Tailored Teen Alcohol and Violence Prevention in the ER

急诊室中量身定制的青少年酒精和暴力预防

• 批准号: 7019998
• 负责人: Maureen A Walton
• 金额: $ 62.72万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7019998
• 关键词: adolescence (12-20); age difference; alcoholism /alcohol abuse prevention; behavior therapy; behavioral /social science research tag; child behavior; clinical research; drug abuse; emergency health services; gender difference; high risk behavior /lifestyle; human subject; human therapy evaluation; injury prevention; interactive multimedia; juvenile delinquency; longitudinal human study; medically underserved population; mental health personnel; motivation; patient oriented research; racial /ethnic difference; substance abuse related behavior; urban area; violence; violence prevention

DESCRIPTION (provided by applicant): Alcohol misuse and violent behavior are serious and prevalent problems among urban adolescents and have large impacts on morbidity and mortality. Research from a variety of disciplines and methodological approaches has demonstrated that temporal connections between alcohol misuse and violent behavior tend to increase throughout adolescence, likely due to shared risk factors. For example, national data suggest that 49% of adolescent drinkers also report violent behaviors (e.g., physical fighting, and weapon usage.) in the past year. The urban Emergency Department (ED) provides a unique setting for addressing alcohol misuse and violent behaviors among adolescents, and capitalizes on a "teachable moment." This five-year study will refine promising intervention approaches to incorporate tailoring technology based on assessment of the adolescents' personal risk behaviors to address both alcohol misuse and violent behaviors. This randomized controlled trial will screen approximately 3200 adolescents in the ED (ages 14-18) over 30 months. Those who screen positive for both past year alcohol use and violent behaviors (approximately 30%) will be stratified by sex and then randomized to one of three conditions (n=250/group): Computer adapted motivational interviewing + skills training, Therapist adapted motivational interviewing + skills training, and an informational pamphlet control condition. Primary outcomes will be evaluated at 3- and 12-months and include alcohol use/misuse, violent behaviors, illicit drug use, unintentional injury, delinquency, and weapon carriage. A 1-week follow-up assessment will assess hypothesized mechanisms of change related to the interventions including stage of change, self-efficacy, intervention fidelity, and other intervention process measures. Additional covariates that will be examined include sex, race, and age. This study capitalizes upon the research team's prior experience delivering ED-based alcohol interventions, using both tailored computerized programs and brief motivational advice sessions to address common behaviors among at-risk inner-city youth. The proposed study integrates empirically-derived brief intervention strategies for alcohol misuse and violent behaviors using state-of-the-art technology to tailor the interventions to the specific risk factors of the adolescent in a high-risk urban ED setting; tailored computerized programs use available technology to augment and/or replace the need for clinical staff in the ED setting, where there is limited staff time to effect behavior change. This project will provide the critical first step toward the implementation of an integrated prevention program addressing overlapping risk factors that has the potential to be delivered to the millions of adolescents visiting urban EDs each year.

描述（由申请人提供）：滥用酒精和暴力行为是城市青少年的严重且普遍的问题，对发病率和死亡率产生了很大的影响。来自各种学科和方法论方法的研究表明，滥用酒精和暴力行为之间的时间联系在整个青春期都会增加，这可能是由于共同的危险因素所致。例如，国家数据表明，有49％的青春期饮酒者还报告了过去一年的暴力行为（例如身体上的战斗和武器使用）。城市急诊室（ED）提供了一个独特的环境，以解决青少年之间的滥用酒精和暴力行为，并在“可教的时刻”中大写。这项为期五年的研究将根据对青少年个人风险行为的评估来完善有希望的干预方法，以纳入裁缝技术，以解决酒精滥用和暴力行为。这项随机对照试验将在30个月内筛选ED（14-18岁）的大约3200名青少年。那些对过去一年饮酒和暴力行为呈阳性的人（约30％）将按性别进行分层，然后随机分为三个条件之一（n = 250/组）：计算机适用的动机访谈 +技能培训，治疗师适应动机访谈 +技能培训，以及信息的小册子控制条件。主要结果将在3个月和12个月的时间进行评估，包括酒精使用/滥用行为，非法吸毒，无意伤害，犯罪和武器运输。 1周的随访评估将评估与干预措施有关的变化的假设机制，包括变化阶段，自我效能感，干预保真度和其他干预过程指标。将检查的其他协变量包括性，种族和年龄。这项研究利用研究团队的先前经验提供了基于ED的酒精干预措施，同时使用量身定制的计算机计划和简短的动机建议会议来解决高危市中心的城市城市青年之间的共同行为。拟议的研究将使用最先进的技术纳入了对酒精滥用和暴力行为的经验衍生的简短干预策略，以在高风险的城市ED环境中对青少年的特定风险因素进行调查；量身定制的计算机程序使用可用技术来增加和/或替代在ED环境中的临床人员需求，在员工有限的时间来改变行为的情况下。该项目将为实施一项集成的预防计划提供关键的第一步，该计划应对重叠的风险因素，这有可能向每年访问Urban EDS的数以百万计的青少年交付。