Jiang Shan, Wu Lingli, Gao Xiaoli
Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Addict Behav. 2017 Oct;73:216-235. doi: 10.1016/j.addbeh.2017.05.023. Epub 2017 May 22.
This systematic review aimed to synthesize the evidence on the effectiveness of motivational interviewing (MI), delivered in modes other than face-to-face individual counseling, in preventing and treating substance abuse related behaviors.
Four databases (PubMed/MEDLINE, PsycINFO, ISI Web of Science and Cochrane Library) were searched for randomised clinical trials (RCTs) that evaluated the effectiveness of alternative modes of MI (other than face-to-face individual counseling) in preventing and treating substance abuse. Eligible studies were rated on methodological quality and their findings were qualitatively synthesized.
A total of 25 articles (on 22 RCTs) were eligible for this review. Beyond face-to-face counseling, telephone was the most frequently used medium for delivering MI (11 studies), followed by Internet communication (4 studies) and short message service (SMS) (2 studies). Mail was incorporated as a supplement in one of the studies for telephone MI. In contrast to one-to-one individual counseling, group MI was adopted in 5 studies. The effectiveness of telephone MI in treating substance abuse was supported by all of the published RCTs we located. Internet-based MI was effective in preventing and treating alcoholism, but its outcome appeared to be inconsistent for smoking cessation and poor for abstinence from illicit drugs. SMS-based MI appeared to be useful for controlling tobacco and drinking. Group MI was attempted for quitting alcohol and drugs, with mixed findings on its outcomes.
Collectively, the studies reviewed indicate that telephone MI is a promising mode of intervention in treating and preventing substance abuse. The effectiveness of other alternative modes (SMS-based MI, Internet-based MI and group MI) remains inconclusive given the controversial findings and a limited number of studies. By synthesizing the currently available evidence, this systematic review suggested that telephone MI might be considered as an alternative to face-to-face MI for treating and preventing substance abuse. Further research is needed to investigate the effectiveness of SMS-based MI, Internet MI, group MI and other alternative modes. Studies with methodological rigor and incorporating MI fidelity measures have great potential to advance the understanding in this field.
本系统评价旨在综合有关以非面对面个体咨询模式提供的动机性访谈（MI）在预防和治疗物质滥用相关行为方面有效性的证据。
检索了四个数据库（PubMed/MEDLINE、PsycINFO、ISI Web of Science和Cochrane图书馆），以查找评估替代性MI模式（非面对面个体咨询）在预防和治疗物质滥用方面有效性的随机临床试验（RCT）。对符合条件的研究进行方法学质量评分，并对其结果进行定性综合分析。
共有25篇文章（涉及22项RCT）符合本评价的纳入标准。除面对面咨询外，电话是最常使用的提供MI的媒介（11项研究），其次是互联网通信（4项研究）和短信服务（SMS）（2项研究）。在一项电话MI研究中，邮件被用作补充手段。与一对一的个体咨询不同，5项研究采用了团体MI。我们找到的所有已发表的RCT均支持电话MI在治疗物质滥用方面的有效性。基于互联网的MI在预防和治疗酒精中毒方面有效，但其在戒烟方面的结果似乎不一致，对戒除非法药物效果不佳。基于短信服务的MI似乎对控制烟草使用和饮酒有用。团体MI尝试用于戒酒和戒毒，但其结果不一。
总体而言，所审查的研究表明，电话MI是治疗和预防物质滥用的一种有前景的干预模式。鉴于研究结果存在争议且研究数量有限，其他替代模式（基于短信服务的MI、基于互联网的MI和团体MI）的有效性仍不确定。通过综合现有证据，本系统评价表明，电话MI可被视为治疗和预防物质滥用的面对面MI的替代方式。需要进一步研究来调查基于短信服务的MI、互联网MI、团体MI及其他替代模式的有效性。具有方法学严谨性并纳入MI保真度测量的研究有很大潜力推动该领域的认识发展。
