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一项针对个性特点的选择性预防计划在减少酒精使用及相关危害方面的长期效果:一项整群随机对照试验

The long-term effectiveness of a selective, personality-targeted prevention program in reducing alcohol use and related harms: a cluster randomized controlled trial.

作者信息

Newton Nicola C, Conrod Patricia J, Slade Tim, Carragher Natacha, Champion Katrina E, Barrett Emma L, Kelly Erin V, Nair Natasha K, Stapinski Lexine, Teesson Maree

机构信息

NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.

Department of Psychiatry, Université de Montréal, Montréal, QC, Canada.

出版信息

J Child Psychol Psychiatry. 2016 Sep;57(9):1056-65. doi: 10.1111/jcpp.12558. Epub 2016 Apr 19.

Abstract

BACKGROUND

This study investigated the long-term effectiveness of Preventure, a selective personality-targeted prevention program, in reducing the uptake of alcohol, harmful use of alcohol, and alcohol-related harms over a 3-year period.

METHODS

A cluster randomized controlled trial was conducted to assess the effectiveness of Preventure. Schools were block randomized to one of two groups: the Preventure group (n = 7 schools) and the Control group (n = 7 schools). Only students screening as high-risk on one of four personality profiles (anxiety sensitivity, negative thinking, impulsivity, and sensation seeking) were included in the analysis. All students were assessed at five time points over a 3-year period: baseline; immediately after the intervention; and 12, 24, and 36 months after baseline. Students were assessed on frequency of drinking, binge drinking, and alcohol-related harms. Two-part latent growth models were used to analyze intervention effects, which included all students with data available at each time point. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000026820; www.anzctr.org.au).

RESULTS

A total of 438 high-risk adolescents (mean age, 13.4 years; SD = 0.47) from 14 Australian schools were recruited to the study and completed baseline assessments. Relative to high-risk Control students, high-risk Preventure students displayed significantly reduced growth in their likelihood to consume alcohol [b = -0.225 (0.061); p < .001], to binge drink [b = -0.305 (.096); p = 0.001], and to experience alcohol-related harms [b = -0.255 (0.096); p = .008] over 36 months.

CONCLUSIONS

Findings from this study support the use of selective personality-targeted preventive interventions in reducing the uptake of alcohol, alcohol misuse, and related harms over the long term. This trial is the first to demonstrate the effects of a selective alcohol prevention program over a 3-year period and the first to demonstrate the effects of a selective preventive intervention in Australia.

摘要

背景

本研究调查了“预防计划”(Preventure)这一针对特定人格的选择性预防项目在3年期间减少酒精摄入、有害饮酒及与酒精相关危害方面的长期效果。

方法

开展了一项整群随机对照试验以评估“预防计划”的效果。学校被整群随机分为两组之一:“预防计划”组(n = 7所学校)和对照组(n = 7所学校)。分析仅纳入在四种人格特征(焦虑敏感性、消极思维、冲动性和寻求刺激)之一上筛查为高风险的学生。所有学生在3年期间的五个时间点接受评估:基线期;干预结束后立即评估;以及基线期后的12、24和36个月。对学生的饮酒频率、暴饮以及与酒精相关的危害进行评估。使用两部分潜在增长模型分析干预效果,该模型纳入了在每个时间点有可用数据的所有学生。本试验已在澳大利亚新西兰临床试验注册中心注册(ACTRN12612000026820;www.anzctr.org.au)。

结果

来自澳大利亚14所学校的共438名高风险青少年(平均年龄13.4岁;标准差 = 0.47)被招募到本研究并完成了基线评估。相对于高风险对照组学生,高风险“预防计划”组学生在36个月内饮酒可能性的增长显著降低 [b = -0.225(0.061);p <.001],暴饮可能性的增长显著降低 [b = -0.305(.096);p = 0.001],以及经历与酒精相关危害可能性的增长显著降低 [b = -0.255(0.096);p =.008]。

结论

本研究结果支持使用针对特定人格的选择性预防干预措施来长期减少酒精摄入、酒精滥用及相关危害。本试验是首个证明选择性酒精预防项目在3年期间效果的研究,也是首个证明在澳大利亚选择性预防干预措施效果的研究。

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