危险的朋友会改变初级保健简短干预青少年饮酒的效果吗？
Do risky friends change the efficacy of a primary care brief intervention for adolescent alcohol use?
机构信息
Craig Dalsimer Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Harvard Medical School, Boston, Massachusetts; Center for Adolescent Substance Abuse Research, Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts.
出版信息
J Adolesc Health. 2014 Apr;54(4):449-53. doi: 10.1016/j.jadohealth.2013.09.012. Epub 2013 Nov 8.
PURPOSE
To determine if peer risk (having friends who drink or approve of drinking) modifies the effects of a computer-facilitated screening and provider brief advice (cSBA) intervention on adolescent alcohol use.
METHODS
We assessed the intervention effect using logistic regression modeling with generalized estimating equations on a sample of 2,092 adolescents. Effect modification by peer risk was analyzed separately for alcohol initiation (drinking at follow-up in baseline nondrinkers) and cessation (no drinking at follow-up in baseline drinkers) by testing an interaction term (treatment condition by peer risk). Interpretation of the interaction effect was further clarified by subsequent stratification by peer risk.
RESULTS
The intervention effect on alcohol cessation was significantly greater among those with peer risk (adjusted relative risk ratios; risk 1.44, 1.18-1.76 vs. no risk .98, .41-2.36) at 3 months' follow-up. There was no such finding for alcohol initiation.
CONCLUSIONS
Alcohol screening and brief provider counseling may differentially benefit adolescent drinkers with drinking friends.
目的
确定同伴风险（有饮酒或赞成饮酒的朋友）是否会改变计算机辅助筛查和提供者简短建议（cSBA）干预对青少年饮酒的影响。
方法
我们使用广义估计方程对 2092 名青少年的样本进行逻辑回归建模，以评估干预效果。通过测试交互项（治疗条件与同伴风险），分别对酒精初饮（在基线不饮酒者的随访中饮酒）和戒断（在基线饮酒者的随访中不饮酒）分析同伴风险的作用修饰。通过随后按同伴风险分层，进一步阐明了交互作用的影响解释。
结果
在 3 个月随访时，具有同伴风险的青少年（风险比为 1.44，1.18-1.76，无风险比为 0.98，0.41-2.36）的戒酒干预效果显著更高。对于酒精初饮，没有这样的发现。
结论
对有饮酒朋友的青少年进行酒精筛查和简短的提供者咨询可能会有不同的益处。
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