TELECOM & BIBLIOTHERAPY PROGRAMS FOR PROBLEM DRINKERS

描述（由申请人提供）：本研究将使用基于计算机的自动电话系统（酒精电话连接通信[TLC-ALC]）开发并初步评价一种易于传播的、基于人群的、低成本的问题饮酒干预措施。TLC-ALC将仿照自助书籍《如何控制你的饮酒》（2004年）中使用的内容和行为策略。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）语音记录TLC对话，以及5）编程的TLC-ALC系统及其语音识别功能的计算机软件测试（调试）。每一步都涉及一个反复的过程，由适当的项目工作人员和外部审查人员对工作进行审查和修订。潜在参与者参与每一步。 TLC-ALC将在一项评估研究中进行测试，其中将有一个对照组，该对照组将接受最低限度的干预/注意力控制计划，包括NIAAA信息和转诊小册子以及基于计算机的自动电话（TLC）系统，该系统加强了小册子的信息并提供一般健康信息。 200名研究参与者将是问题饮酒者，他们是从波士顿大都市地区报纸广告的反应中招募来的。他们将被随机分配到2个研究组（每组100人）。将对研究受试者进行6个月的随访，前3个月进行干预。将在基线、3个月和6个月时通过电话访谈对每名研究参与者进行评价。 干预将针对两个主要结果：过去一个月内的饮酒频率（戒酒天数百分比[PDA]）和饮酒强度（每日饮酒量（DDD）），以及两个次要结果：安全饮酒指南（DWG）内的饮酒，以及酒精使用的负面后果。该研究将评估参与者特征对结果的影响，并评估干预对假设的中介（干预）行为变量的影响：饮酒的变化阶段，避免大量饮酒的自我效能和与酒精相关的期望。 将检验以下假设。在3个月的干预期间：（1）与对照组相比，接受TLC-ALC的参与者将显著降低其饮酒频率和强度;（2）与对照组相比，接受干预的参与者将更有可能将其饮酒量减少到NIAAA指南范围内，并减少饮酒的负面后果;（3）这些干预效果将维持到6个月的随访点。该研究还将探讨调节和干预变量效应以及6个月内干预效应的时间过程。

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.