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针对前往急诊科就诊的14至17岁青少年预防酒精相关伤害的面对面和电子简短干预方法的联合随机对照试验(SIPS junior)。

Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14-17 years presenting to Emergency Departments (SIPS junior).

作者信息

Deluca Paolo, Coulton Simon, Alam M Fasihul, Cohen David, Donoghue Kim, Gilvarry Eilish, Kaner Eileen, Maconochie Ian, McArdle Paul, McGovern Ruth, Newbury-Birch Dorothy, Patton Robert, Phillips Ceri, Phillips Thomas, Russell Ian, Strang John, Drummond Colin

机构信息

Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Centre for Health Services Studies, University of Kent, Canterbury, UK.

出版信息

BMC Public Health. 2015 Apr 10;15:345. doi: 10.1186/s12889-015-1679-4.

Abstract

BACKGROUND

Alcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effects of brief interventions on a range of alcohol consumption outcomes. A recent review of reviews also suggests that electronic brief interventions (eBIs) using internet and smartphone technologies may markedly reduce alcohol consumption compared with minimal or no intervention controls. Interventions that target non-drinking youth are known to delay the onset of drinking behaviours. Web based alcohol interventions for adolescents also demonstrate significantly greater reductions in consumption and harm among 'high-risk' drinkers; however changes in risk status at follow-up for non-drinkers or low-risk drinkers have not been assessed in controlled trials of brief alcohol interventions.

DESIGN AND METHODS

The study design comprises two linked randomised controlled trials to evaluate the effectiveness and cost-effectiveness of two intervention strategies compared with screening alone. One trial will focus on high-risk adolescent drinkers attending Emergency Departments (Eds) and the other will focus on those identified as low-risk drinkers or abstinent from alcohol but attending the same ED. Our primary (null) hypothesis is similar for both trials: Personalised Feedback and Brief Advice (PFBA) and Personalised Feedback plus electronic Brief Intervention (eBI) are no more effective than screening alone in alcohol consumed at 12 months after randomisation as measured by the Time-Line Follow-Back 28-day version. Our secondary (null) hypothesis relating to economics states that PFBA and eBI are no more cost-effective than screening alone. In total 1,500 participants will be recruited into the trials, 750 high-risk drinkers and 750 low-risk drinkers or abstainers. Participants will be randomised with equal probability, stratified by centre, to either a screening only control group or one of the two interventions: single session of PFBA or eBI. All participants will be eligible to receive treatment as usual in addition to any trial intervention. Individual participants will be followed up at 6 and 12 months after randomisation.

DISCUSSION

The protocol represents an ambitious innovative programme of work addressing alcohol use in the adolescent population.

TRIAL REGISTRATION

ISRCTN45300218. Registered 5th July 2014.

摘要

背景

酒精是全球公共卫生面临的主要威胁。尽管慢性酒精相关疾病的主要负担在于成年人,但其根源往往在青少年时期。从12岁到20岁,酒精消费及相关危害急剧增加。多项针对年轻人的试验报告了简短干预对一系列酒精消费结果有显著的积极影响。最近一项综述的综述也表明,与极少干预或无干预对照相比,使用互联网和智能手机技术的电子简短干预(eBI)可能会显著减少酒精消费。针对不饮酒青少年的干预措施可延缓饮酒行为的开始。针对青少年的基于网络的酒精干预措施也表明,“高风险”饮酒者的酒精消费和危害显著降低;然而,在简短酒精干预的对照试验中,尚未评估不饮酒者或低风险饮酒者在随访时风险状态的变化。

设计与方法

该研究设计包括两项相关的随机对照试验,以评估两种干预策略与单纯筛查相比的有效性和成本效益。一项试验将聚焦于前往急诊科(ED)的高风险青少年饮酒者,另一项试验将聚焦于被确定为低风险饮酒者或不饮酒但前往同一急诊科的人群。两项试验的主要(无效)假设相似:通过时间线回溯28天版本测量,个性化反馈与简短建议(PFBA)以及个性化反馈加电子简短干预(eBI)在随机分组后12个月的酒精消费量方面并不比单纯筛查更有效。我们与经济学相关的次要(无效)假设是,PFBA和eBI在成本效益方面并不比单纯筛查更高。总共将招募1500名参与者进入试验,750名高风险饮酒者以及750名低风险饮酒者或戒酒者。参与者将以相等的概率随机分组,按中心分层,分为单纯筛查对照组或两种干预措施之一:单次PFBA或eBI。除任何试验干预外,所有参与者都有资格接受常规治疗。个体参与者将在随机分组后的6个月和12个月进行随访。

讨论

该方案代表了一项针对青少年人群饮酒问题的雄心勃勃的创新性工作计划。

试验注册

ISRCTN45300218。于2014年7月5日注册。

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