RANDOMIZED TRIAL OF A STAGE-BASED PRIMARY CARE PROGRAM

这项研究的主要目的是测试 针对青少年高危人群的酒精滥用预防策略 初级卫生保健机构。这些预防战略将基于 创新多成分激励阶段(McMOS)理论研究 模特。具体地说，我们建议评估以下三项措施的效果： 名为STARS计划(开始服用)的组件预防干预 酒精有严重的风险)。这一干预将涉及：1)青年自我 教学模块和相应的录音带；2)简要健康 由医生和护士提供会诊；和3)[6延长 护士提供的后续会诊。] 这项研究将采用实验设计来测试 建议初级卫生保健干预。这项研究旨在 审查可复制的、以保健为基础的预防战略。初级阶段 将审查的结果衡量标准包括酒精消费模式，以及 酒精使用的获得和改变的阶段。次要的，调解 结果衡量标准将包括使用其他药物，包括 香烟、无烟烟草、大麻和可卡因；使用频率 避免饮酒的自我控制策略；认知 社会因素包括期望信念、自我效能感、 可影响性、感知的使用普及率和使用意图；以及 与酒精有关的健康信念和避免饮酒的动机。 短期(3个月)、中期(1年)和长期(2年)成果 将确定相应的预防策略。纵向研究 在青少年酒精领域是非常需要的 防止虐待(Coodstadt，1986；Hansen，1992；Moskowitz，1989)。这个 拟议的两年后续行动将提供有关以下方面的宝贵信息 干预组件的潜在长期持续影响， 以及各种致病因素在运动中的时间作用 青少年经历了酒精使用、习得和改变的阶段。

The primary purpose of this research is to test the effectiveness of alcohol abuse prevention strategies targeting high-risk youth in a primary health care setting. These prevention strategies will be based on an innovative Multi-Component Motivational Stages (McMOS) theoretical model. Specifically, we propose to evaluate the efficacy of a three- component prevention intervention titled the STARS program (Start Taking Alcohol Risks Seriously). This intervention will involve: 1) youth Self- Instructional Modules and corresponding audio-tapes; 2) brief Health Consultations provided by physicians and nurses; and 3) [six Extended Follow-Up Consultations provided by nurses.] This study will employ an experimental design to test the effects of the proposed primary health care intervention. This study is designed to examine replicable, health care-based prevention strategies. The primary outcome measures to be examined include alcohol consumption patterns, and the stages of alcohol use acquisition and change. Secondary, mediating outcome measures will include the use of other drugs including cigarettes, smokeless tobacco, marijuana and cocaine; frequency of use of self-control strategies for avoiding alcohol consumption; cognitive and social factors including expectancy beliefs, self-efficacy, influenceability perceived prevalence of use, and intentions to use; and alcohol-related health beliefs and motivation to avoid alcohol use. Short-term (3 months), mid-term (1 year) and long-term (2 year) outcomes will be determined for the prevention strategies. Longitudinal studies such as the one proposed are much needed in the area of youth alcohol abuse prevention (Coodstadt, 1986; Hansen, 1992; Moskowitz, 1989). The proposed two year follow-up will provide invaluable information regarding the potential long-term sustained effects of the intervention components, and the temporal role of various causative factors in the movement of youth through the stages of alcohol use acquisition and change.