A cluster-randomized trial of a behavioral activation intervention administered in a college freshman orientation course

摘要 从高中到大学的过渡是一个发展敏感期，对 酒精使用量的上升。尽管危险饮酒在新生中是一个常见的问题，但参与 治疗服务非常低。与治疗资源的参与率较低可能是因为 在学生可能对改变饮酒不感兴趣的时候，干预措施直接针对饮酒。 此外，由于有针对性地关注酒精使用，目前的干预措施也没有解决以下问题 新生入学，如压力大、睡眠差等。解决学生最关心的问题的方法 关注，这也间接减少饮酒，可能会特别有效。 行为激活(BA)是一种通过引导间接治疗精神病的干预措施 个人确定他们生活中的目标，并鼓励个人参与加强以下活动 与他们的目标保持一致(Lejuez等人，2001)。虽然BA最初用于治疗抑郁症，但它已经有效地 适用于物质使用，因为BA作用于与问题饮酒有关的相同强化过程。 BA通过专注于加强参与来解决饮酒而不是具体提到酒精使用的问题 符合学生目标的活动。一项初步研究提供了初步迹象，即短暂的BA干预 在为期一学期的新生迎新课程中，饮酒量显著减少。 与标准取向相比的相关问题(雷诺兹等人)。2011年)。值得注意的是，这种方法从未提出 喝酒的问题，除非是学生自己提出来的。 这项研究的目的是进行一项完全有效的整群随机试验，测试BA管理 在为期一学期(16周)的新生迎新课程中，与540岁的标准迎新课程相比 新生分布在36个课程部分(文学士和标准迎新形式各18个部分)。A 5- 一个月的治疗后评估将衡量效果的持久性。调解分析将测试机制 行动的一部分。有了这个建议的R01，我们将测试与BA的有希望的干预，解决限制因素 通过不直接针对酒精和通过将干预融入大学来参与其他项目 此外，还有对调解人进行测试的好处，以指导今后的工作。此应用程序表示一个 制定干预课程的第一步，该课程可以广泛传播，以解决顽固的 大学生饮酒问题及其诸多后果。

ABSTRACT The transition from high school to college is a developmentally sensitive period that is high risk for escalations in alcohol use. Although risky drinking is a common problem among freshmen, engagement in treatment services is very low. Low rates of engagement with treatment resources may occur because interventions target drinking directly at a time when students may be uninterested in changing their drinking. Moreover, with a targeted focus on alcohol use, current interventions also do not address the concerns of incoming freshmen, such as stress and sleep. Approaches that address the problems students are most concerned about, that also indirectly reduce drinking, may be particularly effective. Behavioral activation (BA) is an intervention that indirectly addresses psychopathy by guiding individuals to identify goals in their lives, and encouraging individuals to engage in reinforcing activities that align with their goals (Lejuez et al, 2001). While initially used to treat depression, BA has been efficaciously applied to substance use because BA acts on the same reinforcement process implicated in problem drinking. BA addresses drinking without specific reference to alcohol use by focusing on engagement in reinforcing activities that align with students’ goals. A pilot study provided initial indication that a brief BA intervention administered in a semester-long freshman orientation course resulted in a significant decrease in drinking- related problems, compared to standard orientation (Reynolds et al. 2011). Notably, the approach never raised the issue of drinking unless raised by a student themselves. The purpose of the study is to conduct a fully powered cluster randomized trial testing BA administered in a semester-long (16 week) freshman orientation course, compared to a standard orientation course in 540 freshmen spread over 36 course sections (18 sections each of the BA and standard orientation format). A 5- month post-treatment assessment will measure durability of effects. Mediation analyses will test mechanisms of action. With this proposed R01, we will test a promising intervention with BA that addresses factors limiting participation in other programs by not targeting alcohol directly and by integrating an intervention into college curriculum, with the additional benefit of testing mediators to guide future work. This application represents a first step toward developing an intervention course that could be widely disseminated to address the persistent college drinking problem and its many consequences.