An RCT of Brief Intervention for Problem Drinking and Partner Violence

针对酗酒问题和伴侣暴力问题的短期干预的随机对照试验

基本信息

批准号：
8277419
负责人：
KARIN V RHODES
金额：
$ 50.93万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-01 至 2015-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8277419
关键词：
Accident and Emergency department Acute Address Advisory Committees Alcohol abuse Alcohol consumption Alcohol dependence Alcohols Blinded Clinical Coercion Communities Complex Control Groups Counseling Country Couples Data Diagnosis Effectiveness Emergency Medicine Ethnic Origin Etiology Evidence based intervention Failure Female Frequencies Gender Goals Grant Health Health behavior Healthcare Heavy Drinking Illicit Drugs Individual Injury International Intervention Intervention Studies Interview Interviewer Length Literature Manuals Measures Mediator of activation protein Medical Mental Depression Mental Health Modeling Monitor Morbidity - disease rate Outcome Patients Pattern Persons Post-Traumatic Stress Disorders Preventive Intervention Primary Health Care Provider Psychotherapy Public Health Quality of life Randomized Controlled Trials Recording of previous events Reporting Research Personnel Resources Risk Role Safety Screening procedure Self Efficacy Services Severities Sexual abuse Social Workers Source Substance abuse problem Support Groups Support System System Telephone Time Training Translating United States Victimization Violence Visit Voice Woman Writing assault base brief intervention brief motivational intervention court drinking efficacy research experience falls follow-up hazardous drinking improved intervention effect intimate partner violence male men mortality motivational enhancement therapy motivational intervention multidisciplinary partner violence perpetrators physical abuse physical conditioning primary outcome psychosocial public health relevance response satisfaction secondary outcome treatment program

项目摘要

DESCRIPTION (provided by applicant): Intimate partner violence (IPV) remains a major source of morbidity and mortality in the United States, with women suffering the majority of adverse long-term consequences. While both men and women perpetrate IPV at similar rates, this grant will focus on IPV-involved women drinkers (victims, perpetrators, or both). IPV and heavy drinking (4 or more drinks/day for women) are commonly seen in as co-occurring conditions in the emergency department (ED) setting, both acutely and chronically, with apparent bi-directional causation; but these two conditions are rarely addressed together. There is evidence that brief opportunistic interventions in the ED setting are effective in reducing subsequent hazardous drinking and alcohol-related injuries, but results have been less clear in women. Interventions that take a collaborative treatment approach to IPV and substance abuse have resulted in improved outcomes but have focused almost exclusively on male perpetrators, even though heavy drinking is also associated with IPV victimization and perpetration in women; indeed a woman's perpetration of IPV puts her at increased risk of violent victimization. Advised by international experts on gender and alcohol use and motivational enhancement therapy, the multidisciplinary group of investigators with experience in IPV, emergency medicine, brief ED interventions, motivational interviewing, psychotherapy efficacy research, and the modeling of complex psychosocial data, propose a randomized controlled trial with 600 women ED patients who self-disclose co-occurring problem drinking and intimate partner violence to assess whether a brief motivational intervention can decrease primary outcomes of episodes of heavy drinking and incidents of IPV, assessed weekly using an Interactive Voice Response System for 12 weeks. Both the intervention and the assessed control group will also be contacted every at 3, 6 and 12 months using individualized "safe" phone contact by interviewers blinded to group assignment for 12 months following the ED visit. To identify the impact of assessment alone, we will include a no-contact control group assessed for outcomes only at 3 months. All groups will receive standard written referrals. Secondary outcomes include IPV severity, alcohol quantity/frequency, self-rated health, health behaviors, quality of life, and relationship satisfaction. We will explore likely mediators and moderators of the intervention. The brief 25 minute manual-guided motivational intervention, which will be monitored for fidelity, will be delivered by trained social workers at the time of the ED visit, followed by a 15 minute phone booster at 10 days, as this is a model that could be generalizable to other acute health care settings. PUBLIC HEALTH RELEVANCE: We propose a randomized controlled trial with 600 women emergency department (ED) patients to assess whether a brief motivational enhancement intervention can decrease co-occurring heavy drinking and IPV (both victimization and perpetration) and encourage follow up with community-based resources. The 25 minute manual-guided intervention, monitored for fidelity, will be delivered at the time of the ED visit by social workers trained in motivational interviewing, followed by a phone booster at 10 days. Primary outcomes of episodes of heavy drinking and incidents of IPV will be assessed weekly using an Interactive Voice Response System for 12 weeks. The intervention and the assessed control group will also be contacted at 3, 6 and 12 months using individualized "safe" phone contact by interviewers blinded to group assignment. To identify the impact of assessment alone, we will include a no-contact control group assessed only at 3 months. All groups will receive standard written referrals.

描述（由申请人提供）：在美国，亲密的伴侣暴力（IPV）仍然是发病率和死亡率的主要来源，妇女遭受了大部分不良长期后果。尽管男性和女性都以类似的速度进行IPV，但该赠款将集中于IPV涉及的女性饮酒者（受害者，肇事者或两者兼而有之）。在急诊科（ED）环境中，通常将IPV和大量饮酒（女性饮料每天为4或更多），无论是急性和慢性病，都有明显的双向因果关系；但是这两个条件很少被共同解决。有证据表明，在ED环境中进行了简短的机会性干预措施可有效减少随后的危险饮酒和与酒精有关的伤害，但妇女的结果尚不清楚。采用协作治疗方法的IPV和药物滥用的干预措施导致了进步的改善，但几乎只专注于男性肇事者，即使大量饮酒也与女性IPV受害和犯罪有关。的确，妇女对IPV的实施使她面临着暴力受害的风险。国际性别和饮酒和动机增强治疗的国际专家的建议，具有IPV，急诊医学，简短的ED干预，动机访谈，心理疗法疗效研究以及复杂心理社会数据的建模的多学科研究人员小组，并提出了与600名培养型饮用者的次数型自我培训的患者，对复杂的心理社会数据进行了建模大量饮酒和IPV事件的发作结果，每周使用交互式语音响应系统评估12周。在ED访问后12个月内，使用对小组分配的访调员的个性化“安全”电话联系，在3、6和12个月内，干预措施和评估对照组都将在3、6和12个月之间与之联系。为了确定仅评估的影响，我们将包括一个仅在3个月时对结果进行评估的无接触对照组。所有小组将收到标准的书面推荐。次要结果包括IPV严重性，酒精数量/频率，自我评估的健康，健康行为，生活质量和人际关系满意度。我们将探讨干预措施的调解人和主持人。短暂的25分钟手动引导的动机干预将在ED访问时受过训练的社会工作者进行监控，然后在ED访问时提供15分钟的电话助推器，因为这是可以推广到其他急性医疗保健环境的型号。公共卫生相关性：我们建议与600名女性急诊科（ED）患者进行一项随机对照试验，以评估短暂的动机增强干预措施是否可以减少同时发生的大量饮酒和IPV（受害和实施），并鼓励对基于社区的资源进行后续资源。经过25分钟的手动引导干预措施，该干预措施将在ED访问时由接受励志采访的社会工作者进行，随后在10天后进行电话助推器。大量饮酒和IPV事件的主要结果将每周使用交互式语音响应系统进行12周评估。干预措施和评估的对照组也将在3、6和12个月与对小组分配的访调员的个性化“安全”电话联系。为了确定仅评估的影响，我们将包括一个仅在3个月时评估的无接触对照组。所有小组将收到标准的书面推荐。