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）：作为健康福利计划的一部分，员工援助计划（EAP）提供短期咨询和长期推荐。 EAP环境为进行高危饮酒提供了一次独特的机会，以进行筛查和简短的干预措施（SBI）。使用EAP来解决高危饮酒并防止更严重的酒精问题发展对于降低受雇人群中这些问题的普遍性至关重要。不幸的是，临床医生没有通过EAP来确定大多数高危饮酒者，也没有通过EAPS提供服务，以供他们饮酒。这项为期两年的服务研究的主要目的是了解如何在标准EAP环境中实施SBI来饮酒。大量证据支持SBI在其他环境中的有效性，例如初级保健和大学环境。但是，只有少数已发表的研究研究了将SBI实施到工作场所人群中的可行性。这些SBI干预措施通常持续约20-30分钟，并采用动机采访方法。这些干预措施的简短性质可能使整合变得可行，但是从组织和员工的角度来看，EAP可能会有一些障碍，这将使实施具有挑战性。在当前的研究中，我们将首先与EAP员工一起进行焦点小组，以确定与EAP内的SBI实施和招募SBI有关的障碍和促进因素。使用此信息，与仅标准EAP护理相比，我们将对SBI进行随机试验作为标准EAP护理的附加方法。 EAP临床医生将提供SBI干预和EAP会议。干预将是客户第二届会话的附加组件。进入EAP后，将使用审核-C筛选客户进行高危饮酒。在审计-C上得分五个或更高的女性客户得分的男性客户将随机分配给干预措施（n = 50）或对照组（n = 50）组。为了评估干预措施的功效，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护理中相关的基本成本数据，并探索收集行政数据以进行未来成本效益研究的可行性。该R21是我们理解将酒精干预进入工作场所并检查与此类干预相关的潜在功效和成本的潜在障碍的第一步。这项试验试验的结果具有影响护理标准的巨大潜力，以识别和干预EAP环境中的高危饮酒者。 公共卫生相关性：在标准EAP护理中广泛实施SBI具有降低工作场所酒精使用障碍的巨大潜力，并降低了职业，社会和与未经治疗的处于危险中的饮酒相关的职业，社会和健康问题。迄今为止，很少有研究检查在EAP环境中实施SBI，并且对遇到的障碍知之甚少。这项试验试验的结果具有影响护理标准的巨大潜力，以识别和干预EAP环境中的高危饮酒者。