Multidisciplinary Approach to Reduce Injury and Alcohol Use

描述（由申请人提供）：需要对处于不同变化阶段的受伤患者进行短暂酒精干预的不同有效性进行系统评价。已经对受伤的患者进行了几项短暂酒精干预的随机试验（Bazargan-Hejazi等人，2005; Gentilello等人，1999; Longabaugh等人，2001; Monti等人，1999，Mello等人，2005）。总的来说，这些研究表明，对受伤患者进行短暂的酒精干预可以有效地减少酒精摄入量和相关后果，包括伤害再犯。然而，对受伤患者的单一简短干预并没有被证明对所有接受酒精相关损伤治疗的患者群体有效。正如目前的研究所建议的那样，一些受伤的患者可能需要一个助推器会议，以实现积极的治疗结果，其他人可能需要转诊进行额外的治疗。不同强度的干预需求可能与客户的准备程度或变化阶段有关。该提案假设，助推器会话的必要性取决于患者在治疗酒精相关损伤时改变其饮酒行为的动机。此外，目前拟议的研究将扩大目前的调查结果，对受伤患者的简短干预，包括治疗转诊和减少伤害的组成部分的评价。后续治疗利用是酒精依赖和共病疾病（包括药物依赖或抑郁症）患者以及有心理社会问题（如无家可归）患者的一个特别重要的关注结果。先前对受伤患者进行短暂干预的研究排除了患有共病心理社会问题的患者群体，并发现严重酒精问题患者的有效性有限。因此，对成年受伤患者的研究结果的普遍性可能是有限的，这种方法在更广泛的受伤患者人群中的有效性仍然未知。通过解决上述关键问题，本研究将巩固和扩大我们目前的理解，对受伤患者的各种简短的干预策略的效用，并将显着提高临床有效性和普遍性，目前的研究结果。

DESCRIPTION (provided by applicant): A systematic evaluation of the differential effectiveness of brief alcohol interventions with injured patients at various stages of change is needed. Several randomized trials of brief alcohol interventions have been conducted with injured patients (Bazargan-Hejazi et al, 2005; Gentilello et al.,1999; Longabaugh et al., 2001; Monti et al.,1999, Mello et al, 2005). In general, these studies demonstrate that brief alcohol interventions with injured patients may effectively reduce alcohol intake and related consequences, including injury recidivism. However, a single brief intervention with injured patients has not proven effective with all patient populations presenting for treatment of an alcohol related injury. As suggested by current research, some injured patients may need a booster session to achieve positive treatment outcomes and others may require referral for additional treatment. The need for intervention at different levels of intensity may be associated with the client's readiness or stage of change. This proposal hypothesizes that the necessity of a booster session is dependent upon the patient's motivation to change their drinking behavior at the time they present for treatment of an alcohol related injury. Further, the currently proposed study will extend current findings regarding brief intervention with injured patients to include an evaluation of the treatment referral and harm reduction components. Subsequent treatment utilization is a particularly important outcome of interest among patients with alcohol dependence and comorbid disorders including drug dependence or depression as well as those with psychosocial problems such as homelessness. Prior studies of brief intervention with injured patients have excluded patient groups with comorbid psychosocial problems and found limited effectiveness among patients with severe alcohol problems. As a result, the generalizibility of findings to adult injured patients may be limited and the effectiveness of this approach in the broader population of injured patients remains unknown. By addressing the key issues described above, this study will consolidate and expand our current understanding regarding the utility of various brief intervention strategies with injured patients and will significantly enhance the clinical effectiveness and generalizability of current findings.