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快速解决研究:针对因酒精相关伤害和疾病前往急诊科及危机支持护理部门的年轻人进行简短干预的随机对照试验。

The Quik Fix study: a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care.

作者信息

Hides Leanne, Kavanagh David J, Daglish Mark, Cotton Susan, Connor Jason P, Barendregt Jan J, Young Ross McD, Sanders Davina, White Angela, Mergard Lance

机构信息

Center for Youth Substance Abuse Research (CYSAR), School for Psychology & Counselling, Institute of Health & Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Ave, Brisbane, Queensland, 4059, Australia.

出版信息

BMC Emerg Med. 2014 Aug 8;14:19. doi: 10.1186/1471-227X-14-19.

Abstract

BACKGROUND

Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people.

METHODS/DESIGN: Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness.

DISCUSSION

This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will be greatest for PI, followed by MI, and then AF/I at 1, 3, 6 and 12 months on the primary and secondary outcome variables. Telephone-delivered brief interventions could provide a youth-friendly, accessible, efficacious, cost-effective and easily disseminated treatment for addressing the significant public health issue of alcohol misuse and related harm in young people.

TRIAL REGISTRATION

This trial is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12613000108718.

摘要

背景

酒精是导致年轻人受伤、残疾和死亡的一个主要可预防因素。大量因酒精相关损伤和疾病的年轻人前往医院急诊科就诊。获得简短、有效、可及且具有成本效益的治疗是这一年龄组的一项国际卫生重点事项。虽然越来越多的证据表明简短动机性访谈(MI)在减少年轻人饮酒方面有效,但仍有很大空间来增强其影响,并确定它是否是现有最有效且具成本效益的简短干预类型。尽管针对学校的个性化干预(PI)的证据越来越多,但针对年轻人个体提供的针对酒精滥用的个性化干预的效果尚未确定,也未与动机性访谈进行比较。本研究方案描述了一项随机对照试验,比较通过电话提供的动机性访谈、个性化干预以及仅提供评估反馈/信息(AF/I)的对照措施在减少年轻人饮酒及相关危害方面的效果和成本效益。

方法/设计:参与者将是390名年龄在16至25岁之间、因酒精相关损伤和疾病(包括严重酒精中毒)前往危机支持服务机构或急诊科就诊的年轻人。这项单盲优效性试验将年轻人随机分为:(i)2次动机性访谈;(ii)2次新的个性化干预;或(iii)仅1次评估反馈/信息对照。在1、3、6和12个月时对参与者进行重新评估,评估内容包括饮酒及相关问题的主要结局,以及心理健康症状、功能、问题饮酒严重程度、酒精相关损伤、酒精相关知识、抵制饮酒的应对自我效能感和成本效益等次要结局。

讨论

本研究将确定针对前往危机支持服务机构或急诊科就诊的年轻人,通过电话提供的、减少酒精滥用及相关问题的最有效且具成本效益的简短干预措施。我们预计在1、3、6和12个月时,就主要和次要结局变量而言,个性化干预的效果最佳,其次是动机性访谈,然后是评估反馈/信息对照。通过电话提供的简短干预措施可为解决年轻人酒精滥用及相关危害这一重大公共卫生问题提供一种对年轻人友好、可及、有效、具成本效益且易于传播的治疗方法。

试验注册

本试验已在澳大利亚和新西兰临床试验注册中心注册,注册号为ACTRN12613000108718。

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