RESEARCH ADOLESCENTS FOR PREVENTION

研究青少年的预防

• 批准号: 6968140
• 负责人: Edward Bernstein Bernstein
• 金额: $ 46.17万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-12 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6968140
• 关键词: adolescence (12-20); alcoholic beverage consumption; alcoholism /alcohol abuse education; alcoholism /alcohol abuse prevention; alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; clinical trials; drug addiction; early experience; emergency care; high risk behavior /lifestyle; human subject; human therapy evaluation; injury prevention; interview; longitudinal human study; mass screening; pediatrics; safe sex /sex abstinence; substance abuse related behavior; urban area; violence

Early use of alcohol by youth contributes to initiation of a chain of risky behaviors, and early intervention may prevent a great variety of harmful consequences. In this study, we propose a randomized, controlled design to test the utility in a large, urban Pediatric Emergency Department (PED) of a brief negotiated interview and active referral (the BNI-AR) with patients aged 14-21 who screen positive for risky and dependent drinking in order to reduce alcohol consumption, alcohol related injury and other alcohol related risk behaviors and link young patients with resources and, where appropriate, with the alcohol treatment system. We will screen 10,000 PED patients to detect those with an alcohol related problem. In order to control for assessment reactivity, we will randomize participants to either an intervention group, a control group that receives baseline assessment using a panel of standardized instruments, or a control group that receives no assessment. The intervention consists of normative feedback, review of the pros and cons of current alcohol use, assessment of readiness to change, review of any association between alcohol and injury and/or between alcohol and the patient's presenting medical problem, evaluation of strengths and assets, negotiation of a contract for change, referral to alcohol treatment and/or other resources, and a booster session at 10 days. We follow the three groups at 3 and 12 months to analyze outcomes related to consumption, alcohol problems, injury, fighting, school attendance, safe sex and use of treatment and other resources. We propose to expand in a PED setting with: 1) a large study sample of 1275 14-21 year olds who vary in age, risk profile, racial/ethnic background, reason for visit and severity of alcohol related problems; 2) the use of culturally competent community outreach youth workers to conduct comprehensive screening and motivational intervention, 3) expansion of outcomes to include self report of reduction in intentional and unintentional injury, alcohol-related risks (number of episodes of drinking and driving, physical fights and unsafe sex), and objective measures of motor vehicle record violations, hospital ED visits and trauma admissions, and contact with the alcohol treatment system at one year follow up; 4) analysis of independent effects of age group at entry, age of onset of drinking, quantity and frequency of drinking at baseline, risk-taking propensity and hospital admission; and 5) introduction of a control for assessment reactivity.

青少年过早饮酒会导致一系列危险行为的发生，而早期干预可以防止多种有害后果。在这项研究中，我们提出了一种随机对照设计，以测试在大型城市儿科急诊室 (PED) 对 14-21 岁筛查呈阳性的患者进行简短协商访谈和主动转诊 (BNI-AR) 的实用性。为了减少酒精消耗而进行危险和依赖性饮酒， 酒精相关伤害和其他酒精相关风险行为，并将年轻患者与资源联系起来，并在适当情况下与酒精治疗系统联系起来。我们将对 10,000 名 PED 患者进行筛查，以发现那些有酒精相关问题的人。为了控制评估反应性，我们将参与者随机分配到干预组、使用一组标准化仪器接受基线评估的对照组或对照组 没有收到任何评估。干预措施包括规范性反馈、审查当前饮酒的利弊、评估改变的准备情况、审查酒精与伤害之间和/或酒精与患者出现的医疗问题之间的任何关联、评估优势和资产、谈判变更合同、转介酒精治疗和/或其他资源，以及 10 天的加强课程。我们在 3 个月和 12 个月时对三组进行跟踪，分析与消费、酒精问题、伤害、打架、上学、安全性行为以及治疗和其他资源的使用相关的结果。我们建议在 PED 环境中进行扩展：1) 1275 名 14-21 岁青少年的大型研究样本，他们的年龄、风险状况、种族/族裔背景、就诊原因和酒精相关问题的严重程度各不相同； 2) 利用具有文化能力的社区外展青年工作者进行全面筛查和激励干预，3) 扩大成果范围，包括减少故意和无意伤害、酒精相关风险（酒后驾驶的次数、身体状况）的自我报告打架和不安全性行为），以及对机动车辆记录违规、医院急诊就诊和创伤入院以及一年随访时与酒精治疗系统接触的客观措施； 4) 分析入组时年龄组、开始饮酒年龄、基线饮酒量和频率、冒险倾向和入院情况的独立影响； 5) 引入评估反应性控制。