Institute for Medical Psychology, University Medicine Greifswald.
Institute of Social Medicine and Prevention, University Medicine Greifswald.
Health Psychol. 2018 Jan;37(1):70-80. doi: 10.1037/hea0000556. Epub 2017 Oct 2.
To investigate the comparative 2-year efficacy of brief alcohol interventions delivered in-person versus through computer-generated feedback letters among general hospital inpatients with at-risk alcohol use.
In 2011-2012, all general hospital inpatients aged 18-64 years on 13 wards at 4 medical departments in 1 general hospital were systematically screened for at-risk alcohol use. Nine-hundred sixty-one inpatients who screened positive for at-risk alcohol use and negative for more severe alcohol problems were randomized by timeframe to in-person counseling (PE), computer-generated feedback letters (CO) and assessment only (AO). Both interventions included 3 contacts: on the ward and 1 and 3 months later and were based on the transtheoretical model (TTM). After 6, 12, 18, and 24 months computer-assisted telephone interviews assessed self-report outcomes: gram alcohol per week (primary), at-risk alcohol use and highest blood alcohol concentration (both secondary). Latent growth models were used.
After 24 months, CO resulted in a greater reduction of self-reported gram alcohol per week than AO (p = .027); PE did not differ significantly from AO (p = .503) and CO (p = .088); and group differences concerning secondary outcomes were not statistically significant (ps > 0.07). After 6 months, the odds of at-risk alcohol use were reduced by half in PE versus AO (odds ratio = 0.50, 95% confidence interval: 0.25-0.98).
No significant group differences between in-person counseling and computer-generated feedback letters were found. TTM-based computer-generated feedback letters reduced self-reported gram alcohol over 2 years and can be considered a long-term effective alternative in medical settings when addressing at-risk alcohol use. (PsycINFO Database Record
在有风险的酒精使用的一般住院患者中，比较面对面和通过计算机生成的反馈信件进行简短酒精干预的 2 年效果。
在 2011-2012 年，在 4 个医疗部门的 13 个病房中，对所有 18-64 岁的一般住院患者进行系统筛查，以确定是否有风险的酒精使用。对筛查出有风险的酒精使用且无更严重酒精问题的 961 名住院患者，按时间框架随机分配到面对面咨询（PE）、计算机生成的反馈信件（CO）和仅评估（AO）组。两种干预措施都包括 3 次接触：在病房内以及 1 个月和 3 个月后，干预措施基于跨理论模型（TTM）。在 6、12、18 和 24 个月时，通过计算机辅助电话访谈评估自我报告的结果：每周饮酒量（主要结果）、有风险的酒精使用和最高血液酒精浓度（次要结果）。使用潜在增长模型。
在 24 个月时，CO 导致自我报告的每周饮酒量减少多于 AO（p =.027）；PE 与 AO（p =.503）和 CO（p =.088）之间的差异不显著；次要结果的组间差异无统计学意义（p > 0.07）。在 6 个月时，与 AO 相比，PE 使有风险的酒精使用的几率减半（优势比=0.50，95%置信区间：0.25-0.98）。
面对面咨询与计算机生成的反馈信件之间没有发现显著的组间差异。基于 TTM 的计算机生成的反馈信件在 2 年内减少了自我报告的饮酒量，并且可以在医疗环境中作为处理有风险的酒精使用的长期有效替代方法。
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