San Francisco VA Medical Center, San Francisco, CA, USA.
Gen Hosp Psychiatry. 2012 Sep-Oct;34(5):450-9. doi: 10.1016/j.genhosppsych.2012.04.007. Epub 2012 May 26.
To test the efficacy of telephone-administered motivational interviewing (MI) to enhance treatment engagement in Iraq and Afghanistan veterans with mental health (MH) problems.
Between April 23, 2008, and February 25, 2011, 73 Iraq and Afghanistan veterans who screened positive for ≥1 MH problem(s) on telephone-administered psychometric assessment, but were not engaged in treatment, were randomized to either personalized referral for MH services and four sessions of telephone MI or standard referral and four neutral telephone check-in sessions (control) at baseline, 2, 4 and 8 weeks. Blinded assessment occurred at 8 and 16 weeks.
In intent-to-treat analyses, 62% assigned to telephone MI engaged in MH treatment compared to 26% of controls [relative risk (RR)=2.41, 95% confidence interval (CI)=1.33-4.37, P=.004], which represented a large effect size (Cohen's h=0.74). Participants in the MI group also demonstrated significantly greater retention in MH treatment than controls [MI mean visits (S.D.)=1.68 (2.73) and control mean visits (S.D.)=0.38 (0.81), incidence rate ratio (IRR)=4.36, 95% CI=1.96-9.68, P<.001], as well as significant reductions in stigma and marijuana use at 8 weeks (P<.05).
Telephone MI enhances MH treatment engagement in Iraq and Afghanistan veterans with MH problems.
测试电话管理的动机性访谈（MI）对增强有心理健康（MH）问题的伊拉克和阿富汗退伍军人参与治疗的效果。
在 2008 年 4 月 23 日至 2011 年 2 月 25 日期间，对通过电话进行心理测量评估筛选出有≥1 个 MH 问题但未参与治疗的 73 名伊拉克和阿富汗退伍军人，随机分配到个性化转介 MH 服务和四次电话 MI，或标准转介和四次中立电话检查（对照组）。在基线、2、4 和 8 周时进行盲法评估。在 8 周和 16 周时进行意向性治疗分析。
在意向性治疗分析中，与对照组的 26%相比，分配到电话 MI 的退伍军人中有 62%接受了 MH 治疗[相对风险（RR）=2.41，95%置信区间（CI）=1.33-4.37，P=.004]，这代表了一个较大的效应大小（Cohen's h=0.74）。与对照组相比，MI 组的退伍军人在 MH 治疗中的保留率也显著更高[MI 组的平均就诊次数（标准差）=1.68（2.73）和对照组的平均就诊次数（标准差）=0.38（0.81），发生率比（IRR）=4.36，95%CI=1.96-9.68，P<.001]，并且在 8 周时，耻辱感和大麻使用显著减少（P<.05）。
电话 MI 增强了有 MH 问题的伊拉克和阿富汗退伍军人的 MH 治疗参与度。
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