Barriers to Entry into Couples' Treatment of Problematic Alcohol Use

描述(由申请人提供)：酒精使用问题有重要的公共卫生后遗症，并与许多以关系为导向的负面后果有关，包括关系不和谐和亲密伴侣暴力(IPV)。因此，有问题的酒精使用对被确认的患者以及那些与酗酒者有密切关系的人都有影响。越来越多的证据表明，与酒精问题的单独治疗相比，酒精中毒的行为伴侣疗法更有效地降低了IPV，提高了关系满意度，这与酒精使用发生在家庭系统内的观点一致。然而，尽管存在对有问题的酒精使用的高效治疗方法，并伴随着关系和非关系领域的改善，但事实证明，招募夫妇接受治疗是困难的，特别是在社区环境中。很少有研究对夫妇治疗酒精问题的准入门槛进行评估，因此难以针对阻止夫妇进入并参与现有有效治疗的因素。为了让研究人员和临床医生有效地将治疗传播给需要服务的个人，需要对进入治疗的障碍进行评估。这项研究旨在通过在NIH路线图网络项目中确定的以下步骤来帮助了解治疗进入的障碍：患者报告的结果测量信息系统(PROIS)。PROMIS结合了题库、定性访谈和定量方法，以开发区分寻求治疗和不寻求治疗的个人的项目。我们将在三个治疗环境中与患者、他们的伴侣以及治疗酒精问题和关系不和谐的专家一起进行这些信息收集程序。基于我们通过题库和定性访谈收集的数据，我们将开发自我报告的项目，以衡量进入治疗的障碍。在条目派生之后，我们将在现场测试条目，并使用条目反应理论方法进行量化条目分析，以评估条目的心理测量学特性。总而言之，这项拟议的研究涉及一种混合方法，以收集有关夫妇治疗酒精问题的门槛的信息，然后对项目进行心理测量评估。对已开发物品的管理将允许确定和确定进入夫妇在不同治疗环境中有问题的酒精使用的治疗的障碍。

DESCRIPTION (provided by applicant): Alcohol use problems have important public health sequelae, and are associated with a number of relationship-oriented negative outcomes, including relationship discord and intimate partner violence (IPV). Thus, problematic alcohol use has implications for both the identified patient, as well as those who are engaged in close relationships with alcohol abusing individuals. Consistent with the notion that alcohol use occurs within a family system, growing evidence suggests that behavioral couple therapy for alcoholism decreases IPV and increases relationship satisfaction more effectively than individual treatments for alcohol problems. However, despite the existence of highly efficacious treatments for problematic alcohol use and attendant improvements in relationship and non-relationship domains, recruitment of couples into treatment has proven difficult, particularly in community settings. Few studies have evaluated the barriers to entry for couples' treatment of alcohol problems with resulting difficulty in targeting factors that prevent couples from entering and engaging in available efficacious treatments. In order for researchers and clinicians to effectively disseminate treatments to individuals who are in need of services, research evaluating barriers to treatment entry is required. This study aims to contribute to knowledge of barriers to treatment entry by following steps identified within the NIH Roadmap network project: Patient-Reported-Outcomes Measurement Information System (PROMIS). PROMIS incorporates item banking, qualitative interviews, and quantitative methods to develop items that distinguish between individuals who seek versus those who do not seek treatment. We will conduct these information gathering procedures with patients in three treatment settings, with their partners, and with experts in the treatment of alcohol problems and of relationship discord. Based on data we collect through item banking and qualitative interviews, we will develop items for a self-report measure of barriers to treatment entry. Following item derivation, we will test items in the field with a sample of patients and partners, and conduct quantitative item analysis using item response theory methods to evaluate the psychometric properties of items. In sum, the proposed study involves a mixed methods approach to gathering information about barriers to entry for couples' treatment of alcohol problems, followed by psychometric assessment of items. Administration of the developed items will permit the identification and targeting of barriers to entry into couples' treatment of problematic alcohol use within diverse treatment settings.