art statistical techniques will be used to test study hypotheses regarding adolescent and family change over time, differential effects of the interventions on comorbid youth, the mechanisms by which the treatments achieve their effects, and relapse patterns and predictors. The study has significant potential to advance adolescent alcohol treatment by providing new knowledge to providers and policy makers about effective and cost-beneficial family interventions for youth identified with alcohol problems in the ER and ultimately in other health care settings.

描述（由申请人提供）：酒精仍然是美国青少年的首选药物，青少年饮酒仍然是美国最严重的公共卫生问题之一。然而，在卫生局局长最近的“预防和减少未成年人饮酒行动呼吁”（USDHHS，2007 年）中，他断言“未成年人饮酒并非不可避免，学校、家长和其他成年人也并非无能为力”。因此，根据科学建议和 NIAAA（2006）的研究重点，我们建议进一步开发和严格测试针对青少年酒精问题的两种家庭干预措施，即多维家庭治疗（MDFT）和家庭动机访谈干预（FMII）。家庭干预在治疗成人酗酒和青少年药物滥用方面有着强大的研究和临床传统，但很少有研究关注青少年饮酒的家庭干预。在这项对照试验中，急诊室或创伤中心的 250 名 12 至 18 岁患有酒精相关危机的青少年将被随机分配接受这两种家庭干预措施之一或接受标准护理。 MDFT和FMII这两种家庭干预措施都旨在增强家庭的影响力，以激励和帮助青少年改变，但它们依赖于不同的理论基础和临床技术。两种家庭干预措施均在急诊室就诊后 72 小时内在参与者家中提供 2 次初步参与会议。 MDFT 中的青少年将参加以家庭为中心的完整疗程（3 个月），FMII 青少年将参加为期 3 个月的以行为为导向的 12 步小组治疗。标准护理参与者将接受与 FMII 中的青少年相同的团体治疗，但不会接受参与或家庭会议。我们提出一项随机对照试验，有五个目标： 1. 调查以家庭为中心的干预措施 (MDFT) 和家庭动机访谈干预 (FMII)/小组对有酒精相关危机的青少年的参与潜力和有效性； 2. 探讨共病青少年的差异化治疗效果； 3. 检验动机和家庭因素作为治疗中介的作用； 4. 检查长达 18 个月随访的长期戒断情况、模式和复发预测因素； 5. 比较 MDFT、FMII/团体和标准护理给社会带来的总货币效益和净货币效益。将使用多时间点（摄入、3、6、9、12 和 18 个月的随访）、多领域和方法评估方法来比较干预措施的参与度和保留率、临床结果以及对社会的总和净货币效益。潜在生长曲线模型和其他最先进的统计技术将用于测试有关青少年和家庭随时间变化的研究假设、干预措施对共病青少年的不同影响、治疗实现效果的机制以及复发模式和预测因素。该研究通过向医疗服务提供者和政策制定者提供新知识，为在急诊室以及最终在其他医疗机构中发现有酒精问题的青少年提供有效且具有成本效益的家庭干预措施，从而具有推进青少年酒精治疗的巨大潜力。