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赞比亚采用常见要素治疗法(CETA)减少亲密伴侣暴力和有害饮酒行为的两年治疗效果。

Two-year treatment effects of the common elements treatment approach (CETA) for reducing intimate partner violence and unhealthy alcohol use in Zambia.

作者信息

Kane Jeremy C, Glass Nancy, Bolton Paul A, Mayeya John, Paul Ravi, Mwenge Mwamba, Murray Laura K

机构信息

Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, NY, USA.

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

Glob Ment Health (Camb). 2021 Feb 19;8:e4. doi: 10.1017/gmh.2021.2. eCollection 2021.

Abstract

BACKGROUND

Intimate partner violence (IPV) and unhealthy alcohol use are common yet often unaddressed public health problems in low- and middle-income countries. In a randomized trial, we found that the common elements treatment approach (CETA), a multi-problem, flexible, transdiagnostic intervention, was effective in reducing IPV and unhealthy alcohol use among couples in Zambia at a 12-month post-baseline assessment. In this follow-up study, we investigated whether treatment effects were sustained among CETA participants at 24-months post-baseline.

METHODS

Participants were heterosexual couples in Zambia in which the woman reported IPV perpetrated by the male partner and in which the male had hazardous alcohol use. Couples were randomized to CETA or treatment as usual plus safety checks. Measures were the Severity of Violence Against Women Scale (SVAWS) and the Alcohol Use Disorders Identification Test (AUDIT). The trial was stopped early upon recommendation by the trial's DSMB due to CETA's effectiveness following the 12-month assessment. Control participants exited the study and were offered CETA. This brief report presents data from an additional follow-up assessment conducted among original CETA participants at a 24-month visit.

RESULTS

There were no meaningful changes in SVAWS or AUDIT scores between 12- and 24-months. The within-group treatment effect for SVAWS from baseline to 24-months was 1.37 ( < 0.0001) and AUDIT was 0.85 ( < 0.0001).

CONCLUSIONS

The lack of change in levels of IPV and unhealthy alcohol use between the 12- and 24-month post-baseline timepoints suggests that treatment gains were sustained among participants who received CETA for at least two years from intervention commencement.

摘要

背景

亲密伴侣暴力(IPV)和不健康饮酒是低收入和中等收入国家常见但往往未得到解决的公共卫生问题。在一项随机试验中,我们发现常见要素治疗方法(CETA),一种多问题、灵活的跨诊断干预措施,在基线后12个月的评估中,对减少赞比亚夫妇中的亲密伴侣暴力和不健康饮酒有效。在这项随访研究中,我们调查了在基线后24个月时,CETA参与者的治疗效果是否得以维持。

方法

参与者为赞比亚的异性恋夫妇,其中女性报告遭受男性伴侣的亲密伴侣暴力,且男性存在有害饮酒行为。夫妇被随机分为接受CETA组或常规治疗加安全检查组。测量指标为针对妇女暴力行为严重程度量表(SVAWS)和酒精使用障碍识别测试(AUDIT)。由于CETA在12个月评估后的有效性,试验在试验数据安全监测委员会的建议下提前终止。对照组参与者退出研究并被提供CETA。本简要报告呈现了在24个月随访时对原CETA参与者进行的额外随访评估数据。

结果

在12个月至24个月期间,SVAWS或AUDIT分数没有有意义的变化。从基线到24个月,SVAWS的组内治疗效果为1.37(<0.0001),AUDIT为0.85(<0.0001)。

结论

在基线后12个月至24个月的时间点之间,亲密伴侣暴力水平和不健康饮酒情况没有变化,这表明从干预开始接受CETA治疗至少两年的参与者维持了治疗效果。

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