Preventing Alcohol/Prescribed Drug Misuse in the National Guard: Web and Peer BI

防止包括预备役在内的军事人员滥用酒精和处方阿片类药物/镇静剂 组件，现役士兵和退伍军人是国家优先事项。军方正面临一场危机， 有问题的酒精和处方药使用，特别是阿片类药物和镇静剂滥用， 需要有效的预防和早期干预。使用酒精和/或阿片类药物/镇静剂的服务人员 (AOS)滥用有可能导致不良后果，如受伤、工作表现下降、心理健康 问题、自杀和艾滋病毒/其他性传播感染。尽管对平民的研究表明， 筛查、短暂干预和转诊治疗（SBIRT）方法可以减少药物使用， 问题，这些协议还没有得到充分的研究，在军事人员。这项研究还 指出需要采取战略来加强收益，以维持短暂干预（BI）的效果，但 这些干预措施的“助推器”尚未得到充分研究。新兴技术，如基于Web的 提供干预措施和助推器提供了机会，定制SBIRT干预措施和解决 军事人员的地理障碍，如陆军国民警卫队（NG）。此外，同行外联 干预措施在军事界具有很高的可接受性。BuddytoBuddy同伴支持 程序，将加强，包括AOS误用在这项研究中，已成功地用于NG单位。的 一项拟议的研究将在30个月的招募期内筛选约4,300名独特的个体，作为士兵的一部分。 密歇根州陆军NG的准备就绪处理，以确定750名年龄在18-60岁之间的参与者， 处方阿片类药物或镇静剂滥用。通过触摸屏电脑平板电脑筛选将用于招募NG 在过去3个月内滥用酒精/处方阿片类药物或镇静剂的成员。参与者将被 随机分为三种情况之一：1）网络提供的酒精/处方药物滥用短暂干预， 网络助推器会议（W+W; n=250）; 2）网络提供的简短干预与同行提供的助推器会议 （W+P; n=250）;或3）加强的家庭护理（EUC; n=250）。这项研究的目的是开发、完善和测试 量身定制的激励性BI与各种持续的助推器强化（网络与同行），并进行 一项随机对照试验，比较这些BI（W+W; W+P）与常规治疗对随后的 酒精/毒品消费及其后果，包括伤害、身心健康功能和艾滋病毒 入组后4个月、8个月和12个月的风险行为。随机分配将按性别分层， 酒精与处方阿片类药物/镇静剂滥用。这项研究将直接向领导层和关键部门提供信息， 利益相关者了解最先进的基于技术的BI的影响，结合Web助推器或同行 外展，在NG军事人员，以打击日益扩大的酒精/处方药问题之间 美国预备役部队和现役士兵。如果成功的话，研究的结果将提高翻译 并可能对公众健康产生重大影响。

Preventing alcohol and prescribed opioid/sedative misuse among military personnel including Reserve components, active duty soldiers, and Veterans is a national priority. The military is facing a crisis related to problematic alcohol and prescription drug use, particularly opioid and sedative misuse, and there is a critical need for effective prevention and early interventions. Service members with alcohol and/or opioid/sedative (AOS) misuse are at risk for poor outcomes such as injuries, reduced job performance, mental health problems, suicide, and HIV/other sexually transmitted infections. Although research in civilians indicates that Screening, Brief Intervention, and Referral to Treatment (SBIRT) approaches can reduce substance use and problems, these protocols have not been studied adequately in military personnel. This body of research also points to the need for strategies to reinforce gains in order to sustain Brief Intervention (BI) effects, but "boosters" to these interventions have not been well-studied. Emerging technologies, such as Web-based delivery of interventions and boosters provide the opportunity to tailor SBIRT interventions and address geographical barriers for military personnel such as the Army National Guard (NG). In addition, peer-outreach interventions have high levels of acceptability in military communities. The BuddytoBuddy peer support program, to be enhanced to include AOS misuse in this study, been used successfully in NG units. The proposed study will screen ~ 4,300 unique individuals over a 30-month enrollment period as part of Soldier Readiness Processing in the Michigan Army NG to identify 750 participants age 18-60 with alcohol and/or prescribed opioid or sedative misuse. Screenings via touch-screen computer tablets will be used to recruit NG members with alcohol/prescribed opioid or sedative misuse in the prior 3 months. Participants will be randomized to one of three conditions: 1) Web-delivered alcohol/prescribed drug misuse brief intervention with Web booster sessions (W+W; n=250); 2) Web-delivered brief intervention with Peer-delivered booster sessions (W+P; n=250); or 3) Enhanced Usual Care (EUC; n=250). The aims of the study are to develop, refine and test tailored motivational BIs with varied continuing booster reinforcements (Web vs. Peer) and to conduct a randomized controlled trial comparing the efficacy of these BIs (W+W; W+P) to usual care on subsequent alcohol/drug consumption and consequences, including injury, mental and physical-health functioning, and HIV risk behaviors at 4-, 8-, and 12-months post-enrollment. Random assignment will be stratified by gender and alcohol vs. prescription opioid/sedative misuse. The proposed study will directly inform leadership and key stakeholders about the impact of state-of-the-art technology-based BIs, combined with Web boosters or peer outreach, in NG military personnel to combat the growing scope of alcohol/prescription drug problems among U.S. reserve component and active duty soldiers. If successful, the results of the study will enhance translation to the general population and could have a major public health impact.