Intensive Referral to Al-Anon: Benefits to Concerned Others and Their Drinkers

密集转介给 Al-Anon：对关心他人及其饮酒者的好处

• 批准号: 9337318
• 负责人: Michael Anthony Cucciare
• 金额: $ 42.25万
• 依托单位: PALO ALTO VETERANS INSTIT FOR RESEARCH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9337318
• 关键词: Abstinence; Address; Adherence; Adoption; Adult; Affect; Al-Anon; Alcohol abuse; Alcoholics Anonymous; Alcoholism; Clinical; Data; Disease; Domestic Violence; Effectiveness; Equation; Family; Family member; Foundations; Friends; Funding; Gender; Goals; Health; Health Personnel; Hybrids; Individual; Intake; Intervention; Knowledge; Life; Literature; Longitudinal Studies; Mediator of activation protein; Medical; Mental disorders; Methodology; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Patients; Persons; Public Health; Published Comment; Quality of life; Randomized Controlled Trials; Recovery; Research; Resources; Rewards; Site; Social Functioning; Source; Substance Addiction; Substance Use Disorder; Support Groups; Training; United States; Veterans; Work; World Health Organization; addiction; alcohol abuse therapy; alcohol use disorder; base; community based treatment; coping; design; drinking; evidence base; help-seeking behavior; improved; improved outcome; innovation; interest; intervention effect; meetings; member; negative affect; peer; problem drinker; programs; psychological symptom; research study; treatment as usual; treatment program; trial design; uptake

Project Abstract: At least 100 million adults worldwide are adversely affected by the substance addiction of a close relative. Al-Anon Family Groups, a 12-step mutual-help program for people concerned about another’s drinking, is widely available and effective. However, there is a critical lack of knowledge about how to facilitate Al-Anon participation among concerned others (COs), and the extent to which Al-Anon also benefits drinkers. This unique study will examine the effectiveness of Al-Anon Intensive Referral (AIR) with COs of individuals in treatment for alcohol use disorders (“drinkers”). AIR’s goal is to facilitate Al-Anon participation and positive outcomes (e.g., better quality of life, active coping) among COs. The project will also examine the extent to which AIR is associated with treatment engagement, Alcoholics Anonymous (AA) participation, and positive outcomes among drinkers. Although literature on alcoholism as a family disorder frequently states that COs positively influence drinkers’ outcomes, data from methodologically strong studies are sorely lacking. This project builds on two main lines of research by this study team: (1) implementing and showing the effectiveness of Intensive Referral, a 12-step facilitation method, to increase AA participation and improve outcomes among patients in treatment for substance use disorders, and their COs; and (2) a recent NIAAA longitudinal R21 study to identify the benefits and mechanisms of Al-Anon participation to newcomers, members, and their drinkers. In a randomized controlled trial of AIR, this 4-year project has three Specific Aims. Aim 1: Implement AIR at three sites (Little Rock, AR; Omaha, NE; Palo Alto, CA) to evaluate AIR’s effectiveness for COs. COs (N=534) and their drinkers (N=534) will be assessed at baseline and 3-month, 6-month, and 1-year follow-ups. Hypotheses are that, compared to usual care, AIR will (1A) accelerate help-seeking and increase Al-Anon participation, and (1B) improve CO outcomes. Aim 2: Evaluate AIR’s effectiveness for drinkers. Hypotheses are that AIR will be associated with drinkers having (2A) more treatment and AA participation, and (2B) better drinking outcomes. We will examine Aims 1 and 2 using generalized mixed-effects regression models (GLMM). Aim 3: Examine AIR’s mechanisms of action (mediators and moderators). In addition, we will examine reciprocal effects of CO and drinker functioning using Structural Equation Modeling (SEM). This project is built on the foundation that it is essential to help COs because of their own suffering. In addition, it is essential to help COs in order to help drinkers (whose better functioning, in turn, also helps COs). In contrast to other family-based approaches to addiction treatment, AIR is feasible to deliver in real-world treatment programs, requiring few resources. After completing this RCT, if AIR is shown to be effective, the next step in this research program will be to conduct an implementation study (Hybrid Type 2) to disseminate and sustain AIR across treatment programs, thereby helping COs and drinkers.

项目摘要：全世界至少有1亿成人受到了一种物质成瘾的影响 亲戚。 Al-Anon家庭团体，一个为12步的共同用途计划，适合关心他人的人 喝酒，广泛可用且有效。但是，关于如何促进的批评缺乏知识 Al-Anon参与有关他人的参与（COS），以及Al-Anon也使饮酒者受益的程度。 这项独特的研究将研究Al-Anon密集型转介（AIR）的有效性 接受酒精使用障碍治疗的人（“饮酒者”）。空气的目标是促进Al-Anon的参与 COS之间的积极结果（例如，生活质量更好，积极应对）。该项目还将检查 空气与治疗参与，匿名（AA）参与以及 饮酒者的积极结果。尽管关于酗酒的文献作为一种家庭疾病，经常表明 COS积极影响饮酒者的结果，从方法论上强大的研究中的数据非常缺乏。 该项目基于该研究团队的两种主要研究线：（1）实施和展示 密集推荐的有效性，一种12步促进方法，以增加AA参与并改善 在药物使用障碍治疗中的患者及其COS的结果； （2）最近的NIAAA 纵向R21研究以确定Al-Anon参与的好处和机制， 成员和他们的饮酒者。 在一项随机对照试验中，这个4年的项目具有三个特定的目标。目标1：实施 在三个地点（Little Rock，AR； NE； NE； CA）空气，以评估空气对COS的有效性。 cos （n = 534）及其饮酒者（n = 534）将在基线和3个月，6个月和1年的随访中进行评估。 假设是，与通常的护理相比，Air（1A）会加速寻求帮助并增加Al-Anon 参与，（1B）改善CO结果。目标2：评估空气对饮酒者的有效性。假设 空气会与（2a）更多治疗和AA参与的饮酒者以及（2B）更好 饮酒结果。我们将使用广义混合效应回归模型检查目标1和2 （glmm）。目标3：检查空气的作用机理（调解人和主持人）。此外，我们将 使用结构方程建模（SEM）检查CO和饮酒器功能的相互影响。 该项目以这样的基础为基础，即由于自己的苦难而为COS提供帮助。在 另外，必须帮助COS以帮助饮酒者（反过来也可以帮助COS）。 与其他基于家庭的成瘾治疗方法相反，空气可以在现实世界中提供可行 治疗计划，需要很少的资源。完成此RCT后，如果证明空气有效， 该研究计划的下一步将是进行实施研究（混合类型2）以进行传播 并在治疗计划中维持空气，从而帮助COS和饮酒者。