Brief Alcohol Intervention to Reduce At-Risk Drinking Among Type 2 Diabetes

描述(由申请人提供)：高风险饮酒在糖尿病患者中很常见，并与较差的糖尿病治疗依从性和结果有关。虽然到目前为止，在这一人群中减少饮酒的方法基本上还没有被探索出来，但减少高危饮酒的简短干预已经在其他患者群体中得到了很好的验证，并提供了减少糖尿病患者高危饮酒的承诺，从而改善了糖尿病治疗的依从性和结果。我们假设，相对于一般健康教育，在标准的糖尿病治疗中增加短暂的酒精干预，将减少糖尿病患者的总体饮酒量和重度饮酒天数，这些患者是饮酒者的高危人群。此外，我们预计接受短暂酒精干预的参与者比接受一般健康教育的参与者有更好的糖尿病治疗依从性和结果。我们还预计，酒精摄入量的减少将中介短暂的酒精干预对糖尿病治疗依从性和结果的影响。此外，我们还将探索潜在的治疗机制。这项拟议的研究是一项随机的两组设计，随着时间的推移重复测量，将护士提供的短暂酒精干预加上标准的糖尿病治疗与一般健康教育进行比较。在这项研究中，我们将从一家大型城市初级保健诊所招募240名2型糖尿病患者。为了有资格参加这项研究，患者必须报告有风险的饮酒和较差的糖尿病治疗依从性。这项研究有望为2型糖尿病患者建立一种有效的干预方法，这些患者是有饮酒风险的人，在他们的饮酒行为没有改变的情况下，他们很可能保持较差的糖尿病治疗依从性和结果，从而导致糖尿病相关发病率和死亡率的增加。这项研究中提出的干预措施代表了一种减少糖尿病患者高风险饮酒的新方法，如果有效，可以很容易地整合到各种治疗环境中的糖尿病治疗中。此外，这项研究还将提供有关酒精使用与糖尿病治疗依从性和结果之间的关系的有价值的信息，以及关于有饮酒风险的2型糖尿病患者酒精使用的变化机制的有价值的信息。 公共卫生相关性：这项拟议的研究旨在测试一种干预措施，以减少2型糖尿病患者的高风险饮酒。高危饮酒与较差的糖尿病治疗依从性和控制性有关。如果成功，这种干预可以帮助糖尿病患者更好地控制他们的糖尿病，过上更健康的生活。

DESCRIPTION (provided by applicant): At-risk drinking is common among diabetic patients and is associated with inferior diabetes treatment adherence and outcomes. While methods for reducing alcohol use in this population have been largely unexplored to date, brief interventions to reduce at-risk drinking have been well-validated in other patient populations and offer the promise to reduce at-risk drinking among diabetic patients, resulting in improved diabetes treatment adherence and outcomes. We hypothesize that adding a brief alcohol intervention to standard diabetes treatment, relative to general health education, will reduce overall drinking volume and heavy drinking days among diabetic patients who are at-risk drinkers. Furthermore, we expect participants who receive the brief alcohol intervention to have better diabetes treatment adherence and outcomes than the participants receiving general health education. We also expect that reduced alcohol consumption will mediate the effect of the brief alcohol intervention on diabetes treatment adherence and outcomes. In addition, we will explore potential treatment mechanisms. The proposed study is a randomized, two-group design with repeated measures over time, comparing a brief nurse-delivered alcohol intervention plus standard diabetes treatment to general health education. For this study, we will recruit a sample of 240 Type 2 diabetic patients from a large, urban primary care clinic. To be eligible for the study, patients must report at-risk drinking and poor diabetes treatment adherence. This study holds the promise of establishing an efficacious intervention approach for Type 2 diabetic patients who are at-risk drinkers and are likely to maintain poor diabetes treatment adherence and outcomes in the absence of a change in their drinking behavior, resulting in increased diabetes-related morbidity and mortality. The intervention proposed in this study represents a novel approach to reducing at-risk drinking among diabetic patients that, if efficacious, can be readily integrated into the treatment of diabetes in a variety of treatment settings. In addition, this study will provide valuable information regarding the relationship between alcohol use and diabetes treatment adherence and outcomes and about the mechanisms of change in alcohol use among Type 2 diabetic patients who are at-risk drinkers. PUBLIC HEALTH RELEVANCE: The proposed study is designed to test an intervention to reduce at-risk drinking among Type 2 diabetic patients. At-risk drinking is associated with inferior diabetes treatment adherence and control. If successful, this intervention could help diabetics to gain better control of their diabetes and live healthier lives.