Interventions for Unemployed Hazardous Drinkers

描述(申请人提供)：对失业的危险饮酒者的干预尽管美国经济最近有所改善，但失业仍然是一个严重的问题，估计表明三分之一的失业者饮酒水平处于危险水平，对他们的健康和找工作的能力产生了不利影响。增援干预措施非常重要 有效减少物质使用，也可用于增加求职活动。该项目与CT联合劳工局合作，旨在减少危险饮酒，提高失业者积极参与求职活动的积极性。它将评估加强阴性呼气测定器样本和求职活动的独立和综合影响，以确定改善这一人群结果的最简单和最具成本效益的方法。有危险饮酒的失业人员(N=280)将被随机分配到四种情况之一，采用2×2设计：标准护理，提交酒精测试阴性样本时加强标准护理，求职活动加强标准护理，或酒精测试阴性样本和求职活动标准护理强化。所有条件下的参与者都将获得CT联合劳工局的常规服务部分，以及使用新型酒精测定仪和手机视频捕获程序的酒精监测。研究干预措施的有效期为四个月，参与者将接受为期一年的跟踪调查。酒精和其他药物的使用、就业、精神症状和全球健康指标将在整个治疗和后续行动中进行评估。加强酒精测试阴性样本有望显著减少饮酒，加强求职活动有望 提高再就业率，缩短就业时间。假设加强酒精测试阴性样本和求职活动都能改善这两个领域的结果。加强干预还可能减少精神痛苦和身体衰退的缓慢进展，这在失业者中很常见。如果有效和具有成本效益，这项研究的结果可能会刺激在失业服务方面采用强化干预措施。减少危险饮酒的不利后果和改善重新就业可能会对美国人口中高度脆弱的群体产生显著的好处。

DESCRIPTION (provided by applicant): Interventions for unemployed hazardous drinkers despite recent improvements in the US economy, unemployment remains a significant concern, and estimates indicate that one-third of unemployed persons drink at hazardous levels, adversely impacting their health and abilities to find jobs. Reinforcement interventions are highly efficacious in reducing substance use, and they can be applied to increase job-seeking activities as well. In partnership with CT United Labor Agency, this project is designed to reduce hazardous drinking and enhance active participation in job-seeking activities among those with job loss. It will evaluate the independent and combined effects of reinforcing negative breathalyzer samples and job-seeking activities to ascertain the simplest and most cost-effective approach to improving outcomes in this population. Unemployed individuals with hazardous drinking (N = 280) will be randomly assigned to one of four conditions using a 2 x 2 design: standard care, standard care with reinforcement for submitting negative breathalyzer samples, standard care with reinforcement for job-seeking activities, or standard care plus reinforcement for both negative breathalyzer samples and job-seeking activities. Participants in all conditions will receive usual services part of CT United Labor Agency, along with alcohol monitoring using a novel breathalyzer and cell phone video capture procedure. The study interventions will be in effect for four months, and participants will be followed for one year. Alcohol and other drug use, employment, psychiatric symptoms, and global measures of health will be assessed throughout treatment and follow-up. Reinforcing negative breathalyzer samples is expected to significantly reduce drinking, and reinforcing job-seeking activities is expected to increase re-employment rates and reduce time until job attainment. Reinforcing both negative breathalyzer samples and job-seeking activities is hypothesized to improve outcomes along both domains. The reinforcement interventions may also decrease psychiatric distress and slow progression of physical decline, common among the unemployed. If efficacious and cost- effective, results from this study may stimulate adoption of reinforcement interventions in the context of unemployment services. Reducing the adverse consequences of hazardous drinking and improving job re- entry may have pronounced benefits in a highly vulnerable segment of the US population.