Intensive Referral to Al-Anon: Benefits to Concerned Others and Their Drinkers

密集转介给 Al-Anon：对关心他人及其饮酒者的好处

• 批准号: 9337318
• 负责人: Michael Anthony Cucciare
• 金额: $ 42.25万
• 依托单位: PALO ALTO VETERANS INSTIT FOR RESEARCH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9337318
• 关键词: Abstinence; Address; Adherence; Adoption; Adult; Affect; Al-Anon; Alcohol abuse; Alcoholics Anonymous; Alcoholism; Clinical; Data; Disease; Domestic Violence; Effectiveness; Equation; Family; Family member; Foundations; Friends; Funding; Gender; Goals; Health; Health Personnel; Hybrids; Individual; Intake; Intervention; Knowledge; Life; Literature; Longitudinal Studies; Mediator of activation protein; Medical; Mental disorders; Methodology; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Patients; Persons; Public Health; Published Comment; Quality of life; Randomized Controlled Trials; Recovery; Research; Resources; Rewards; Site; Social Functioning; Source; Substance Addiction; Substance Use Disorder; Support Groups; Training; United States; Veterans; Work; World Health Organization; addiction; alcohol abuse therapy; alcohol use disorder; base; community based treatment; coping; design; drinking; evidence base; help-seeking behavior; improved; improved outcome; innovation; interest; intervention effect; meetings; member; negative affect; peer; problem drinker; programs; psychological symptom; research study; treatment as usual; treatment program; trial design; uptake

Project Abstract: At least 100 million adults worldwide are adversely affected by the substance addiction of a close relative. Al-Anon Family Groups, a 12-step mutual-help program for people concerned about another’s drinking, is widely available and effective. However, there is a critical lack of knowledge about how to facilitate Al-Anon participation among concerned others (COs), and the extent to which Al-Anon also benefits drinkers. This unique study will examine the effectiveness of Al-Anon Intensive Referral (AIR) with COs of individuals in treatment for alcohol use disorders (“drinkers”). AIR’s goal is to facilitate Al-Anon participation and positive outcomes (e.g., better quality of life, active coping) among COs. The project will also examine the extent to which AIR is associated with treatment engagement, Alcoholics Anonymous (AA) participation, and positive outcomes among drinkers. Although literature on alcoholism as a family disorder frequently states that COs positively influence drinkers’ outcomes, data from methodologically strong studies are sorely lacking. This project builds on two main lines of research by this study team: (1) implementing and showing the effectiveness of Intensive Referral, a 12-step facilitation method, to increase AA participation and improve outcomes among patients in treatment for substance use disorders, and their COs; and (2) a recent NIAAA longitudinal R21 study to identify the benefits and mechanisms of Al-Anon participation to newcomers, members, and their drinkers. In a randomized controlled trial of AIR, this 4-year project has three Specific Aims. Aim 1: Implement AIR at three sites (Little Rock, AR; Omaha, NE; Palo Alto, CA) to evaluate AIR’s effectiveness for COs. COs (N=534) and their drinkers (N=534) will be assessed at baseline and 3-month, 6-month, and 1-year follow-ups. Hypotheses are that, compared to usual care, AIR will (1A) accelerate help-seeking and increase Al-Anon participation, and (1B) improve CO outcomes. Aim 2: Evaluate AIR’s effectiveness for drinkers. Hypotheses are that AIR will be associated with drinkers having (2A) more treatment and AA participation, and (2B) better drinking outcomes. We will examine Aims 1 and 2 using generalized mixed-effects regression models (GLMM). Aim 3: Examine AIR’s mechanisms of action (mediators and moderators). In addition, we will examine reciprocal effects of CO and drinker functioning using Structural Equation Modeling (SEM). This project is built on the foundation that it is essential to help COs because of their own suffering. In addition, it is essential to help COs in order to help drinkers (whose better functioning, in turn, also helps COs). In contrast to other family-based approaches to addiction treatment, AIR is feasible to deliver in real-world treatment programs, requiring few resources. After completing this RCT, if AIR is shown to be effective, the next step in this research program will be to conduct an implementation study (Hybrid Type 2) to disseminate and sustain AIR across treatment programs, thereby helping COs and drinkers.

项目摘要：全球至少有1亿成年人受到一种药物成瘾的不利影响 近亲。Al-Anon家庭小组，为关心他人的人提供12步互助计划 饮酒，随处可见，而且有效。然而，人们严重缺乏关于如何促进 Al-Anon在关心的其他人中的参与(Cos)，以及Al-Anon也在多大程度上使饮酒者受益。 这项独特的研究将检验Al-Anon强化转诊(AIR)与COS的有效性 治疗酒精使用障碍的个人(“饮酒者”)。AIR的目标是促进Al-Anon的参与 和积极的结果(例如，更好的生活质量，积极的应对)。该项目还将审查 空气与治疗参与、戒酒互助会(AA)参与的程度有关，以及 饮酒者中的积极结果。尽管关于酗酒作为一种家庭障碍的文献经常指出 因为这对饮酒者的结果有积极的影响，所以从方法论上强有力的研究中得出的数据非常缺乏。 这个项目建立在这个研究小组的两条主线研究的基础上：(1)实施和展示 强化转介的有效性，这是一种12步促进方法，可增加AA的参与度并改善 药物使用障碍患者的治疗结果和他们的COS；和(2)最近的NIAAA R21纵向研究，以确定Al-Anon参与对新来者的好处和机制， 会员和他们的饮酒者。 在AIR的随机对照试验中，这个为期4年的项目有三个具体目标。目标1：实施 在三个地点(阿肯色州小石城、内华达州奥马哈、加利福尼亚州帕洛阿尔托)评估AIR对CoS的有效性。COS (N=534)及其饮酒者(N=534)将在基线以及3个月、6个月和1年的随访中进行评估。 假设是，与通常的护理相比，空气将(1A)加速求助并增加Al-Anon 参与，以及(1B)改善CO结果。目标2：评估空气对饮酒者的有效性。假设 空气是否会与饮酒者有更多的治疗和AA参与有关，以及(2B)更好 饮酒结果。我们将使用广义混合效应回归模型来检验目标1和目标2 (GLMM)。目标3：研究空气的作用机制(调节剂和调节剂)。此外，我们还将 使用结构方程模型(SEM)检验一氧化碳和饮酒者功能之间的相互影响。 这个项目是建立在这样一个基础上的，那就是帮助Cos因为他们自己的痛苦是必不可少的。在……里面 此外，为了帮助饮酒者(他们更好的功能反过来也有助于Cos)，帮助Cos是至关重要的。 与其他以家庭为基础的成瘾治疗方法不同，空气在现实世界中是可行的 治疗方案，只需要很少的资源。完成此RCT后，如果空气被证明有效， 此研究计划的下一步将是进行实施研究(混合类型2)，以传播 并在治疗计划中保持空气，从而帮助COS和饮酒者。