University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA.
Drug Alcohol Depend. 2013 Oct 1;132(3):646-53. doi: 10.1016/j.drugalcdep.2013.04.020. Epub 2013 May 25.
This paper describes outcomes from a randomized controlled trial examining the efficacy of brief interventions delivered by a computer (CBI) or therapist (TBI) among adolescents in urban primary care clinics.
Patients (ages 12-18) self-administered a computer survey. Adolescents reporting past year cannabis use completed a baseline survey and were randomized to control, CBI or TBI, with primary (cannabis use, cannabis related consequences - CC) and secondary outcomes [alcohol use, other drug use (illicit and non-medical prescription drugs), and driving under the influence of cannabis (DUI)] assessed at 3, 6, and 12 months.
1416 adolescents were surveyed; 328 reported past year cannabis use and were randomized. Comparisons of the CBI relative to control showed that at 3 months the group by time interaction (G × T) was significant for other drug use and CC, but not for cannabis use, alcohol use, or DUI; at 6 months, the G × T interaction was significant for other drug use but not for cannabis use, alcohol use, or CC. For analyses comparing the TBI to control, at 3 months the G×T interaction was significant for DUI, but not significant for cannabis use, alcohol use, or CC; at 6 months, the G×T interaction was not significant for any variable. No significant intervention effects were observed at 12 months.
Among adolescent cannabis users presenting to primary care, a CBI decreased cannabis related problems and other drug use and a TBI decreased cannabis DUI in the short-term. Additional boosters may be necessary to enhance these reductions over time.
本文描述了一项随机对照试验的结果，该试验考察了计算机（CBI）或治疗师（TBI）提供的简短干预措施在城市初级保健诊所中青少年中的疗效。
患者（12-18 岁）自行进行计算机调查。报告过去一年使用大麻的青少年完成基线调查，并随机分为对照组、CBI 组或 TBI 组，主要结局（大麻使用、与大麻相关的后果-CC）和次要结局[酒精使用、其他药物使用（非法和非医疗处方药物）和大麻影响下驾驶（DUI）]在 3、6 和 12 个月时进行评估。
共调查了 1416 名青少年；328 名报告过去一年使用过大麻，并进行了随机分组。与对照组相比，CBI 的组间时间交互作用（G×T）在 3 个月时对其他药物使用和 CC 有显著影响，但对大麻使用、酒精使用或 DUI 无显著影响；在 6 个月时，G×T 交互作用对其他药物使用有显著影响，但对大麻使用、酒精使用或 CC 无显著影响。对于比较 TBI 与对照组的分析，在 3 个月时，DUI 的 G×T 交互作用显著，但大麻使用、酒精使用或 CC 不显著；在 6 个月时，任何变量的 G×T 交互作用均不显著。在 12 个月时未观察到显著的干预效果。
在向初级保健就诊的青少年大麻使用者中，CBI 减少了与大麻相关的问题和其他药物使用，TBI 减少了大麻 DUI，在短期内效果显著。随着时间的推移，可能需要额外的强化措施来增强这些减少效果。
