Implementing a Screening and Brief Intervention in the EAP for At-Risk Drinkers

在 EAP 中对高危饮酒者实施筛查和简短干预

• 批准号: 7921690
• 负责人: Karen Chan Osilla
• 金额: $ 27万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7921690
• 关键词: Absenteeism; Accidents; Address; Administrator; Affect; Alcohol abuse; Caring; Client; Control Groups; Counseling; Data; Dependence; Dimensions; Early Diagnosis; Effectiveness; Eligibility Determination; Employee; Employee Assistance Program (Health Care); Employee Health; Face; Facilities and Administrative Costs; Family; Feedback; Female; Focus Groups; Future; Health; Health Benefit; Health Services Research; Heavy Drinking; Individual; Intervention; Mental Depression; Methods; Modeling; Nature; Occupational; Occupations; Outcome; Parents; Pharmaceutical Preparations; Population; Prevalence; Prevention; Primary Health Care; Process; Productivity; Protocols documentation; Publishing; Randomized; Recovery; Recruitment Activity; Relative (related person); Research; Research Design; Risk; Services; Telephone; Time; Training; Treatment Efficacy; Work; Workplace; adverse outcome; alcohol intervention; alcohol screening and brief intervention; alcohol use disorder; college; cost; cost effectiveness; drinking; drinking behavior; experience; follow-up; high risk drinking; improved; innovation; male; medical specialties; motivational enhancement therapy; pilot trial; prevent; public health relevance; randomized trial; research study; screening and brief intervention; standard care

DESCRIPTION (provided by applicant): Employee assistance programs (EAPs) offer short-term counseling and long-term referrals to employees as part of a health benefits package. The EAP setting presents a unique opportunity to conduct screening and brief interventions (SBIs) for at-risk drinking. Using an EAP to address at-risk drinking and to prevent more serious alcohol problems from developing may be critical to reducing the prevalence of these issues among employed individuals. Unfortunately, the majority of at-risk drinkers are not identified by clinicians through EAPs, nor are they provided services through EAPs for their drinking if identified. The main objective of this two-year services research study is to understand how to implement SBIs for at-risk drinking in a standard EAP setting. Substantial evidence supports the effectiveness of SBIs in other settings such as primary care and college settings. However, only a few published studies have examined the feasibility of implementing SBIs into workplace populations. These SBI interventions typically last about 20-30 minutes and utilize a Motivational Interviewing approach. The brief nature of these interventions may make it feasible to integrate, but there may be several barriers specific to the EAP from an organization and staff perspective that would make it challenging to implement. In the current study, we will first conduct focus groups with EAP staff to determine the barriers and facilitating factors associated with implementing and recruiting for a SBI for at-risk drinking within the EAP. Using this information, we will conduct a randomized trial of the SBI as an add-on to standard EAP care compared to standard EAP care alone. EAP Clinicians will deliver both the SBI intervention and EAP sessions. The intervention will be an add-on to the client's second session. Upon entering the EAP, clients will be screened for at-risk drinking using the AUDIT-C. Male clients scoring five or higher and female clients scoring three or higher on the AUDIT-C will be randomly assigned to either the intervention (n=50) or control (n=50) group. To assess the efficacy of the intervention, we will examine drinking and health outcomes at 3- and 6-month follow-ups. Finally, we will gather basic cost data associated with adding the SBI to standard EAP care and explore the feasibility of gathering administrative data for a future cost-effectiveness study. This R21 represents our first critical step in understanding potential barriers to bringing alcohol interventions into the workplace and examining potential efficacy and costs associated with this type of intervention. Results from this pilot trial have significant potential to influence standards of care for identifying and intervening with at-risk drinkers in the EAP setting. PUBLIC HEALTH RELEVANCE: Widely implementing SBIs in standard EAP care has a great potential for decreasing the prevalence of alcohol use disorders in the workplace as well as decreasing the costs of occupational, societal, and health problems associated with untreated at-risk drinking. To date, few studies have examined the implementation of an SBI in an EAP setting, and very little is known about the barriers that would be encountered. Results from this pilot trial have significant potential to influence standards of care for identifying and intervening with at-risk drinkers in the EAP setting.

描述（由申请人提供）：员工援助计划 (EAP) 为员工提供短期咨询和长期转介，作为健康福利计划的一部分。 EAP 环境为对高危饮酒人群进行筛查和简短干预 (SBI) 提供了独特的机会。使用 EAP 来解决高风险饮酒问题并防止出现更严重的酒精问题，对于减少就业人员中这些问题的发生率可能至关重要。不幸的是，大多数高危饮酒者并未被临床医生通过 EAP 识别出来，如果被发现，也不会通过 EAP 为他们提供饮酒服务。这项为期两年的服务研究的主要目标是了解如何在标准 EAP 环境中针对高风险饮酒实施 SBI。大量证据支持 SBI 在初级保健和大学等其他环境中的有效性。然而，只有少数已发表的研究探讨了在工作场所人群中实施 SBI 的可行性。这些 SBI 干预通常持续约 20-30 分钟，并采用动机访谈方法。这些干预措施的简短性质可能使其整合可行，但从组织和工作人员的角度来看，EAP 可能存在一些特定的障碍，这将使其实施具有挑战性。在当前的研究中，我们将首先与 EAP 工作人员进行焦点小组讨论，以确定与在 EAP 内实施和招募高危饮酒 SBI 相关的障碍和促进因素。利用这些信息，我们将进行一项随机试验，将 SBI 作为标准 EAP 护理的补充，与单独的标准 EAP 护理进行比较。 EAP 临床医生将提供 SBI 干预和 EAP 课程。该干预将是客户第二次治疗的附加项目。进入 EAP 后，将使用 AUDIT-C 对客户进行高风险饮酒筛查。在 AUDIT-C 中得分为 5 分或以上的男性客户和得分为 3 分或以上的女性客户将被随机分配到干预组 (n=50) 或对照组 (n=50)。为了评估干预措施的效果，我们将在 3 个月和 6 个月的随访中检查饮酒和健康结果。最后，我们将收集与将 SBI 添加到标准 EAP 护理相关的基本成本数据，并探讨为未来成本效益研究收集管理数据的可行性。 R21 代表了我们在了解将酒精干预措施引入工作场所的潜在障碍并检查与此类干预措施相关的潜在功效和成本方面迈出的第一个关键步骤。该试点试验的结果有很大潜力影响 EAP 环境中识别和干预高危饮酒者的护理标准。 公共卫生相关性：在标准 EAP 护理中广泛实施 SBI 对于降低工作场所酒精使用障碍的患病率以及降低与未经治疗的高危饮酒相关的职业、社会和健康问题的成本具有巨大潜力。迄今为止，很少有研究考察 SBI 在 EAP 环境中的实施，并且对可能遇到的障碍知之甚少。该试点试验的结果有很大潜力影响 EAP 环境中识别和干预高危饮酒者的护理标准。