Evaluating the Efficacy of Alcohol Screening & Brief Intervention at a University

描述（由申请人提供）：当前研究的广泛、长期目标是通过实施和评估有效、低成本的个体筛查和短暂干预（SBI）策略，在大学医学和心理健康环境中寻求医疗保健的高风险大学生群体中减少酒精使用和相关的负面健康、社会和法律后果。SBI策略，特别是大学生简短酒精筛查和干预（BASICS）模型（Dimeff, Baer, Kivlahan, & Marlatt, 1999），已经得到研究的支持，被认为是减少大学生酒精滥用（Baer, Kivlahan, Blume, McKnight, & Marlatt, 2001; Borsari & Carey, 2000； Larimer等人，2001；Marlatt等人，1998）和酒精相关后果（Baer等人，2001；Marlatt等人，1998）的有效和经济有效的手段。此外，我们开始更好地研究和理解使用简短干预可以导致行为改变的机制（Carey, Carey, Maisto, and Henson, 2006; Carey, Henson, Carey, and Maisto, 2007）。基于动机的SBI项目（包括BASICS和其他干预形式）的研究存在一个显著的局限性，即它们通常是在大学生通常接受健康相关服务的自然环境之外进行的，例如校园健康中心和咨询中心。几项研究已经证实了SBI项目在初级保健机构（例如，Fleming, Brown, & Brown, 2004; Reiff-Hekking, Ockene, Hurley, & Reed, 2005）和急诊室（例如，Longabaugh等人，2001；Monti等人，1999）的有效性，但这项工作并没有完全抽样大学生。目前的研究旨在通过检查在大学初级医疗和精神卫生保健机构寻求服务的本科生和研究生的目标人群中，以各种干预形式提供SBI在减少酒精使用和相关负面后果方面的功效和成本效益来解决文献中的这些空白。具体来说，NIAAA大学生一级筛查和简短干预（BASICS）模型（Dimeff等人，1999年），一种针对高风险酒精使用（e-Chug）的商业网络教育干预，仅限网络提供的个性化饮酒反馈（PDF）的管理（Dimeff等人，1999年），以及仅限评估（等候名单控制条件），将对其短期和长期效果进行检查。其次，本研究旨在研究干预效果的调节因子和调节因子在治疗条件内和跨治疗条件下的作用。第三，本研究将考察在本项目过程中，参与者在大学环境中的学业表现和保留率的模式和变化。本研究的具体目的将在纵向随机试验研究的背景下完成，采用组间设计来评估BASICS、e-Chug和个性化饮酒反馈在减少酒精使用和相关负面后果方面的短期和长期疗效。将特别强调对治疗效果的调节因子和调节因子的评估，以便更好地阐明这些因素对短期和长期干预结果的作用。此外，拟议的项目将评估参与者在大学环境中的学习成绩和保留率的模式和变化。

DESCRIPTION (provided by applicant): The broad, long-term objective of the current research is to reduce alcohol use and related negative health, social, and legal consequences in a high-risk population of college students seeking health care at a university- based medical and mental health setting, through implementation and evaluation of effective, low-cost individual Screening and Brief Intervention (SBI) strategies. SBI strategies, particularly the Brief Alcohol Screening and Intervention for College Students (BASICS) model (Dimeff, Baer, Kivlahan, & Marlatt, 1999), have been supported by research to be an efficient and cost-effective means of reducing alcohol abuse (Baer, Kivlahan, Blume, McKnight, & Marlatt, 2001; Borsari & Carey, 2000; Larimer et al. 2001; Marlatt et al., 1998) and alcohol-related consequences (Baer et al., 2001; Marlatt et al., 1998) among college students. Further, we are beginning to better examine and understand the mechanisms that can result in behavior change using brief interventions (Carey, Carey, Maisto, and Henson, 2006; Carey, Henson, Carey, and Maisto, 2007). A significant limitation of the research on motivational-based SBI programs, including BASICS and other intervention formats, is that they have generally been conducted outside of naturalistic settings in which college students typically receive health-related services, such as campus-based health centers and counseling centers. Several studies have confirmed the effectiveness of SBI programs in both primary care settings (e.g., Fleming, Brown, & Brown, 2004; Reiff-Hekking, Ockene, Hurley, & Reed, 2005) and emergency rooms (e.g., Longabaugh et al., 2001; Monti et al., 1999), but this work has not exclusively sampled college students. The current research is designed to address these gaps in the literature by examining the efficacy and cost- effectiveness of the delivery of SBI in a variety of intervention formats in reducing alcohol use and related negative consequences in a target population of undergraduate and graduate students seeking services at university-based primary medical and mental health care settings. Specifically, the NIAAA Tier I Screening and Brief Intervention for College Students (BASICS) model (Dimeff at al., 1999), a commercially-available Web- based educational intervention for high-risk alcohol use (e-Chug), the administration of Web-delivered personalized drinking feedback (PDF)-only (Dimeff, et al., 1999), and an assessment-only (wait-list control condition), will be examined in regard to their short-term and longer-term efficacy. Second, the proposed research is designed to examine the role of mediators and moderators of intervention efficacy, both within and across treatment conditions. Third, this current research will examine patterns of and changes in participant academic performance and retention within the university environment during the course of this project. The specific aims of this research will be accomplished in the context of a longitudinal randomized trial study using a between-group design to assess the short-term and longer-term efficacy of BASICS, e-Chug, and personalized drinking feedback-only in reducing alcohol use and associated negative consequences. Specific emphasis will be placed on the evaluation of mediators and moderators on treatment efficacy, in an effort to better clarify the roles of these factors on short-term and long-term intervention outcomes. Additionally, the proposed project will evaluate patterns of and changes in participant academic performance and retention within the university environment across time for study participants. PUBLIC HEALTH RELEVANCE: The purpose of the current research study is to reduce alcohol use and related negative health, social, and legal consequences in a high-risk population of college students seeking health care at a university-based medical and mental health setting, through implementation and evaluation of effective, low-cost individual Screening and Brief Intervention (SBI) strategies. SBI strategies, particularly the Brief Alcohol Screening and Intervention for College Students (BASICS) model (Dimeff, Baer, Kivlahan, & Marlatt, 1999), have been supported by research to be an efficient and cost-effective means of reducing alcohol abuse (Baer, Kivlahan, Blume, McKnight, & Marlatt, 2001; Borsari & Carey, 2000; Larimer et al. 2001; Marlatt et al., 1998) and alcohol- related consequences (Baer et al., 2001; Marlatt et al., 1998) among college students. We will explore how these interventions work when delivered in different formats, such as face-to-face and via the Web.