CBT by Phone to Promote Use of Alcohol Related Care and Reduce Drinking

摘要 已经开发了许多基于证据的酒精使用障碍（AUD）治疗方法，并且研究 研究表明，获得酒精专业护理的人改善了饮酒结果， 然而，只有一小部分患有AUD的个体获得治疗。使用筛选，简要 干预和转诊治疗（SBIRT）干预是增加治疗的潜在策略 然而，几乎没有证据表明这些干预措施增加了参与酒精相关护理的人数， 缺乏证据表明这种护理是改善饮酒结果的机制。当前 一项通过电话进行一次性干预的随机对照试验（RCT）旨在解决这些问题 证据的差距。具体的目的是表明，研究志愿者年龄18岁及以上的AUD谁是 与信息控制条件相比，分配到干预措施的人更有可能开始饮酒 专业护理（目标1），减少了饮酒频率（以戒酒天数百分比衡量）， 酒精使用强度（以每天饮酒量衡量）（目标2）和治疗参与 作为改善饮酒结果的中介（目标3）。创新包括使用SBIRT 基于计划行为理论和认知行为治疗原则的干预， 干预措施从一开始就针对电话管理而制定，其明确目的是促进 治疗参与。该项目是为了响应PA-15-299，酒精使用障碍：行为 治疗，服务和恢复研究。它建立在一个较小的疗效试验，表明， 干预导致参与酒精相关护理的增加（Stecker等人，2012年），并延伸到 通过几种方式进行研究，包括通过使用先验测试来确定干预措施的功效， 改善饮酒结果，治疗参与是改善结果的中介。

Abstract Numerous evidence based treatments for alcohol use disorder (AUD) have been developed, and research shows that individuals who obtain alcohol specialty care have improved drinking outcomes and are more likely to recover, yet a small percentage of individuals with AUD obtain treatment. Use of Screening, Brief Intervention, and Referral to Treatment (SBIRT) interventions is a potential strategy to increase treatment seeking, yet there is little evidence that these interventions increase participation in alcohol-related care and a lack of evidence that such care serves as a mechanism for improved drinking outcomes. The current randomized controlled trial (RCT) of a one session intervention delivered by telephone seeks to address these gaps in evidence. The specific aims are to show that research volunteers ages 18 and older with AUD who are assigned to the intervention compared to an information control condition are more likely to initiate alcohol specialty care (aim 1), have decreased frequency of alcohol use (as measured by percent days abstinent) and intensity of alcohol use (as measured by drinks per drinking day) (aim 2), and that treatment engagement serves as a mediator of the improved drinking outcomes (aim 3). Innovations include the use of an SBIRT intervention based on the theory of planned behavior and cognitive behavioral treatment principles and that the intervention was developed for phone administration from the onset and was explicitly designed to promote treatment engagement. The project is in response to PA-15-299, Alcohol Use Disorders: Behavioral Treatment, Services, and Recovery Research. It builds on a smaller efficacy trial that showed that the intervention leads to increased engagement in alcohol-related care (Stecker et al., 2012) and extends that study in several ways including through the use of a priori tests to determine efficacy of the intervention to improve drinking outcomes and that treatment engagement serves as a mediator of the improved outcomes.