A cluster-randomized trial of a behavioral activation intervention administered in a college freshman orientation course

摘要 从高中到大学的过渡是一个发展敏感期， 酒精使用的升级。尽管危险饮酒是新生中常见的问题， 治疗服务非常低。治疗资源参与率低可能是因为 在学生们可能对改变饮酒方式不感兴趣的时候，干预措施直接针对饮酒问题。 此外，由于目前的干预措施有针对性地侧重于酒精使用，因此也没有解决 新生，如压力和睡眠。解决学生最关心的问题的方法 这也间接地减少了饮酒，可能特别有效。 行为激活（BA）是一种干预，通过引导 个人确定他们生活中的目标，并鼓励个人参与强化活动， 与他们的目标保持一致（Lejuez et al，2001）。虽然最初用于治疗抑郁症，但BA一直有效 因为BA作用于与问题饮酒有关的同一强化过程。 BA解决饮酒问题，但没有具体提到酒精的使用，重点是加强参与 与学生目标相一致的活动。一项试点研究初步表明， 在为期一个学期的新生入学指导课程中进行的一项研究， 与标准方向相比，存在一些相关问题（Reynolds等人，2011年）。值得注意的是，这种方法从未提出 除非是学生自己提出来的。 本研究的目的是进行一项充分把握度的随机分组试验， 在为期一个学期（16周）的新生迎新课程中，与540名学生的标准迎新课程相比， 新生分布在36个课程部分（18个部分的BA和标准的方向格式）。一个5- 治疗后一个月的评估将衡量效果的持久性。调解分析将检验各种机制 的行动。有了这个拟议的R 01，我们将测试一个有希望的干预与BA，解决因素限制 参与其他项目，不直接针对酒精，并将干预措施纳入大学教育 课程，并具有测试调解人的额外好处，以指导未来的工作。此应用程序代表一个 制定干预课程的第一步，可以广泛传播， 大学生饮酒问题及其后果

ABSTRACT The transition from high school to college is a developmentally sensitive period that is high risk for escalations in alcohol use. Although risky drinking is a common problem among freshmen, engagement in treatment services is very low. Low rates of engagement with treatment resources may occur because interventions target drinking directly at a time when students may be uninterested in changing their drinking. Moreover, with a targeted focus on alcohol use, current interventions also do not address the concerns of incoming freshmen, such as stress and sleep. Approaches that address the problems students are most concerned about, that also indirectly reduce drinking, may be particularly effective. Behavioral activation (BA) is an intervention that indirectly addresses psychopathy by guiding individuals to identify goals in their lives, and encouraging individuals to engage in reinforcing activities that align with their goals (Lejuez et al, 2001). While initially used to treat depression, BA has been efficaciously applied to substance use because BA acts on the same reinforcement process implicated in problem drinking. BA addresses drinking without specific reference to alcohol use by focusing on engagement in reinforcing activities that align with students’ goals. A pilot study provided initial indication that a brief BA intervention administered in a semester-long freshman orientation course resulted in a significant decrease in drinking- related problems, compared to standard orientation (Reynolds et al. 2011). Notably, the approach never raised the issue of drinking unless raised by a student themselves. The purpose of the study is to conduct a fully powered cluster randomized trial testing BA administered in a semester-long (16 week) freshman orientation course, compared to a standard orientation course in 540 freshmen spread over 36 course sections (18 sections each of the BA and standard orientation format). A 5- month post-treatment assessment will measure durability of effects. Mediation analyses will test mechanisms of action. With this proposed R01, we will test a promising intervention with BA that addresses factors limiting participation in other programs by not targeting alcohol directly and by integrating an intervention into college curriculum, with the additional benefit of testing mediators to guide future work. This application represents a first step toward developing an intervention course that could be widely disseminated to address the persistent college drinking problem and its many consequences.