Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA; Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, MI 48109, USA; Institute for Healthcare Policy and Innovation, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA.
J Subst Abuse Treat. 2019 Apr;99:67-72. doi: 10.1016/j.jsat.2019.01.014. Epub 2019 Jan 18.
To examine the efficacious components of a computer-delivered brief intervention (CBI) for reducing marijuana use among adults presenting to a low-income urban emergency department (ED), which a prior report found to decrease marijuana use at a 6-month follow-up.
Participants were 237 ED patients reporting recent drug use (46% male; 54% African-American; mean age, 30.7) who were randomized to receive a CBI consisting of an interactive program guided by a virtual health counselor. The primary outcome was past 30-day marijuana use at 6-month follow-up assessed using the Timeline Follow-Back (TLFB). Intervention components related to change in marijuana use at 6 month follow-up examined in the current study included participant responses to items within five CBI domains that were rooted in motivational interviewing: goals for change, strengths, evoking-change (concerns about use and benefits of change), challenges, and tools for change.
The evoking-change domain was related to significant reductions in marijuana use at 6 months (B = -2.91, SE = 1.10, p < .01). Within this domain, items focused on concerns about family and friends were related to reductions in marijuana use of up to 5.5 fewer days of marijuana use in the past month (B = -5.49, SE = 1.63, p < .01).
An ED-based brief intervention, delivered by computer, was effective in reducing marijuana use. Intervention components focused on perceived concerns about use and benefits of change in relation to family and friends were critical domains within a CBI associated with reductions in marijuana use at 6-month follow-up.
考察一种计算机提供的简短干预（CBI）在减少低收入城市急诊部（ED）就诊成年人中使用大麻的有效成分，先前的报告发现该干预可减少 6 个月随访时的大麻使用。
参与者为 237 名报告近期吸毒（46%为男性；54%为非裔美国人；平均年龄 30.7 岁）的 ED 患者，他们被随机分配接受 CBI，该干预由一个虚拟健康顾问指导的互动程序组成。主要结果是使用 TLFB 在 6 个月随访时评估的过去 30 天的大麻使用情况。当前研究中检查与 6 个月随访时大麻使用变化相关的干预成分包括参与者对五个 CBI 领域内项目的回应，这些项目基于动机访谈：改变目标、优势、引发改变（对使用的关注和改变的好处）、挑战和改变工具。
引发改变领域与 6 个月时大麻使用显著减少相关（B=−2.91，SE=1.10，p<.01）。在这个领域内，关注家人和朋友的项目与减少最多 5.5 天的大麻使用相关，即在过去一个月中使用大麻减少了 5.5 天（B=−5.49，SE=1.63，p<.01）。
基于 ED 的简短干预，通过计算机提供，在减少大麻使用方面是有效的。干预成分侧重于与家人和朋友有关的对使用和改变好处的感知关注，是与 6 个月随访时大麻使用减少相关的 CBI 关键领域。
