Department of Emergency Medicine,
Injury Prevention Center, University of Michigan Medical School, Ann Arbor, Michigan.
Pediatrics. 2018 Jul;142(1). doi: 10.1542/peds.2017-3525. Epub 2018 Jun 5.
With this study, we examined secondary outcomes of an emergency department (ED)-based brief intervention (BI) on dating violence perpetration and victimization and depression symptoms over 3, 6, and 12 months.
ED patients (14-20 years) were screened for risk drinking. Patients who received positive screen results were randomly assigned to a computer BI ( = 277), therapist BI ( = 278), or control condition ( = 281). After the 3-month assessment, participants were randomly assigned to receive the post-ED BI or control condition. BIs were used to address alcohol consumption and consequences (eg, dating violence and depression symptoms) by using motivational interviewing.
A total of 836 patients were enrolled in the randomized controlled trial of 4389 patients screened and 1054 who reported risky drinking. Regression models were used to examine longitudinal effects of the alcohol BI on dating violence perpetration, dating violence victimization, and depression symptoms. The therapist BI resulted in a significant reduction of dating violence perpetration up to 12 months (incidence rate ratio [IRR] = 0.53; 95% confidence interval [CI]: 0.37-0.77) and depression symptoms up to 3 months (IRR = 0.85; 95% CI: 0.72-1.00) after the intervention. Computer BI resulted in a reduction of dating violence perpetration (IRR = 0.52; 95% CI: 0.35-0.76) and depression symptoms (IRR = 0.78; 95% CI: 0.66-0.94) 6 months postintervention. Post-ED BIs were associated with lower perpetration at 12 months and lower victimization at 6 and 12 months, irrespective of BI intervention randomization at baseline; however, they did not affect depression symptoms.
A single-session ED BI revealed previously to show promise in reducing underage drinking also demonstrates promise in preventing dating violence perpetration and depression symptoms. These technology-enhanced BIs could be particularly helpful given the potential for more efficient resource usage and ease of future implementation.
通过本研究，我们考察了基于急诊科（ED）的简短干预（BI）对恋爱暴力实施和受害以及抑郁症状在 3、6 和 12 个月时的次要结果。
ED 患者（14-20 岁）接受了风险饮酒筛查。接受阳性筛查结果的患者被随机分配至计算机 BI（=277）、治疗师 BI（=278）或对照组（=281）。在 3 个月评估后，参与者被随机分配接受 ED 后 BI 或对照组。BI 用于通过使用动机性访谈来解决饮酒和后果（例如，恋爱暴力和抑郁症状）。
在对 4389 名筛查和 1054 名报告危险饮酒的患者进行的随机对照试验中，共有 836 名患者入组。使用回归模型检验酒精 BI 对恋爱暴力实施、恋爱暴力受害和抑郁症状的纵向影响。治疗师 BI 导致恋爱暴力实施的显著减少，直至 12 个月（发病率比 [IRR]=0.53；95%置信区间 [CI]：0.37-0.77）和抑郁症状在干预后 3 个月（IRR=0.85；95% CI：0.72-1.00）。计算机 BI 导致恋爱暴力实施（IRR=0.52；95% CI：0.35-0.76）和抑郁症状（IRR=0.78；95% CI：0.66-0.94）在干预后 6 个月减少。ED 后 BI 与 12 个月时的实施率降低和 6 和 12 个月时的受害率降低相关，无论基线 BI 干预的随机分配如何；然而，它们对抑郁症状没有影响。
单次 ED BI 先前已显示出在减少未成年饮酒方面有希望，也显示出在预防恋爱暴力实施和抑郁症状方面有希望。鉴于更有效利用资源的潜力和未来实施的便利性，这些技术增强型 BI 可能特别有帮助。
