Kypri Kypros, Langley John D, Saunders John B, Cashell-Smith Martine L
School of Medicine and Public Health, University of Newcastle, NSW, Australia.
Addiction. 2007 Jan;102(1):62-70. doi: 10.1111/j.1360-0443.2006.01632.x.
The concept that assessment of a person's health status without subsequent intervention has beneficial effects in itself has stimulated much interest in underlying psychological mechanisms, methodological implications and its public health potential. There have, however, been few experimental studies of assessment effects.
To test the hypothesis that assessment in itself produces a reduction in hazardous drinking.
Two conditions (group A, leaflet only and group B, leaflet and assessment but no intervention) of a four-arm randomized controlled trial with enrollment in March-April 2003.
A total of 975 students (17-29 years) attending a primary health-care clinic completed a web-based Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Of 599 who scored >or= 8576 consented to follow-up and were included in the full four-arm trial, of whom 293 (153 women) were assigned to groups A and B.
Group A received an information leaflet at baseline. Group B received the information leaflet and 10 minutes of web-based assessment 4 weeks later.
Drinking frequency, typical quantity, heavy episode frequency, personal problems and academic problems.
Baseline mean AUDIT scores were 15.0 (SD = 5.4) and 14.9 (SD = 5.0) in groups A and B, respectively. Twelve months after baseline, relative to group A, group B reported lower overall consumption (geometric means ratio 0.82, 95% CI: 0.68-0.98), fewer heavy drinking episodes (0.66, 0.47-0.91), fewer problems (0.81, 0.67-0.99) and lower AUDIT scores (beta = -1.63, -0.62 to -2.65).
Brief assessment appeared to reduce hazardous drinking. Controlled trials that rely on assessment may therefore underestimate treatment effects. Limitations include the possibility of measurement artefact due to social desirability bias.
认为在不进行后续干预的情况下评估一个人的健康状况本身就具有有益效果，这一观点激发了人们对潜在心理机制、方法学意义及其公共卫生潜力的浓厚兴趣。然而，关于评估效果的实验研究却很少。
检验评估本身会减少有害饮酒这一假设。
2003年3月至4月进行的一项四臂随机对照试验中的两种情况（A组，仅发放传单；B组，发放传单并进行评估但不进行干预）。
共有975名年龄在17至29岁之间、前往初级保健诊所就诊的学生完成了一份基于网络的酒精使用障碍识别测试（AUDIT）问卷。在599名得分≥8分的学生中，76人同意接受随访并被纳入完整的四臂试验，其中293人（153名女性）被分配到A组和B组。
A组在基线时收到一份信息传单。B组在4周后收到信息传单并接受10分钟的基于网络的评估。
饮酒频率、典型饮酒量、重度饮酒发作频率、个人问题和学业问题。
A组和B组的基线平均AUDIT得分分别为15.0（标准差 = 5.4）和14.9（标准差 = 5.0）。在基线后的12个月，与A组相比，B组报告的总体饮酒量较低（几何均数比为0.82，95%置信区间：0.68 - 0.98），重度饮酒发作次数较少（0.66，0.47 - 0.91），问题较少（0.81，0.67 - 0.99），AUDIT得分较低（β = -1.63，-0.62至-2.65）。
简短评估似乎能减少有害饮酒。因此，依赖评估的对照试验可能会低估治疗效果。局限性包括由于社会期望偏差导致测量假象的可能性。
