ReDIAL: A Telephone Brief Intervention for Injured Emergency Department Patients

ReDIAL：针对急诊科受伤患者的电话简短干预

基本信息

批准号：
8436320
负责人：
Michael J Mello
金额：
$ 57.35万
依托单位：
RHODE ISLAND HOSPITAL
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：
2010-03-01 至 2015-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8436320
关键词：
Accident and Emergency department Accounting Address Adoption Affect Alcohol abuse Alcohol consumption Alcohols Appointment Area Attenuated Automobile Driving Back Behavior Behavior Therapy Centers for Disease Control and Prevention (U.S.)Communities Consent Control Groups Coupled Data Data Analyses Distal Education Educational Intervention Effect Modifiers (Epidemiology)Effectiveness Effectiveness of Interventions Elements Emergency Medicine Equation Evaluation Event Face Frequencies Funding Future Goals Guidelines Health Health Services Accessibility Home environment Hospitals Impulsivity Individual Injury Intervention Life Link Measurement Measures Mediating Mediation Mediator of activation protein Modeling National Institute on Alcohol Abuse and Alcoholism Nature Outcome Participant Pathway interactions Patient Self-Report Patients Population Populations at Risk Predisposition Prevalence Probability Proxy Questionnaires Randomized Readiness Recruitment Activity Relative (related person)Research Research Design Resources Risk Safety Series Services Severities Site Strategic Planning Structural Models System Target Populations Telephone Testing Time Treatment Factor Treatment outcome Vehicle crash Visit Work active method alcohol abuse therapy alcohol intervention behavior change brief alcohol intervention brief intervention clinical care cost cost effective cost effectiveness design direct application dosage drinking driving behavior experience high risk drinking impaired driving performance improved injured intervention effect longitudinal analysis motivational enhancement therapy novel prevent programs psychosocial screening screening and brief intervention success theories therapy development tool treatment as usual treatment effect

项目摘要

DESCRIPTION (provided by applicant): The long-term goal of the present program of research is to reduce impaired driving, risky drinking and alcohol- related injuries among injured patients who present in a hospital emergency department (ED). The current proposed project, ReDIAL, will conceptually replicate, strengthen and seek to understand the findings of DIAL (recently completed CDC-funded RCT), which established the acceptability and effectiveness of telephone- delivered brief intervention (TBI) in reducing impaired driving and decreasing the frequency of alcohol-related injuries among injured ED patients with risky alcohol use. ReDIAL primary aims are to: examine the effects of a more intensive telephone BI (added booster session of TBI) on 1) risky alcohol use and alcohol related injuries; 2) impaired driving and other driving related negative consequences; 3) estimate the cost effectiveness of screening plus TBI 4) identify mechanisms of change and the active ingredients of treatment that explain the effect of TBI on proximal and distal outcomes; and 5) identify and assess the effect that patient predispositions have on the relationship between TBI and changes in risky driving and alcohol injuries. This study will recruit injured ED patients who screen positive for risky alcohol use (i.e. exceed NIAAA quanity/frequency guidelines). Eligible patients will be consented in the ED and will receive an appointment for an initial contact call within 1 week. At the initial telephone call the research participant will receive an assessment and then will be randomized into one of two conditions: 1) TBI or 2) a comparison control group with a home safety educational program. Both will be provided over three telephone sessions: the initial call (immediately following randomization) and two booster calls at 2 weeks and 6 weeks after randomization. Participants are assessed for levels of risky alcohol use, alcohol-related injuries, impaired driving, and other driving related negative consequences at 4, 8, and 12 months post-randomization. ReDIAL addresses a focus area in the NIAAA 2008-2013 strategic plan in identifying strategies to enhance screening, brief interventions, and appropriate referrals to additional services and PA-07-066 research objectives: identification and evaluation of mechanisms underlying the actions of behavioral therapies and the development of effective strategies aimed at assisting systems to identify and implement appropriate empirically-supported interventions. With 30 million yearly US ED visits for injuries and the prevalence of risky alcohol use between 20-30% in ED patients, ReDIAL's success in achieving its aims has the potential for TBI to become an accepted part of routine ED clinical care and prevent future injury occurrence.

描述（由申请人提供）：本研究计划的长期目标是减少医院急诊科 (ED) 受伤患者的驾驶不清醒、危险饮酒和酒精相关伤害。当前拟议的项目 ReDIAL 将从概念上复制、加强并寻求理解 DIAL（最近完成的 CDC 资助的 RCT）的研究结果，该研究结果确立了电话简短干预 (TBI) 在减少不清醒驾驶和减少不良驾驶方面的可接受性和有效性。因危险饮酒而受伤的 ED 患者中与酒精相关的伤害的频率。 ReDIAL 的主要目的是：检查更密集的电话 BI（添加 TBI 强化课程）对 1) 危险饮酒和酒精相关伤害的影响； 2) 不清醒驾驶及其他与驾驶相关的负面后果； 3) 估计筛查加 TBI 的成本效益 4) 确定变化机制和治疗活性成分，以解释 TBI 对近端和远端结果的影响； 5) 确定并评估患者易感性对 TBI 与危险驾驶和酒精伤害变化之间关系的影响。本研究将招募危险饮酒筛查呈阳性的受伤 ED 患者（即超过 NIAAA 数量/频率指南）。符合条件的患者将在急诊室获得同意，并将在 1 周内收到初次联系电话的预约。在最初的电话中，研究参与者将接受评估，然后被随机分配到以下两种情况之一：1) TBI 或 2) 具有家庭安全教育计划的对照组。两者都将通过三次电话会议提供：初次通话（随机化后立即进行）以及随机化后 2 周和 6 周时的两次加强通话。在随机分组后 4、8 和 12 个月，对参与者的危险饮酒、酒精相关伤害、驾驶不清醒和其他驾驶相关负面后果的水平进行评估。 ReDIAL 解决了 NIAAA 2008-2013 战略计划中的一个重点领域，即确定加强筛查、简短干预和适当转介其他服务的策略以及 PA-07-066 研究目标：识别和评估行为疗法和行为疗法背后的机制。制定有效的战略，旨在协助系统确定和实施适当的经验支持的干预措施。美国每年有 3000 万人次因受伤而就诊，并且 ED 患者中危险饮酒的患病率在 20-30% 之间，ReDIAL 成功实现其目标，有可能使 TBI 成为常规 ED 临床护理的公认组成部分，并预防未来的伤害发生。