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同伴提供的创伤治疗在农村社区中的效果:一项随机非劣效性试验。

Effectiveness of Peer-Delivered Trauma Treatment in a Rural Community: A Randomized Non-inferiority Trial.

机构信息

Department of Psychiatry and Behavioral Sciences, University of New Mexico, MSC 09 5030, Albuquerque, NM, 87131, USA.

Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.

出版信息

Community Ment Health J. 2019 Oct;55(7):1125-1134. doi: 10.1007/s10597-019-00443-3. Epub 2019 Jul 23.

Abstract

This randomized controlled non-inferiority trial explored the effectiveness of Seeking Safety (SS) delivered by peer providers compared to its delivery by licensed behavioral health clinicians. The study enrolled 291 adults with PTSD and/or substance use disorders. Data were collected at 3 and 6-months post start of treatment. With respect to long-term outcomes, at 6 months PTSD symptoms decreased by 5.1 points [95% CI (- 9.0, - 1.1)] and by 4.9 points [95% CI (- 8.6, - 1.1)] and coping skills increased by 5.5 points [95% CI (0.4, 10.6)] and by 5.6 points [95% CI (0.8, 10.4)], in the peer- and clinician-led groups, respectively. This study demonstrated non-inferiority of peer-delivered SS compared to clinician-delivered SS for reducing PTSD symptoms and similar outcomes for both groups with respect to coping skills. A confirmatory study on the effectiveness of peer-delivered trauma-specific services is warranted, especially given the potential for increasing access to such treatment in underserved rural communities.

摘要

这项随机对照非劣效试验旨在探究同伴提供者提供的寻求安全( Seeking Safety,SS )与持照行为健康临床医生提供的 SS 在疗效上的差异。该研究纳入了 291 名患有 PTSD 和/或物质使用障碍的成年人。数据在治疗开始后 3 个月和 6 个月时收集。就长期结果而言,在 6 个月时,PTSD 症状分别减轻了 5.1 分[95%CI(-9.0,-1.1)]和 4.9 分[95%CI(-8.6,-1.1)],应对技能分别提高了 5.5 分[95%CI(0.4,10.6)]和 5.6 分[95%CI(0.8,10.4)],在同伴和临床医生主导的组中分别。本研究表明,同伴提供的 SS 与临床医生提供的 SS 在降低 PTSD 症状方面具有非劣效性,并且两组在应对技能方面的结果相似。需要开展一项关于同伴提供的创伤特异性服务有效性的验证性研究,特别是考虑到在服务不足的农村社区中增加获得这种治疗的可能性。

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