ReDIAL: A Telephone Brief Intervention for Injured Emergency Department Patients

描述（由申请人提供）：本研究计划的长期目标是减少医院急诊科（艾德）受伤患者中的驾驶障碍、危险饮酒和酒精相关损伤。目前拟议的项目ReDIAL将在概念上复制、加强和寻求理解DIAL（最近完成的CDC资助的随机对照试验）的结果，该研究确定了电话简短干预（TBI）在减少有风险饮酒的受伤艾德患者的驾驶障碍和降低酒精相关伤害频率方面的可接受性和有效性。Redial的主要目标是：检查更密集的电话BI的影响（增加了TBI的助推器会议）1）危险的酒精使用和酒精相关的伤害; 2）受损的驾驶和其他驾驶相关的负面后果; 3）估计筛查加TBI的成本效益4）确定解释TBI对近端和远端结果的影响的变化机制和治疗的活性成分;以及5）识别和评估患者倾向对TBI与危险驾驶和酒精损伤的变化之间的关系的影响。本研究将招募危险酒精使用筛查呈阳性（即超过NIAAA数量/频率指南）的受伤艾德患者。合格患者将在艾德获得知情同意，并将在1周内接受首次电话联系预约。在最初的电话中，研究参与者将接受评估，然后将被随机分为两种情况之一：1）TBI或2）具有家庭安全教育计划的比较对照组。将通过三次电话会议提供这两种信息：首次电话会议（随机化后立即）和随机化后2周和6周的两次加强电话会议。在随机化后4、8和12个月，评估参与者的危险酒精使用、酒精相关损伤、驾驶受损和其他驾驶相关负面后果的水平。ReDIAL解决了NIAAA 2008-2013年战略计划中的一个重点领域，确定了加强筛查、简短干预和适当转介到其他服务的战略，以及PA-07-066研究目标：识别和评估行为疗法的作用机制，并制定有效的策略，旨在帮助系统识别和实施适当的经验-支持干预。美国艾德每年因受伤就诊3000万次，艾德患者中危险饮酒的患病率在20-30%之间，ReDIAL在实现其目标方面的成功有可能使TBI成为常规艾德临床护理的可接受部分，并预防未来的伤害发生。

DESCRIPTION (provided by applicant): The long-term goal of the present program of research is to reduce impaired driving, risky drinking and alcohol- related injuries among injured patients who present in a hospital emergency department (ED). The current proposed project, ReDIAL, will conceptually replicate, strengthen and seek to understand the findings of DIAL (recently completed CDC-funded RCT), which established the acceptability and effectiveness of telephone- delivered brief intervention (TBI) in reducing impaired driving and decreasing the frequency of alcohol-related injuries among injured ED patients with risky alcohol use. ReDIAL primary aims are to: examine the effects of a more intensive telephone BI (added booster session of TBI) on 1) risky alcohol use and alcohol related injuries; 2) impaired driving and other driving related negative consequences; 3) estimate the cost effectiveness of screening plus TBI 4) identify mechanisms of change and the active ingredients of treatment that explain the effect of TBI on proximal and distal outcomes; and 5) identify and assess the effect that patient predispositions have on the relationship between TBI and changes in risky driving and alcohol injuries. This study will recruit injured ED patients who screen positive for risky alcohol use (i.e. exceed NIAAA quanity/frequency guidelines). Eligible patients will be consented in the ED and will receive an appointment for an initial contact call within 1 week. At the initial telephone call the research participant will receive an assessment and then will be randomized into one of two conditions: 1) TBI or 2) a comparison control group with a home safety educational program. Both will be provided over three telephone sessions: the initial call (immediately following randomization) and two booster calls at 2 weeks and 6 weeks after randomization. Participants are assessed for levels of risky alcohol use, alcohol-related injuries, impaired driving, and other driving related negative consequences at 4, 8, and 12 months post-randomization. ReDIAL addresses a focus area in the NIAAA 2008-2013 strategic plan in identifying strategies to enhance screening, brief interventions, and appropriate referrals to additional services and PA-07-066 research objectives: identification and evaluation of mechanisms underlying the actions of behavioral therapies and the development of effective strategies aimed at assisting systems to identify and implement appropriate empirically-supported interventions. With 30 million yearly US ED visits for injuries and the prevalence of risky alcohol use between 20-30% in ED patients, ReDIAL's success in achieving its aims has the potential for TBI to become an accepted part of routine ED clinical care and prevent future injury occurrence.