Celio Mark A, Mastroleo Nadine R, DiGuiseppi Graham, Barnett Nancy P, Colby Suzanne M, Kahler Christopher W, Operario Don, Suffoletto Brian, Monti Peter M
Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912.
Community and Public Affairs, Binghamton University (SUNY), Binghamton, NY 13902.
Addict Res Theory. 2017;25(4):318-325. doi: 10.1080/16066359.2016.1276902. Epub 2017 Jan 18.
Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings.
简短动机干预(MI)是一种有效的方法,可减少急诊科(ED)患者的重度饮酒及相关的性风险行为,但对急诊科工作人员的要求强度使得现场实施MI在后勤方面具有挑战性。这项概念验证性试点研究检验了使用视频会议技术在急诊科环境中为患者提供针对重度饮酒和危险性行为的MI的可接受性和后勤可行性。采用了严格的筛查程序,以确保试点样本代表了急诊科患者中能从这种多目标MI中受益的目标部分。来自7名通过视频会议接受MI的急诊科患者样本(57%为女性;平均年龄 = 35岁)的定性和定量混合数据一致显示出高度的满意度、参与度和可接受性。观察到的完成率支持后勤可行性,患者反馈确定了通过使用高清硬件、确保更强的网络连接以及有效传达有关隐私保护的信息来改善体验的方法。干预后患者评分以及对录音会话的独立评分(使用动机性访谈技能编码系统)都非常高,这表明干预保真度和MI依从性并未因交付方式而受到影响。总体而言,这些数据表明视频会议是一种可行的技术,可用于在急诊科环境中实施基于证据的简短MI。