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12-step Alternatives and Recovery Outcomes in a Large National Study

大型全国性研究中的 12 步替代方案和恢复结果

基本信息

批准号：
8924892
负责人：
SARAH E. ZEMORE
金额：
$ 21.52万
依托单位：
PUBLIC HEALTH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-10 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8924892
关键词：
Abstinence Address Aftercare Alcohol abuse Alcohol or Other Drugs use Alcohols Attitude Behavior Therapy Clinical Communities Data Dependence Dimensions Drops Drug usage Effectiveness Female Friends General Population Group Homes Growth Health Health Services Research Income Individual Intervention Lead Legal Literature Longitudinal Studies Measures Motivation National Institute on Alcohol Abuse and Alcoholism Nature Outcome Patients Pharmaceutical Preparations Pharmacological Treatment Policy Maker Provider Published Comment Quality of life Recording of previous events Recovery Recruitment Activity Religion and Spirituality Reporting Research Research Design Research Personnel Respondent Self Management Services Severities Social Network Source Subgroup Substance abuse problem Surveys Testing Time Training Woman Work addiction alcohol use disorder court demographics evidence based guidelines follow-up improved infancy knowledge base meetings member mortality peer networks programs randomized trial satisfaction sobriety substance abuse treatment treatment planning volunteer

项目摘要

DESCRIPTION (provided by applicant): It is now generally accepted that AA and other 12-step groups contribute to better substance use outcomes for those who are addicted to alcohol and/or drugs and choose to attend them. Nevertheless, most individuals do not sustain regular involvement in 12-step groups, even when 12-step participation is the focus of treatment. Meanwhile, involvement in 12-step alternatives is substantial and appears to be growing. The largest such alternatives include Women for Sobriety (WFS), Self-Management and Recovery Training (SMART), LifeRing, and Secular Organization for Sobriety (SOS). Yet, research relating to the effectiveness of 12-step alternatives is almost non-existent, and there are no known longitudinal studies on group members. Research on the effectiveness of the various alternatives is important to enhancing the integration of formal treatment with appropriate alternatives, improving referral practices, and informing courts and other legal bodies (e.g., EAP programs) involved in mandating substance abuse treatment, as well as the general population. The current study will thus capitalize on a very large, recent, national study of individuals in recovery from an alcohol and/or drug problem to follow respondents recruited from 12-step groups (N=261) and their alternatives (N=390; total N=651) and measure mutual help group involvement and recovery outcomes. Respondents will complete a First Follow-up survey and additional follow-ups at 6 and 12 months (Second and Third Follow-ups). Our primary aim is to test whether associations between mutual help group involvement and recovery outcomes (such as abstinence and quality of life) differ across mutual help groups (Aim 2). We will also compare respondents identifying WFS, SMART, LifeRing, and SOS as their primary mutual help group to 12-step members on demograpcharhics, clinical severity, and nature of involvement (Aim 1), and examine predictors of group satisfaction and drop-out/declining involvement across mutual help groups (Aim 3). Despite some small subgroups, we expect generally sufficient numbers within each group to facilitate comparisons between individual 12-step alternatives and AA. The current study should, in the short term, contribute to the knowledge base on the benefits and limits of specific mutual help groups, and may lead to more focused study of one or more promising alternative(s) to AA and to study designs that can best address questions of effectiveness, such as randomized trials. Ultimately, the current line of research could support both the growth of effective mutual help groups and the recovery of the many individuals who may be willing to use them. This proposal responds to PA-13-161 (Alcohol Use Disorders: Treatment, Services Research, and Recovery, NIAAA), soliciting research on behavioral and pharmacological treatment for alcohol use disorders.

描述（由申请人提供）：现在人们普遍认为，AA和其他12步小组有助于那些酗酒和/或吸毒并选择参加的人获得更好的药物使用结果。尽管如此，大多数人并不经常参与12步小组，即使12步参与是治疗的重点。与此同时，参与12步替代方案的人数很多，而且似乎在增加。最大的此类替代方案包括妇女戒酒组织、自我管理和康复训练组织、生命圈组织和世俗戒酒组织。然而，有关12步替代方案的有效性的研究几乎是不存在的，也没有已知的小组成员的纵向研究。对各种替代办法的有效性进行研究，对于加强正规治疗与适当替代办法的结合、改进转诊做法以及向法院和其他法律的机构（例如，EAP计划）参与强制药物滥用治疗，以及一般人群。因此，目前的研究将利用一个非常大的，最近，从酒精和/或药物问题恢复的个人的国家研究，以遵循从12步组（N=261）和他们的替代品（N=390;总N=651）招募的受访者，并测量互助组的参与和恢复结果。受访者将完成首次随访调查，并在6个月和12个月时进行额外随访（第二次和第三次随访）。我们的主要目的是测试互助组参与和恢复结果（如禁欲和生活质量）之间的关联是否在互助组之间存在差异（目的2）。我们还将比较确定WFS，SMART，LifeRing和SOS作为其主要互助组的受访者与12步成员的人口统计学特征，临床严重程度和参与性质（目标1），并检查互助组的组满意度和退出/参与下降的预测因素（目标3）。尽管有一些小的亚组，但我们预计每个组内通常有足够的数量来促进单个12步替代方案和AA之间的比较。目前的研究应在短期内有助于建立关于特定互助小组的益处和局限性的知识基础，并可能导致对一种或多种有希望的AA替代方案进行更有针对性的研究，并导致能够最好地解决有效性问题的研究设计，例如随机试验。最终，目前的研究可以支持有效的互助小组的发展和许多可能愿意使用它们的人的康复。本提案响应PA-13-161（酒精使用障碍：治疗，服务研究和恢复，NIAAA），征求对酒精使用障碍的行为和药理学治疗的研究。