A STAGE MATCHED ALCOHOL INTERVENTION FOR MANAGED CARE

管理式护理的阶段匹配酒精干预

• 批准号: 6509040
• 负责人: ROBERT G LAFORGE
• 金额: $ 55.25万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-04-01 至 2005-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6509040
• 关键词: alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; clinical trials; cognitive behavior therapy; comprehension; computer assisted instruction; decision making; disease /disorder proneness /risk; expectancy; gender difference; health care cost /financing; health care service utilization; human subject; human therapy evaluation; longitudinal human study; managed care; motivation; outcomes research; peer group; psychometrics; self help; substance abuse related behavior

This project addresses important questions of technology transfer by evaluating an innovative secondary prevention program for managed care. The program will proactively recruit at-risk drinkers and administer a computer-based low intensity motivationally matched individualized cognitive-behavioral intervention. The study will examine the impact of a brief stage matched intervention, involving periodic assessment and expert system feedback, on high risk alcohol use. It is designed to test whether the stage matched intervention outperforms periodic assessment alone, whether periodic assessment itself is effective, and whether these results differ by gender. Although non-dependent at-risk drinkers contribute substantially to the nation's overall burden of alcohol-related morbidity and mortality, many at-risk drinkers do not perceive their alcohol use a problematic, and few are prepared to change those behaviors. Brief self-help interventions targeted to the individual needs and motivational readiness of at-risk drinkers have great potential to bring about meaningful reduction in harmful drinking. Over the past decade interactive self-help interventions, based on the Transtheoretical Model of change, have demonstrated important public health impacts in large scale clinical trials of smoking and other health behaviors. A three group randomized controlled design will compare a brief intervention condition with two control conditions; a minimal assessment post-test only control and an assessment only control condition. Multiple outcomes and sensitive measures of intermediate variables are used to evaluate the change process. The study will proactively screen the managed care population to identify a gender balanced sample of 1,235 non-dependent "at risk" drinkers who would not normally be targeted for intervention. There is a six month intervention period followed by 3 outcome assessments at 6 month intervals. Secondary analyses will examine potential mediators of behavior change, and explore the relationship of at-risk drinking to medical care utilization and costs. This unique recruitment and intervention strategy requires few resources from health care providers and is likely to be highly disseminable to other managed care organizations.

该项目通过评估管理式医疗的创新二级预防计划来解决技术转让的重要问题。 该计划将主动招募有风险的饮酒者，并实施基于计算机的低强度动机匹配的个性化认知行为干预。 该研究将探讨短期阶段匹配干预措施（包括定期评估和专家系统反馈）对高风险饮酒的影响。 它旨在测试阶段匹配干预是否优于单独的定期评估，定期评估本身是否有效，以及这些结果是否因性别而异。 尽管非依赖性高危饮酒者对国家与酒精相关的发病率和死亡率的总体负担做出了重大贡献，但许多高危饮酒者并不认为他们的饮酒有问题，而且很少有人准备改变这些行为。 针对高危饮酒者的个人需求和动机准备的简短自助干预措施有很大潜力显着减少有害饮酒。 在过去的十年中，基于跨理论变革模型的交互式自助干预措施在吸烟和其他健康行为的大规模临床试验中证明了对公共卫生的重要影响。 三组随机对照设计将简单的干预条件与两个对照条件进行比较；仅测试后最低评估控制和仅评估控制条件。 多重结果和中间变量的敏感测量用于评估变革过程。该研究将主动筛查管理式护理人群，以确定 1,235 名非依赖性“高危”饮酒者的性别均衡样本，这些人通常不会成为干预的目标。 有六个月的干预期，随后每隔 6 个月进行 3 次结果评估。 二次分析将检查行为改变的潜在中介因素，并探讨高危饮酒与医疗保健利用和成本的关系。 这种独特的招募和干预策略只需要医疗保健提供者提供很少的资源，并且很可能向其他管理式医疗组织高度传播。