ReDIAL: A Telephone Brief Intervention for Injured Emergency Department Patients

ReDIAL：针对急诊科受伤患者的电话简短干预

• 批准号: 8230786
• 负责人: Michael J Mello
• 金额: $ 70.37万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8230786
• 关键词: Accident and Emergency department; Accounting; Address; Adoption; Affect; Alcohol abuse; Alcohol consumption; Alcohols; Appointment; Area; Attenuated; Automobile Driving; Back; Behavior; Behavior Therapy; Centers for Disease Control and Prevention (U.S.); Communities; Consent; Control Groups; Coupled; Data; Data Analyses; Distal; Education; Educational Intervention; Effect Modifiers (Epidemiology); Effectiveness; Effectiveness of Interventions; Elements; Emergency Medicine; Equation; Evaluation; Event; Face; Frequencies; Funding; Future; Goals; Guidelines; Health; Health Services Accessibility; Home environment; Hospitals; Impulsivity; Individual; Injury; Intervention; Life; Link; Measurement; Measures; Mediating; Mediation; Mediator of activation protein; Modeling; National Institute on Alcohol Abuse and Alcoholism; Nature; Outcome; Participant; Pathway interactions; Patient Self-Report; Patients; Population; Populations at Risk; Predisposition; Prevalence; Probability; Proxy; Questionnaires; Randomized; Readiness; Recruitment Activity; Relative (related person); Research; Research Design; Resources; Risk; Safety; Screening procedure; Series; Services; Severities; Site; Strategic Planning; Structural Models; System; Target Populations; Telephone; Testing; Time; Treatment Factor; Treatment outcome; Vehicle crash; Visit; Work; active method; alcohol abuse therapy; alcohol intervention; behavior change; brief alcohol intervention; brief intervention; clinical care; cost; cost effective; cost effectiveness; design; direct application; dosage; drinking; driving behavior; experience; high risk drinking; impaired driving performance; improved; injured; intervention effect; longitudinal analysis; motivational enhancement therapy; novel; prevent; programs; psychosocial; screening and brief intervention; success; theories; therapy development; tool; treatment as usual; treatment effect

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.

描述（由申请人提供）：本研究项目的长期目标是减少在医院急诊科（ED）就诊的受伤患者的驾驶障碍、危险饮酒和与酒精相关的伤害。目前拟议的项目，ReDIAL，将在概念上复制、加强并寻求理解DIAL（最近完成的cdc资助的随机对照试验）的发现，该研究确定了电话简短干预（TBI）在减少酒后驾驶和降低危险饮酒的受伤ED患者中酒精相关伤害的频率方面的可接受性和有效性。ReDIAL的主要目的是：检查更密集的电话脑损伤（增加脑损伤加强期）对1)高风险酒精使用和酒精相关伤害的影响；2)驾驶障碍及其他与驾驶相关的不良后果；3)估计筛查加TBI的成本效益；4)确定TBI对近端和远端预后影响的变化机制和治疗的有效成分；5)识别和评估患者易感性对脑损伤与危险驾驶和酒精伤害变化之间关系的影响。本研究将招募对危险饮酒（即超过NIAAA量/频率指南）筛查呈阳性的受伤ED患者。符合条件的患者将在急诊科获得同意，并将在1周内收到初次联系电话的预约。在最初的电话中，研究参与者将收到一份评估，然后将被随机分为两组：1)脑外伤组或2)家庭安全教育项目的对照对照组。这两项都将通过三次电话会议提供：首次电话（随机化后立即）和两次加强电话在随机化后2周和6周。在随机分组后4、8和12个月，评估参与者的危险酒精使用水平、酒精相关伤害、驾驶障碍和其他与驾驶相关的负面后果。ReDIAL解决了NIAAA 2008-2013年战略计划中的一个重点领域，即确定加强筛查、简短干预和适当转诊到额外服务的策略，以及PA-07-066研究目标：识别和评估行为治疗行动的机制，制定有效的策略，旨在协助系统识别和实施适当的经验支持的干预措施。在美国，每年有3000万例外伤患者到急诊科就诊，而且急诊科患者中有20-30%的高危酒精使用，ReDIAL在实现其目标方面的成功，有可能使TBI成为常规急诊科临床护理的一部分，并预防未来的损伤发生。