Brief Intervention to Reduce Substance Use in South African Primary Care

描述（由申请人提供）：本药物健康服务申请由一名新的研究者响应国家药物滥用研究所的计划公告PA-03-107“NIH探索/发展研究资助奖（R21）”和PA-05-139“预防和治疗药物和酒精滥用的健康服务研究”。本探索性研究探讨了可行性，并采用随机对照试验，以评估有效性的简短动机干预（BMI）提供的护士从业人员在减少危险药物和酒精使用的年轻人（年龄18-24岁）在一个新的设置和人口的公共初级卫生保健诊所服务医疗贫困居民在开普敦，南非。BMI在欧洲和北美人群中得到了强有力的实证支持，该方法在南非的医学院中得到了广泛的教授。很少有研究探讨在医疗环境中使用药物的简短动机干预，在南非也没有进行过研究。该研究利用并建立在来自美国和开普敦的研究人员的既定和有效的国际合作基础上，该合作是在NIDA的南部非洲倡议下开始的，并引起了当地临床医生，管理人员和医学院的强烈兴趣。我们建议研究18-24岁年龄组，因为我们在这一人群中的流行病学研究发现，这一年龄组的药物和酒精问题的风险很高，而这些问题又与艾滋病毒危险行为有关。该项目是及时的，因为甲基苯丙胺等毒品的使用在该国的流行率急剧上升。此外，该研究为了解其他国家（包括美国）忙碌的公共初级保健诊所的干预措施做出了重要贡献。根据结果，我们将修改干预措施以提高可行性和有效性，并在NIDA的国际合作PA下提交R 01，以进行更大规模的研究，该研究可以按种族、性别或其他亚组检查有效性。

DESCRIPTION (provided by applicant): This drug health services application by a new investigator responds to the National Institute on Drug Abuse's Program Announcements PA-03-107 the "NIH Exploratory/Developmental Research Grant Award (R21)" and PA-05-139 "Health Services Research on the Prevention and Treatment of Drug and Alcohol Abuse". This exploratory study examines feasibility and uses a randomized controlled trial to assess effectiveness of a Brief Motivational Intervention (BMI) delivered by nurse practitioners in reducing hazardous drug and alcohol use among young adults (aged 18-24 years) in a new setting and population-a public primary health care clinic serving medically indigent residents in Cape Town, South Africa. BMI has strong empirical support in European and North American populations and the methodology is being widely taught in medical schools in South Africa. There are very few studies examining Brief Motivational Interventions for drug use in medical settings, and none have been studied in South Africa. The study uses and builds on an established and effective international collaboration of researchers from the U.S. and Cape Town, begun under NIDA's Southern Africa Initiative, and has the strong interest of local clinicians, administrators, and the medical school. We propose to study the 18-24 year-old age group, because our epidemiological study in this population found that this age group was at high risk of drug and alcohol problems which in turn were linked to HIV risky behaviors. The project is timely as use of drugs, such as methamphetamine, are dramatically increasing in prevalence in the country. In addition, the study offers important contributions to understanding interventions for busy public primary care clinics in other countries, including the U.S. Informed by the results, we will modify the intervention to increase feasibility and effectiveness and submit an R01 under NIDA's International Collaborations PA to conduct a larger study which can examine effectiveness by race, gender, or other subgroups.