Stepped Care for Mandated College Students

描述（由申请人提供）：学院和大学因违反酒精政策而被提交给行政部门的学生人数大幅增加。然而，研究表明，大多数强制学生可能不需要广泛的治疗。分级护理根据个人对治疗的反应将其分配到不同级别的护理。令人鼓舞的研究表明，最低限度的干预和BMI可能会减少强制大学生的大量饮酒。因此，使用这些干预措施实施阶梯式护理可以最大限度地提高治疗效率，减少对校园酒精计划的需求。 参与者将是被授权参加东北部一所私立大学酒精课程的学生。所有参与者都将接受第一步，即15分钟的最低限度干预，包括讨论转诊事件，并提供一本载有减少饮酒建议的小册子。参与者将在六周后进行评估，那些继续表现出危险饮酒的人将接受第二步，随机分配：（a）60-90分钟的简短动机干预（BMI）或（B）仅评估对照。所有学生将完成3，6和9个月的后续评估。这三组将在两个结果指标上进行比较：过去30天内酗酒事件的频率和酒精相关问题。还将对干预的两个步骤评估治疗反应的预测因素（改变准备、酒精预期、首次饮酒年龄、感觉寻求、描述性规范和对转诊的反应）。 研究结果将有助于大学酒精项目确定其有限的资源在治疗强制学生的最有效和最高效的分配。本研究的长期目标是告知预防性干预研究的实用性和成本效益的阶梯式护理方法，并确定个人和情境因素，符合这些影响。

DESCRIPTION (provided by applicant): Colleges and universities have seen a large increase in the number of students referred to the administration for the violation of alcohol policies. However, research indicates that the majority of mandated students may not require extensive treatment. Stepped care assigns individuals to different levels of care according to their response to treatment. Encouraging research indicates that minimal interventions and BMIs may reduce heavy drinking in mandated college students. Thus, implementing stepped care using these interventions could maximize treatment efficiency and reduce the demands on campus alcohol programs. Participants will be students mandated to attend an alcohol program at a northeastern private university. All participants will receive Step 1, a 15-minute minimal intervention including a discussion of the referral incident and the provision of a booklet containing advice to reduce drinking. Participants will be assessed six weeks later, and those continuing to exhibit risky alcohol use will receive Step 2, randomization to: (a) a 60-90 minute brief motivational intervention (BMI) or (b) an assessment-only control. All students will complete 3, 6, and 9 month follow-up assessments. The three groups will be compared on two outcome measures: frequency of binge drinking episodes and alcohol-related problems in the past 30 days. Predictors of treatment response (readiness to change, alcohol expectancies, and age of first drink, sensation seeking, descriptive norms, and reaction to the referral) will also be evaluated for both steps of the intervention. Research findings will assist college alcohol programs in determining the most effective and efficient allocation of their limited resources in treating mandated students. The long-term objectives of this research are to inform preventive intervention research about the utility and cost-effectiveness of stepped-care approaches and to identify individual and situational factors that qualify these effects.