TELECOM & BIBLIOTHERAPY PROGRAMS FOR PROBLEM DRINKERS

描述（由申请人提供）：本研究将开发并执行一项初步评估，使用基于计算机的自动电话系统（酒精电话链接通信[TLC-ALC]），对饮酒问题进行易于传播、以人群为基础、低成本的干预。TLC-ALC将模仿自助书籍《如何控制你的饮酒》（2004）中的内容和行为策略。开发协议将包括五个连续的任务：1)准备TLC- alc设计规范，2)编写实际的TLC对话，3)计算机编程最终的TLC- alc内容、逻辑和数据库，4)记录TLC对话，5)计算机软件测试（调试）编程的TLC- alc系统及其语音识别功能。每个步骤都包含一个迭代过程，在这个过程中，工作由适当的项目人员和外部评审人员进行评审和修改。每个步骤都涉及到潜在的参与者。

DESCRIPTION (provided by applicant): This study will develop and perform a preliminary evaluation of an easily disseminated, population-based, low cost intervention for problem drinking using a computer-based, automated telephone system (Telephone-Linked Communications for Alcohol [TLC-ALC]). TLC-ALC will be modeled after the content and behavioral strategies used in the self-help book, How to Control Your Drinking (2004). The development protocol will entail five sequential tasks: 1) preparing TLC-ALC design specifications, 2) writing the actual TLC dialogues, 3) computer programming the final TLC-ALC content, logic, and database, 4) voice recording the TLC dialogues, and 5) computer software testing (debugging) of the programmed TLC-ALC system and its speech recognition function. Each step involves an iterative process whereby the work is reviewed and revised by the appropriate project staff and the outside reviewer. Potential participants are involved in each step. TLC-ALC will be tested in an evaluation study, in which there will be a control group that will receive a minimal intervention/attention control program consisting of a NIAAA information and referral pamphlet plus a computer-based automated telephone (TLC) system that reinforces the pamphlet's messages and provides general health information. The 200 study participants will be problem drinkers, recruited from responses to newspaper ads in the Boston metropolitan area. They will be randomly assigned to 2 study groups (100 per group). Study subjects will be followed for 6 months, with the first 3 months for the intervention. Each study participant will be evaluated at baseline, and at 3 and 6 months through telephone interviews. The intervention will target 2 primary outcomes: drinking frequency (percent days abstinent [PDA]) and drinking intensity (drinks per drinking day (DDD), in the past month and 2 secondary outcomes: drinking within guidelines (DWG) for safe drinking, and the negative consequences of alcohol use. The study will evaluate the effect of participant characteristics on outcome, and assess the impact of the intervention on postulated mediating (intervening) behavioral variables: stage of change for drinking, self-efficacy for avoiding heavy drinking and alcohol related expectancies. The following hypotheses will be tested. During a 3 month intervention period: (1) participants receiving TLC-ALC will significantly decrease their frequency and intensity of alcohol use compared to controls; (2) participants receiving the intervention will be more likely to decrease their drinking to within NIAAA guidelines and decrease the negative consequences for alcohol use compared to controls; (3) these intervention effects will be maintained to the 6 month follow-up point. The study will also explore moderating and intervening variable effects and the time course of intervention effects across 6 months.