School of Social Work, San Diego State University, San Diego, California.
Naval Hospital Camp Pendleton, Camp Pendleton, California.
J Stud Alcohol Drugs. 2021 Mar;82(2):269-278. doi: 10.15288/jsad.2021.82.269.
Rates of heavy alcohol use among active-duty military personnel in the United States are high and negatively affect individuals within the service branches. This study tested the effectiveness of a military-focused screening, brief intervention, and referral to treatment (SBIRT) intervention for reducing risky alcohol use among active-duty patients.
We used a randomized, parallel, two-group design to test the effectiveness of the SBIRT intervention in a convenience sample of service members recruited from the emergency department of a military hospital. A total of 791 participants were randomized to the SBIRT or usual care conditions, and 472 participants (59.7%) completed a 6-month follow-up. Fifteen percent of the sample was female. Self-reported Alcohol Use Disorders Identification Test (AUDIT), controlled drinking self-efficacy (CDSE), and readiness to change drinking behaviors were assessed at baseline and follow-up.
Among higher risk participants (i.e., AUDIT ≥8), results of a complete case analysis showed a significant reduction in scores on the AUDIT-C (consumption questions from the AUDIT) and a significant increase in CDSE. Null findings were observed for intent-to-treat analyses testing the effectiveness of the SBIRT intervention; significant decreases in AUDIT and AUDIT-C scores and significant increases in CDSE were observed over time, irrespective of condition assignment for both complete case and intent-to-treat analyses.
Results of a complete case analysis provided some support for the effectiveness of the SBIRT intervention for higher risk participants. The results of the more conservative intent-to-treat analyses did not support any of the study hypotheses. Future SBIRT effectiveness trials should also test electronic SBIRT intervention approaches.
美国现役军人中重度饮酒的比率很高,这对服务部门的个人产生了负面影响。本研究测试了一种针对军人的重点筛查、简短干预和转介治疗(SBIRT)干预措施,以减少现役患者的危险饮酒行为。
我们使用随机、平行、两组设计,在一家军事医院急诊科招募的现役军人便利样本中测试 SBIRT 干预的有效性。共有 791 名参与者被随机分配到 SBIRT 或常规护理条件组,其中 472 名参与者(59.7%)完成了 6 个月的随访。该样本的 15%为女性。在基线和随访时评估自我报告的酒精使用障碍识别测试(AUDIT)、控制饮酒自我效能(CDSE)和改变饮酒行为的意愿。
在高风险参与者(即 AUDIT≥8)中,完整案例分析的结果显示 AUDIT-C(AUDIT 的消费问题)得分显著降低,CDSE 显著增加。意向治疗分析测试 SBIRT 干预的有效性时未发现无效结果;无论完整案例分析还是意向治疗分析,随着时间的推移,AUDIT 和 AUDIT-C 得分均显著降低,CDSE 显著增加。
完整案例分析的结果为 SBIRT 干预对高风险参与者的有效性提供了一些支持。更保守的意向治疗分析的结果并不支持研究假设中的任何一个。未来的 SBIRT 有效性试验还应测试电子 SBIRT 干预方法。