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基于诊所的简短干预措施可减少年轻女性的酒精滥用和性风险行为:一项探索性临床试验的结果。

A Brief Clinic-Based Intervention to Reduce Alcohol Misuse and Sexual Risk Behavior in Young Women: Results from an Exploratory Clinical Trial.

机构信息

Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA.

Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA.

出版信息

Arch Sex Behav. 2020 May;49(4):1231-1250. doi: 10.1007/s10508-020-01635-9. Epub 2020 Mar 18.

Abstract

This exploratory trial determined the feasibility, acceptability, and preliminary efficacy of a brief intervention (BI), supplemented with text messaging and a curated Web site, on alcohol use and sexual risk behavior among young women. Young women seeking care at a reproductive health clinic were screened for alcohol misuse and sexual risk behavior. Those who screened positive and who agreed to participate (N = 48; M = 22.67 years) were randomized to either (a) a brief in-person session during which personalized feedback regarding alcohol use and sexual risk taking was provided and discussed, or (b) a control condition. Feasibility was assessed by recruitment and retention rates. Acceptability was assessed with participant ratings of their intervention. Efficacy was measured using self-reported alcohol use and sexual behavior at baseline and during a 3-month follow-up. We supplemented the quantitative data with qualitative data from semi-structured interviews. Feasibility data indicated that 64% of eligible women agreed to participate, 74% of eligible women were enrolled, and 86% of enrolled women were retained through follow-up. Acceptability data showed that women who received the BI reported strong satisfaction with their intervention (M = 4.65 vs. 3.98 on a five-point scale) and also reported that text messaging was helpful (M = 4.73 on a seven-point scale) and acceptable (M = 5.27 on a seven-point scale). Qualitative data provided additional support for BI feasibility and acceptability. Efficacy data showed that women in both conditions reduced alcohol use and sexual risk behavior over time; women who received the BI reduced their maximum daily alcohol intake more than controls (BI from 7.68 to 4.82 standard drinks vs. control from 6.48 to 5.65; Wald χ = 4.93, p < .05). Women in the BI reported fewer occasions of condomless sex (median = 2.50) than controls (median = 5.00) at the follow-up, but this difference was not statistically significant (OR = 0.61, 95% CI [0.32, 1.15]). A brief intervention, supplemented with text messaging and a Web site, that targeted alcohol use and sexual behavior was feasible and acceptable to young women and led to lower levels of alcohol misuse and sexual risk behavior.

摘要

这项探索性试验旨在确定一种简短干预措施(BI)的可行性、可接受性和初步疗效,该措施辅以短信和精心策划的网站,以针对年轻女性的饮酒和性风险行为。在生殖健康诊所寻求护理的年轻女性接受了酒精使用和性风险行为的筛查。那些筛查阳性并同意参与的人(N=48;M=22.67 岁)被随机分配到以下两种情况之一:(a)简短的面对面会议,会上提供并讨论了有关酒精使用和性冒险的个性化反馈;或(b)对照组。可行性通过招募和保留率来评估。可接受性通过参与者对其干预措施的评价来评估。疗效通过自我报告的基线和 3 个月随访期间的酒精使用和性行为来衡量。我们用半结构化访谈的定性数据补充了定量数据。可行性数据表明,64%符合条件的女性同意参与,74%符合条件的女性被纳入研究,86%的纳入女性通过随访保留下来。可接受性数据显示,接受 BI 的女性对其干预措施表示非常满意(五分制,M=4.65 分,而对照组为 3.98 分),并表示短信很有帮助(七分制,M=4.73 分),也可以接受(七分制,M=5.27 分)。定性数据进一步支持 BI 的可行性和可接受性。疗效数据表明,两种情况下的女性随时间推移都减少了饮酒和性风险行为;接受 BI 的女性比对照组减少了最大日饮酒量(BI 从 7.68 标准饮料降至 4.82 标准饮料,而对照组从 6.48 标准饮料降至 5.65 标准饮料;Wald χ=4.93,p<.05)。BI 组报告的无保护性行为次数(中位数=2.50)少于对照组(中位数=5.00),但差异无统计学意义(OR=0.61,95%CI [0.32, 1.15])。针对饮酒和性行为的简短干预措施辅以短信和网站,对年轻女性来说是可行和可接受的,可降低酒精滥用和性风险行为的水平。

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