Automated Bilingual Computerized Alcohol Screening & Intervention in Latinos

自动化双语电脑酒精筛查

基本信息

批准号：
9279040
负责人：
FEDERICO E VACA
金额：
$ 61.51万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-06-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9279040
关键词：
Accident and Emergency department Address Adoption Adult Advocate Affect Age Alcohol abuse Alcohol consumption Alcohol dependence Alcoholism Alcohols American Central American Clinical Communities Community Health Computers Cuban American Data Dependence Drug usage Emergency Department patient Emergency department visit Enrollment Future Gender Guidelines Health Health behavior Hispanics Home environment Human Impairment Individual Injury Institutes Intervention Interview Knowledge Language Latino Life Maintenance Mediation Medical Methods Mexican Americans Minority Multilingualism Nurses Outcome Patients Physicians Population Population Growth Prevention Primary Health Care Puerto Rican Quality of life Race Randomized Randomized Controlled Trials Research Risk Savings Schools Seasons Severities Smoking Status Social Workers Strategic Planning Technology Testing Time Training Transcend Treatment Efficacy United States National Institutes of Health Variant Visit Work alcohol abuse therapy alcohol consequences alcohol intervention alcohol misuse alcohol research alcohol screening alcohol screening and brief intervention alcohol use disorder base bilingualism binge drinking burden of illness comparative efficacy computerized cost drinking efficacy testing experience health disparity health information technology impaired driving performance improved multidisciplinary public health relevance racial and ethnic screening social standard care tailored messaging treatment duration

项目摘要

DESCRIPTION (provided by applicant): The burden of disease on human life due to alcohol is staggering. Alcohol misuse pervasively erodes the quality of life for individual drinkers and has negative and cumulative consequences on communities. U.S. Latinos are disproportionately affected by alcohol misuse and dependence which is of particular concern given that Latinos comprise 56% of U.S. population growth in the past decade. Simultaneously, the number of U.S. residents that speak Spanish at home grew from 17 million to over 35 million. Language barriers, among other unique challenges in the busy emergency department (ED) setting, have limited wide adoption of ED alcohol screening, brief intervention and referral to treatment (SBIRT). Use of Automated Bilingual-Computerized Alcohol Screening and Intervention (AB-CASI) for Latino Drinkers in the ED holds strong early compelling evidence that it can surmount barriers and increase alcohol treatment in vulnerable ED populations. Objective: To conduct a randomized controlled trial that enrolls both English and Spanish speaking adult Latino ED patients to compare the efficacy of AB-CASI to Standard Care (SC) in reducing alcohol consumption and consequences for all levels of unhealthy drinking ranging from at-risk to dependence. Aims: Our seasoned multidisciplinary team will: (1) compare the efficacy of AB-CASI to SC in the reduction of alcohol consumption in unhealthy drinkers, (2) compare the efficacy of AB-CASI to SC in the reduction of alcohol-related negative health behaviors and consequences, (3) compare the efficacy of AB-CASI to SC in 30-day engagement in treatment, and (4) explore variation of AB-CASI on alcohol consumption, alcohol-related negative health behaviors and consequences and 30-day treatment engagement across Latino subpopulations and other potential modifiers. Our hypotheses are: (1) at 12 months, AB-CASI will be superior to SC in reducing the number of binge drinking episodes and the mean number of weekly drinks over the last 28-days, (2) at 12 months, AB-CASI will be superior to SC in reducing alcohol-related negative health behaviors and consequences (episodes of impaired driving, riding with an impaired driver, injuries, arrests, tardiness and days absent from work/school), and (3) AB-CASI will be superior to SC in increasing 30-day treatment engagement. Methods: Adult Latino English and Spanish speaking ED patients who drink over the NIAAA low-risk limits (at-risk to dependence) will be randomized to AB-CASI or SC. Baseline, 30-day, 6 and 12-month assessments will be used to evaluate efficacy of AB-CASI. Significance: The rapid U.S. Latino population growth and increasing diversity of ED populations has major implications for alcohol-related health disparities research and prevention activities. Unique features: Nearly all ED-SBIRT research has excluded Spanish speaking populations. Empirically testing AB-CASI will add indispensable value and unique knowledge to move the field of alcohol research forward. Expected results: AB-CASI efficacy will improve the health of millions of vulnerable Americans with unhealthy alcohol use by transcending barriers.

描述（由申请人提供）：酒精给人类带来的疾病负担是惊人的。酒精滥用普遍损害了饮酒者个人的生活质量，并对社区产生负面和累积的影响。美国拉美裔人受到酒精滥用和酒精依赖的影响尤为严重，因为过去十年拉美裔人口占美国人口增长的 56%，这一点尤其值得关注。与此同时，在家讲西班牙语的美国居民数量从 1700 万增加到超过 3500 万。语言障碍以及繁忙的急诊科 (ED) 环境中的其他独特挑战限制了 ED 酒精筛查、简短干预和转诊治疗 (SBIRT) 的广泛采用。在急诊科对拉丁裔饮酒者使用自动双语计算机酒精筛查和干预 (AB-CASI) 拥有强有力的早期证据，表明它可以克服障碍并增加对弱势急诊科人群的酒精治疗。目的：开展一项随机对照试验，招募讲英语和西班牙语的成年拉丁裔 ED 患者，比较 AB-CASI 与标准护理 (SC) 在减少酒精消耗方面的功效以及对从高风险到各种不健康饮酒水平的后果到依赖。目标：我们经验丰富的多学科团队将：(1) 比较 AB-CASI 与 SC 在减少不健康饮酒者饮酒量方面的功效，(2) 比较 AB-CASI 与 SC 在减少酒精相关负面影响方面的功效健康行为和后果，(3) 比较 AB-CASI 与 SC 在 30 天的治疗参与中的功效，以及 (4) 探索 AB-CASI 对饮酒量、酒精相关的负面健康行为和后果的变化，以及拉丁裔亚群的 30 天治疗参与度和其他潜在的调节因素。我们的假设是：(1) 在 12 个月时，AB-CASI 在减少酗酒次数和过去 28 天每周平均饮酒次数方面优于 SC，(2) 在 12 个月时，AB- CASI 在减少与酒精相关的负面健康行为和后果（不清醒驾驶、与不清醒司机一起骑行、受伤、逮捕、迟到和旷工/缺课）方面优于 SC，以及 (3)在增加 30 天治疗参与度方面，AB-CASI 将优于 SC。方法：饮酒超过 NIAAA 低风险限制（有依赖风险）的成年拉丁裔英语和西班牙语 ED 患者将被随机分配至 AB-CASI 或 SC。基线、30 天、6 和 12 个月评估将用于评估 AB-CASI 的疗效。意义：美国拉丁裔人口的快速增长和 ED 人口多样性的增加对与酒精相关的健康差异研究和预防活动产生了重大影响。独特之处：几乎所有 ED-SBIRT 研究都排除了西班牙语人群。实证测试 AB-CASI 将为推动酒精研究领域的发展增添不可或缺的价值和独特的知识。预期结果：AB-CASI 的功效将跨越障碍，改善数百万饮酒不健康的弱势美国人的健康。