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在接受急诊科护理的青少年中试点开展针对药物使用的简短干预加移动强化干预措施。

Piloting a brief intervention plus mobile boosters for drug use among emerging adults receiving emergency department care.

作者信息

Bonar Erin E, Cunningham Rebecca M, Sweezea Emily C, Blow Frederic C, Drislane Laura E, Walton Maureen A

机构信息

Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI, 48109, USA; Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI, 48109, USA; Center for Sexuality and Health Disparities, University of Michigan, 400 North Ingalls Street, Ann Arbor, MI, 48109, USA.

Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI, 48109, USA; Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI, 48109, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA; Emergency Medicine, Hurley Medical Center, 1 Hurley Plaza, Flint, MI, 48503, USA.

出版信息

Drug Alcohol Depend. 2021 Apr 1;221:108625. doi: 10.1016/j.drugalcdep.2021.108625. Epub 2021 Feb 16.

Abstract

PURPOSE

There are few efficacious prevention interventions for emerging adults (ages 18-25) drug use and concomitant risks (e.g., sexual risk behaviors). We developed and evaluated the feasibility and acceptability of an Emergency Department (ED)-initiated brief intervention (BI) combined with booster messaging as a clinician-extender primarily focusing on drug use, with a secondary focus on condomless sex. We examined descriptive outcomes of alcohol, drug use, and condomless sex.

PROCEDURES

We recruited N = 63 emerging adults who used drugs (primarily cannabis) from an ED (72.4 % participation rate). Their mean age was 21.7 years (SD = 2.3); 67 % were female and 52.4 % were Black/African American. Participants randomized to the intervention (N = 31) received a BI and 28 days of tailored booster messaging (based on drug use motives) daily, and the control condition received a community resource brochure. A post-test occurred at 1-month with a follow-up at 2-months.

RESULTS

The intervention was well-received (83.9 % allocated completed the BI) with 79 % overall liking the BI and 71 % finding it helpful to discuss substances. Mean ratings of booster messages were >4.0 (5-point scale); 77 % liked the daily messages and 91 % found them helpful. Descriptively, the intervention group evidenced absolute reductions over time on alcohol outcomes, cannabis use, and condomless sex.

CONCLUSIONS

This BI with booster messages was feasible and acceptable in the target population of emerging adults who use drugs (i.e., mostly cannabis). This intervention model, initiated during a healthcare visit and accompanied by a clinician-extender, should be tested in a future fully-powered trial.

摘要

目的

针对刚成年的成年人(18 - 25岁)的药物使用及相关风险(如性风险行为),有效的预防干预措施很少。我们开发并评估了一种由急诊科发起的简短干预(BI),并结合强化信息传递,作为一种主要针对药物使用、其次针对无保护性行为的临床辅助手段。我们研究了酒精、药物使用和无保护性行为的描述性结果。

程序

我们从一家急诊科招募了N = 63名使用药物(主要是大麻)的刚成年的成年人(参与率为72.4%)。他们的平均年龄为21.7岁(标准差 = 2.3);67%为女性,52.4%为黑人/非裔美国人。随机分配到干预组(N = 31)的参与者接受了一次简短干预和为期28天的根据药物使用动机定制的每日强化信息传递,对照组则收到一份社区资源手册。在1个月时进行后测,并在2个月时进行随访。

结果

该干预措施受到好评(83.9%被分配到的参与者完成了简短干预),总体上79%的人喜欢该简短干预,71%的人认为讨论药物很有帮助。强化信息的平均评分>4.0(5分制);77%的人喜欢每日信息,91%的人认为它们有帮助。从描述性角度来看,干预组在酒精使用结果、大麻使用和无保护性行为方面随时间出现了绝对减少。

结论

这种带有强化信息的简短干预在使用药物(即主要是大麻)的刚成年的成年人目标人群中是可行且可接受的。这种在医疗就诊期间发起并由临床辅助人员陪同的干预模式,应在未来的充分动力试验中进行测试。

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