The systematic development of a mobile phone-delivered brief intervention for hazardous drinking in India
The systematic development of a mobile phone-delivered brief intervention for hazardous drinking in India
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DOI：
10.1016/j.jsat.2021.108331
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发表时间：
2021-02-19
影响因子：
3.9
通讯作者：
Heath, Anna
中科院分区：
文献类型：
--
作者：
Nadkarni, Abhijit;Costa, Sheina;Heath, Anna
背景：印度酒精使用障碍（AUD）的治疗差距在所有精神健康和物质使用障碍中是最高的。尽管有证据表明针对危险饮酒的短期干预措施具有成本效益，但由于存在一些与人力资源有关的障碍，在低收入和中等收入国家实施的情况很少。本文描述了一项旨在系统地开发移动电话交付的BI以克服这些障碍的研究的过程和输出。方法：本研究采用混合方法，分为四个步骤：(1)通过从两篇近期相关且高质量的系统综述中引用的研究中提取数据，对现有的相关证据基础进行综述；(2)深度访谈（IDIs） 11位全国成瘾研究与实践专家，22位危险饮酒者；(3)德尔菲调查（2轮），通过建立共识来确定干预方案的组成部分；(4)与一系列利益相关者一起举办内容和干预措施发展研讨会，以制定干预措施一揽子计划。结果：研究小组从两个精选的系统综述中获得了72篇期刊文章。从研究中提取的关键内容领域包括与饮酒行为有关的健康事实和统计数据、自我反思、目标设定信息、激励信息以及管理风险情况的技能。由专家和危险饮酒者组成的idi也赞同这些内容领域的大部分内容。德尔菲调查在19个内容领域达成了共识，其中包括针对性建议、个性化反馈和信息、目标管理和应对技能。内容和干预措施发展讲习班形成了一套干预措施，为期8周，每周信息的内容以以下七个主题为指导：安全饮酒/健康教育、减少酒精、饮酒和风险管理、替代饮酒方式、情境内容、冲动管理、维持和预防复发。结论：研究小组在制定干预措施时考虑了情境因素，这对确保干预措施的可接受性和可行性至关重要。有趣的是，背景知情的干预成分与高收入国家开发和测试的BIs有几个共同点。
Background: The treatment gap for alcohol use disorders (AUD) in India is the highest among all mental health and substance use disorders. Despite evidence of the cost effectiveness of brief interventions (BIs) for hazardous drinking, implementation in low- and middle-income countries (LMICs) is rare due to several human resource-related barriers. This paper describes the processes and outputs of a study aimed at systematically developing a mobile phone-delivered BI to overcome such barriers.Methods: This is a mixed methods study with four steps: (1) Review of existing relevant evidence base by extracting data from studies cited in two recent, relevant and high-quality systematic reviews; (2) In-depth interviews (IDIs) with 11 national experts in addictions research and practice, and 22 hazardous drinkers; (3) Delphi survey (2 rounds) to identify components for the intervention package through consensus building; and (4) Content and intervention development workshops with a range of stakeholders to develop the intervention package.Results: The research team sourced 72 journal articles from two selected systematic reviews. Key content areas extracted from the studies included facts and statistics about health related to drinking behavior, self-reflection, goal-setting messages, motivational messages, and skills to manage risky situations. The IDIs with experts and hazardous drinkers endorsed most of these content areas as well. The Delphi survey achieved consensus on 19 content areas, which included targeted recommendations, personalized feedback and information, goal management, and coping skills. The content and intervention development workshops resulted in an intervention package delivered over 8 weeks, with the following seven themes guiding the content of the weekly messages: safe drinking/health education, alcohol reduction, drinking and risk management, drinking alternatives, situational content, urge management, and maintenance and relapse prevention.Conclusion: The research team designed this study to consider contextual factors while developing the intervention, which is important to ensure acceptability and feasibility of the intervention. Interestingly, the contextually informed intervention components had several commonalities with BIs developed and tested in highincome countries.