Preventing Alcohol/Prescribed Drug Misuse in the National Guard: Web and Peer BI

描述（由申请人提供）：防止酒精和规定的阿片类药物/镇静剂滥用的军事人员，包括储备成分，现役士兵和退伍军人是一个国家的优先事项。军队正面临着一场与问题酒精有关的危机， 处方药使用，特别是类阿片和镇静剂滥用，迫切需要有效预防和早期干预。滥用酒精和/或阿片类药物/镇静剂（AOS）的服务人员面临不良后果的风险，如受伤，工作表现下降，心理健康问题，自杀和艾滋病毒/其他性传播感染。虽然在平民中的研究表明，筛查，短暂干预和转诊治疗（SBIRT）的方法可以减少物质的使用和问题，这些协议还没有得到充分的研究，在军事人员。这一研究机构还指出，有必要制定战略，以加强收益，以维持短期干预（BI）的效果，但这些干预措施的“助推器”还没有得到很好的研究。新兴技术，如基于网络的干预措施和助推器的交付提供了机会，定制SBIRT干预措施，并解决军事人员，如陆军国民警卫队（NG）的地理障碍。此外，同行外联干预措施在军事社区有很高的可接受性。BuddytoBuddy同伴支持计划（将在本研究中增强以包括AOS误用）已成功用于NG装置。这项拟议的研究将在30个月的招募期内筛选约4，300名独特的个人，作为密歇根陆军NG士兵准备处理的一部分，以确定750名年龄在18-60岁之间的酒精和/或处方阿片类药物或镇静剂滥用的参与者。通过触摸屏电脑平板电脑进行筛查将用于招募在过去3个月内滥用酒精/处方阿片类药物或镇静剂的NG成员。参与者将被随机分配到以下三种情况之一：1）网络提供的酒精/处方药物滥用简短干预与网络助推器会议（W+W; n=250）; 2）网络提供的简短干预与同行提供的助推器会议（W+P; n=250）;或3）加强的精神护理（EUC; n=250）。这项研究的目的是开发，完善和测试定制的动机BI与各种持续的助推器强化（网络与同行），并进行一项随机对照试验，比较这些BI的疗效（W+W; W+P）对随后的酒精/药物消费和后果进行常规护理，包括伤害，精神和身体健康功能以及4-，8-，和入组后12个月。随机分配将按性别和酒精与处方阿片类药物/镇静剂滥用进行分层。拟议的研究将直接告知领导层和关键利益相关者关于最先进的基于技术的BI的影响，结合网络助推器或同行推广，在NG军事人员中，以打击美国预备役部队和现役士兵中越来越多的酒精/处方药问题。如果成功的话，研究结果将进一步转化为普通人群，并可能产生重大的公共卫生影响。

DESCRIPTION (provided by applicant): Preventing alcohol and prescribed opioid/sedative misuse among military personnel including Reserve components, active duty soldiers, and Veterans is a national priority. The military is facing a crisis related to problematic alcohol and prescription drug use, particularly opioid and sedative misuse, and there is a critical need for effective prevention and early interventions. Service members with alcohol and/or opioid/sedative (AOS) misuse are at risk for poor outcomes such as injuries, reduced job performance, mental health problems, suicide, and HIV/other sexually transmitted infections. Although research in civilians indicates that Screening, Brief Intervention, and Referral to Treatment (SBIRT) approaches can reduce substance use and problems, these protocols have not been studied adequately in military personnel. This body of research also points to the need for strategies to reinforce gains in order to sustain Brief Intervention (BI) effects, but "booster" to these interventions have not been well-studied. Emerging technologies, such as Web-based delivery of interventions and boosters provide the opportunity to tailor SBIRT interventions and address geographical barriers for military personnel such as the Army National Guard (NG). In addition, peer-outreach interventions have high levels of acceptability in military communities. The BuddytoBuddy peer support program, to be enhanced to include AOS misuse in this study, been used successfully in NG units. The proposed study will screen ~ 4,300 unique individuals over a 30-month enrollment period as part of Soldier Readiness Processing in the Michigan Army NG to identify 750 participants age 18-60 with alcohol and/or prescribed opioid or sedative misuse. Screenings via touch-screen computer tablets will be used to recruit NG members with alcohol/prescribed opioid or sedative misuse in the prior 3 months. Participants will be randomized to one of three conditions: 1) Web-delivered alcohol/prescribed drug misuse brief intervention with Web booster sessions (W+W; n=250); 2) Web-delivered brief intervention with Peer-delivered booster sessions (W+P; n=250); or 3) Enhanced Usual Care (EUC; n=250). The aims of the study are to develop, refine and test tailored motivational BIs with varied continuing booster reinforcements (Web vs. Peer) and to conduct a randomized controlled trial comparing the efficacy of these BIs (W+W; W+P) to usual care on subsequent alcohol/drug consumption and consequences, including injury, mental and physical-health functioning, and HIV risk behaviors at 4-, 8-, and 12-months post-enrollment. Random assignment will be stratified by gender and alcohol vs. prescription opioid/sedative misuse. The proposed study will directly inform leadership and key stakeholders about the impact of state-of-the-art technology-based BIs, combined with Web boosters or peer outreach, in NG military personnel to combat the growing scope of alcohol/prescription drug problems among U.S. reserve component and active duty soldiers. If successful, the results of the study will enhance translation to the general population and could have a major public health impact.