12-step Alternatives and Recovery Outcomes in a Large National Study

大型全国性研究中的 12 步替代方案和恢复结果

• 批准号: 8787902
• 负责人: SARAH E. ZEMORE
• 金额: $ 18.32万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8787902
• 关键词: Abstinence; Address; Aftercare; Alcohol abuse; Alcohol or Other Drugs use; Alcohols; Attitude; Behavior Therapy; Clinical; Communities; Data; Dependence; Dimensions; Drops; Drug usage; Effectiveness; Female; Friends; General Population; Group Homes; Growth; Health Services Research; Income; Individual; Intervention; Lead; Legal; Literature; Longitudinal Studies; Measures; Motivation; National Institute on Alcohol Abuse and Alcoholism; Nature; Outcome; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Policy Maker; Provider; Published Comment; Quality of life; Recording of previous events; Recovery; Recruitment Activity; Religion and Spirituality; Reporting; Research; Research Design; Research Personnel; Respondent; Self Management; Services; Severities; Social Network; Source; Subgroup; Substance abuse problem; Surveys; Testing; Time; Training; Woman; Work; addiction; alcohol use disorder; court; demographics; evidence based guidelines; follow-up; improved; infancy; knowledge base; meetings; member; mortality; peer; programs; public health relevance; randomized trial; satisfaction; sobriety; substance abuse treatment; treatment planning; volunteer

DESCRIPTION (provided by applicant): It is now generally accepted that AA and other 12-step groups contribute to better substance use outcomes for those who are addicted to alcohol and/or drugs and choose to attend them. Nevertheless, most individuals do not sustain regular involvement in 12-step groups, even when 12-step participation is the focus of treatment. Meanwhile, involvement in 12-step alternatives is substantial and appears to be growing. The largest such alternatives include Women for Sobriety (WFS), Self-Management and Recovery Training (SMART), LifeRing, and Secular Organization for Sobriety (SOS). Yet, research relating to the effectiveness of 12-step alternatives is almost non-existent, and there are no known longitudinal studies on group members. Research on the effectiveness of the various alternatives is important to enhancing the integration of formal treatment with appropriate alternatives, improving referral practices, and informing courts and other legal bodies (e.g., EAP programs) involved in mandating substance abuse treatment, as well as the general population. The current study will thus capitalize on a very large, recent, national study of individuals in recovery from an alcohol and/or drug problem to follow respondents recruited from 12-step groups (N=261) and their alternatives (N=390; total N=651) and measure mutual help group involvement and recovery outcomes. Respondents will complete a First Follow-up survey and additional follow-ups at 6 and 12 months (Second and Third Follow-ups). Our primary aim is to test whether associations between mutual help group involvement and recovery outcomes (such as abstinence and quality of life) differ across mutual help groups (Aim 2). We will also compare respondents identifying WFS, SMART, LifeRing, and SOS as their primary mutual help group to 12-step members on demograpcharhics, clinical severity, and nature of involvement (Aim 1), and examine predictors of group satisfaction and drop-out/declining involvement across mutual help groups (Aim 3). Despite some small subgroups, we expect generally sufficient numbers within each group to facilitate comparisons between individual 12-step alternatives and AA. The current study should, in the short term, contribute to the knowledge base on the benefits and limits of specific mutual help groups, and may lead to more focused study of one or more promising alternative(s) to AA and to study designs that can best address questions of effectiveness, such as randomized trials. Ultimately, the current line of research could support both the growth of effective mutual help groups and the recovery of the many individuals who may be willing to use them. This proposal responds to PA-13-161 (Alcohol Use Disorders: Treatment, Services Research, and Recovery, NIAAA), soliciting research on behavioral and pharmacological treatment for alcohol use disorders.

描述（由申请人提供）：现在普遍认为，AA和其他12步组为那些沉迷于酒精和/或药物的人提供了更好的药物使用结果并选择参加。然而，即使参与12步是治疗的重点，大多数人也不会定期参与12步组。同时，参与12步替代方案是很大的，并且似乎正在增长。此类最大的替代方案包括清醒的女性（WFS），自我管理和恢复培训（SMART），Lifering和Sobriety（SOS）的世俗组织。然而，与12步替代方案有效性有关的研究几乎不存在，并且没有关于小组成员的纵向研究。对各种替代方案的有效性的研究对于增强正式治疗与适当的替代方案的整合，改善推荐实践以及为涉及强制性药物滥用治疗的法院和其他法律机构（例如EAP计划）提供信息至关重要。因此，当前的研究将利用一项非常大的，最近的全国性研究，该研究是从酒精和/或药物问题中恢复的个人，以跟随从12步组招募的受访者（n = 261）及其替代方案（n = 390;总n = 651）并测量互助群体的参与和恢复结果。受访者将在6个月和12个月（第二和第三个随访）完成第一次后续调查和其他随访。我们的主要目的是测试互助群体参与和恢复结果（例如禁欲和生活质量）之间的关联在互助组之间有所不同（AIM 2）。我们还将比较识别WF，智能，生活和SOS作为其主要互助小组的受访者与12步成员的Demogropcharhics，临床严重程度和参与性质（AIM 1），并检查群体满意度和辍学/下降/下降/下降/下降/下降的参与者（AIM 3）（AIM 3）。尽管有一些小组，但我们期望每组中通常足够的数字可以促进单个12步替代方案与AA之间的比较。当前的研究在短期内应为特定相互帮助小组的收益和局限性的知识基础做出贡献，并可能导致对AA的一种或多种有希望的替代方案的更为专注的研究，并研究设计可以最好地解决有效性问题的设计，例如随机试验。最终，当前的研究路线可以支持有效的共同帮助小组的增长，又可以支持许多愿意使用它们的人的恢复。该提案对PA-13-161（酒精使用障碍：治疗，服务研究和恢复，NIAAA）做出了反应，对酒精使用障碍的行为和药理治疗征集研究。