在爱沙尼亚测试一种最小指导的在线自助酒精使用障碍干预措施的疗效：一项随机对照试验的研究方案。

Testing the efficacy of a minimal-guidance online self-help intervention for alcohol misuse in Estonia: study protocol of a randomized controlled trial.

机构信息

Estonian National Institute for Health Development, Tallinn, Estonia.

Tallinn University|, Tallinn, Estonia.

出版信息

BMC Public Health. 2020 May 27;20(1):790. doi: 10.1186/s12889-020-08791-6.

DOI:10.1186/s12889-020-08791-6

PMID:32460799

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7251728/

Abstract

BACKGROUND

Despite an initial steep decrease in alcohol misuse among Estonians through structural intervention means and the scaling up of alcohol counselling in the mid-2000's, most of the country's alcohol misuse indicators remain clearly higher than European averages. Consequently, an online self-help program was launched as part of an initial behavioral intervention initiative to foster progress in alcohol prevention on a population level.

METHODS

A two-arm randomized controlled trial (RCT) has been designed to compare the efficacy of a culturally-adapted minimal-guidance online self-help program, the 8-week "Selge" online program against a control condition that consists of a self-administered test of alcohol use and advice regarding usual treatment in Estonia. A target sample of 600 individuals will be recruited and randomly assigned to either condition. The program will contain 10 modules based on principles of cognitive behavioural therapy (CBT) and motivational interviewing (MI). Participants in the control group will have access to the full treatment after they complete their final follow-up assessment. The primary outcome will be change in the Alcohol Use Disorders Identification Test (AUDIT) score between the 6-month follow-up and baseline assessments. Secondary outcomes will include the number of standard drinks consumed and alcohol-free days, drinking motives and motivation for change, as well as changes in mental health. Assessments will be completed at baseline, at the end of treatment, and at 6 months follow-up. Data analysis will follow the intention-to-treat principle and employ (generalised) linear mixed models.

DISCUSSION

The "Selge" program is the first and only internet program for the intervention of alcohol misuse in Estonia. If proven effective, it will foster progress in the intervention of alcohol misuse in the Estonian population and be implemented as a standard program amidst the continuum of intervention and care.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN48753339 registered 04/06/2019 retrospectively.

摘要

背景

尽管爱沙尼亚通过结构干预手段和 21 世纪中期扩大酒精咨询服务，使酗酒者人数初始急剧下降，但该国大多数酗酒指标仍明显高于欧洲平均水平。因此，作为初始行为干预举措的一部分，启动了一个在线自助计划，以促进人群层面的酒精预防工作取得进展。

方法

设计了一项两臂随机对照试验（RCT），以比较文化适应的最小指导在线自助计划，即 8 周的“Selge”在线计划与控制条件的疗效，控制条件仅包括在爱沙尼亚进行的酒精使用自我测试和常规治疗建议。将招募并随机分配 600 名目标样本到任一条件中。该计划将包含基于认知行为疗法（CBT）和动机访谈（MI）原则的 10 个模块。对照组的参与者在完成最后一次随访评估后，将获得完整的治疗。主要结局指标是 6 个月随访和基线评估之间的酒精使用障碍识别测试（AUDIT）评分变化。次要结局指标包括消耗的标准饮料数量和无酒日数、饮酒动机和改变动机以及心理健康变化。评估将在基线、治疗结束时和 6 个月随访时进行。数据分析将遵循意向治疗原则，并采用（广义）线性混合模型。