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

防止国民警卫队滥用酒精/处方药：Web 和 Peer BI

• 批准号: 9121342
• 负责人: Frederic C Blow
• 金额: $ 69万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-20 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9121342
• 关键词: Accidents; Address; Affect; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Communities; Consumption; Data; Department of Defense; Drug Prescriptions; Drug usage; Early Intervention; Effectiveness; Electronics; Emerging Technologies; Enrollment; Ethnic Origin; Family; Frequencies; Gender; General Population; HIV; HIV risk; Health; Health Personnel; Individual; Injury; Internet; Intervention; Intervention Studies; Leadership; Literature; Mediation; Mediator of activation protein; Medical; Mental Health; Michigan; Military Personnel; Modeling; Motivation; Online Systems; Opioid; Outcome; Participant; Performance at work; Personal Satisfaction; Pharmaceutical Preparations; Plant Roots; Poaceae; Population; Preventive Intervention; Privacy; Process; Protocols documentation; Provider; Psyche structure; Psychological reinforcement; Psychotropic Drugs; Public Health; Race; Randomized; Randomized Controlled Trials; Readiness; Recording of previous events; Recruitment Activity; Research; Resources; Risk; Risk Behaviors; Safety; Self Efficacy; Services; Sexually Transmitted Diseases; Social support; Soldier; Subgroup; Suicide; Tablet Computer; Techniques; Technology; Testing; Translations; Veterans; Woman; adverse outcome; alcohol misuse; alcohol use disorder; base; brief intervention; combat; comparative efficacy; computerized; drinking; drug misuse; follow-up; hazardous drinking; high risk; improved outcome; intervention effect; longitudinal design; member; men; misuse of prescription only drugs; musculoskeletal injury; novel; opioid misuse; outreach; outreach program; peer; peer support; physical conditioning; prescription opioid; prevent; programs; reduced substance use; screening, brief intervention, referral, and treatment; sedative; sex; touchscreen; treatment as usual; treatment program; trial comparing; volunteer

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.

描述（由申请人提供）：防止包括预备役人员、现役士兵和退伍军人在内的军事人员滥用酒精和处方阿片类药物/镇静剂是国家优先事项。军队正面临与酗酒和问题有关的危机 处方药的使用，特别是阿片类药物和镇静剂的滥用，迫切需要有效的预防和早期干预。滥用酒精和/或阿片类药物/镇静剂 (AOS) 的服役人员面临着不良结果的风险，例如受伤、工作绩效下降、心理健康问题、自杀和艾滋病毒/其他性传播感染。尽管对平民的研究表明筛查、简短干预和转诊治疗 (SBIRT) 方法可以减少药物使用和问题，但这些方案尚未在军事人员中得到充分研究。该研究机构还指出，需要制定强化收益的策略，以维持短暂干预（BI）效果，但这些干预措施的“助推器”尚未得到充分研究。基于网络的干预措施和助推器交付等新兴技术为定制 SBIRT 干预措施和解决陆军国民警卫队 (NG) 等军事人员的地理障碍提供了机会。此外，同伴外展干预措施在军事界具有很高的接受度。 BuddytoBuddy 同伴支持计划已在 NG 单位中成功使用，该计划将在本研究中得到加强，将 AOS 滥用纳入其中。拟议的研究将在 30 个月的登记期内对约 4,300 名独特的个人进行筛查，作为密歇根陆军国民警卫队士兵准备处理的一部分，以识别 750 名年龄在 18 岁至 60 岁之间的参与者，其中有酒精和/或处方阿片类药物或镇静剂滥用的情况。将通过触摸屏电脑平板电脑进行筛选，招募过去 3 个月内曾酗酒/处方阿片类药物或镇静剂滥用的 NG 成员。参与者将被随机分配到以下三种情况之一：1) 通过网络提供的酒精/处方药物滥用简短干预以及网络加强课程（W+W；n=250）； 2) 网络提供的简短干预以及同行提供的强化会议（W+P；n=250）；或 3) 强化日常护理 (EUC；n=250)。该研究的目的是开发、完善和测试具有各种持续强化强化的定制激励 BI（Web 与 Peer），并进行随机对照试验，比较这些 BI（W+W；W+P）与常规护理对随后的酒精/药物消耗和后果（包括伤害、心理和身体健康功能以及 4、8 和 12 个月时的 HIV 风险行为）的功效 注册后。随机分配将按性别、酒精与处方阿片类药物/镇静剂滥用情况进行分层。拟议的研究将直接向领导层和主要利益相关者通报基于最先进技术的商业智能与网络助推器或同行外展相结合对NG军事人员的影响，以应对美国预备役军人和现役士兵中日益严重的酒精/处方药问题。如果成功，该研究结果将加强向普通人群的转化，并可能对公共卫生产生重大影响。