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

防止包括预备役人员在内的军事人员滥用酒精和处方阿片类药物/镇静剂 部件、现役士兵和退伍军人是国家的优先事项。军方正面临一场与 有问题的酒精和处方药使用，特别是阿片类药物和镇静剂的滥用，并存在严重的 需要有效的预防和早期干预。服用酒精和/或阿片类药物/镇静剂的服役人员 滥用(AOS)有可能导致不良后果，如受伤、工作表现下降、精神健康 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)方法可以减少物质使用和 问题，这些方案还没有在军事人员中得到充分的研究。这一研究机构还 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”还没有得到很好的研究。新兴技术，如基于Web的 干预措施和助推器的提供提供了定制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，同行外展 干预措施在军事社区中的可接受性很高。伙伴对伙伴的同伴支持 该方案将得到加强，以便在本研究中包括AOS的滥用，该方案已在天然气装置中成功使用。这个 拟议的研究将在30个月的注册期内筛选约4300名独特的个人作为Soldier的一部分 密歇根陆军NG中的准备过程以识别750名年龄在18-60岁和/或酗酒的参与者 处方阿片类药物或镇静剂滥用。将通过触摸屏电脑平板电脑进行筛选，以招募新一代 在前3个月内滥用酒精/处方阿片类药物或镇静剂的成员。参与者将是 随机分为三种情况之一：1)网络传递酒精/处方药滥用短暂干预 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)加强日常护理(EUC；n=250)。研究的目的是开发、改进和测试 量身定制的激励性BIS，具有各种持续的助推器增援(Web与Peer)，并进行 随机对照试验比较这些BIS(W W；W P)与常规护理在后续护理中的疗效 酒精/药物消费及其后果，包括伤害、心理和身体健康功能以及艾滋病毒 登记后4个月、8个月和12个月的危险行为。随机分配将按性别和 酒精与处方阿片类药物/镇静剂滥用。拟议的研究将直接告知领导层和关键 利益相关者对基于最先进技术的BIS的影响，与Web助推器或同行相结合 外展，在新的军事人员中打击范围越来越大的酒精/处方药问题 美国预备役军人和现役军人。如果研究成功，研究结果将促进翻译 对普通民众来说，并可能对公共卫生产生重大影响。

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.