German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
BMC Emerg Med. 2014 Jun 30;14:13. doi: 10.1186/1471-227X-14-13.
Alcohol misuse among youth is a major public health concern and numbers of adolescents admitted to the emergency department for acute alcoholic intoxication in Germany are recently growing. The emergency setting offers an opportunity to reach at-risk alcohol consuming adolescents and provide brief interventions in a potential "teachable moment". However, studies on brief interventions targeting adolescents in emergency care are scarce and little is known about their effectiveness when delivered immediately following hospitalization for acute alcohol intoxication. In this protocol we present the HaLT-Hamburg trial evaluating a brief motivational intervention for adolescents treated in the emergency department after an episode of acute alcoholic intoxication.
The trial design is a parallel two-arm cluster randomized-controlled trial with follow-up assessment after 3 and 6 months. N = 312 participants aged 17 years and younger will be recruited Fridays to Sundays in 6 pediatric clinics over a period of 30 months. Intervention condition is a manual-based brief motivational intervention with a telephone booster after 6 weeks and a manual-guided intervention for caregivers which will be compared to treatment as usual. Primary outcomes are reduction in binge drinking episodes, quantity of alcohol use on a typical drinking day and alcohol-related problems. Secondary outcome is further treatment seeking. Linear mixed models adjusted for baseline differences will be conducted according to intention-to-treat (ITT) and completers (per-protocol) principles to examine intervention effects. We also examine quantitative and qualitative process data on feasibility, intervention delivery, implementation and receipt from intervention providers, receivers and regular emergency department staff.
The study has a number of strengths. First, a rigorous evaluation of HaLT-Hamburg is timely because variations of the HaLT project are widely used in Germany. Second, prior research has not targeted adolescents in the presumed teachable moment following acute alcohol intoxication. Third, we included a comprehensive process evaluation to raise external validity. Fourth, the study involved important stakeholders from the start to set up organizational structures for implementation and maintaining project impact.
Current Controlled Trials ISRCTN31234060 (April 30th 2012).
青少年酗酒是一个主要的公共卫生问题，最近德国因急性酒精中毒而到急诊就诊的青少年人数不断增加。急诊环境为接触高危饮酒青少年提供了机会，并在潜在的“可教时刻”提供了简短的干预措施。然而，针对急诊护理中青少年的简短干预措施的研究很少，对于在急性酒精中毒住院后立即进行干预的效果知之甚少。在本方案中，我们介绍了 HaLT-Hamburg 试验，该试验评估了一种针对急性酒精中毒发作后在急诊接受治疗的青少年的简短动机干预措施。
试验设计为平行两臂集群随机对照试验，在 3 个月和 6 个月后进行随访评估。将在 30 个月的时间内从 6 家儿科诊所的周五至周日招募 312 名年龄在 17 岁及以下的参与者。干预条件是基于手册的简短动机干预，在 6 周后进行电话强化，并为照顾者提供手册指导的干预，与常规治疗进行比较。主要结局是减少狂欢饮酒发作、典型饮酒日的饮酒量和与酒精相关的问题。次要结局是进一步寻求治疗。将根据意向治疗（ITT）和完成者（方案）原则，使用线性混合模型对干预效果进行调整，以检查干预效果。我们还从干预提供者、接受者和常规急诊工作人员那里检查了关于可行性、干预提供、实施和接收的定量和定性过程数据。
该研究具有许多优势。首先，HaLT-Hamburg 的严格评估是及时的，因为 HaLT 项目的变体在德国得到了广泛应用。其次，之前的研究并未针对急性酒精中毒后假定的可教时刻的青少年进行研究。第三，我们进行了全面的过程评估，以提高外部有效性。第四，该研究从一开始就涉及了重要的利益相关者，以建立实施和维持项目影响的组织结构。
当前对照试验 ISRCTN31234060（2012 年 4 月 30 日）。
