Screening and Brief Intervention in the ED among Mexican-origin Young Adults

墨西哥裔年轻人的急诊科筛查和短暂干预

• 批准号: 8074108
• 负责人: CHERYL J CHERPITEL
• 金额: $ 65.33万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-20 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8074108
• 关键词: 19 year old; 20 year old; Accident and Emergency department; Acute; Address; Admission activity; Adolescent; Adult; Advocate; Affect; Age; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Alcohols; American College of Surgeons; Applications Grants; Area; Attention; Birth; Blinded; Centers for Disease Control and Prevention (U.S.); Cities; Communities; Consent; Country; Coupled; Cultural Characteristics; Data; Development; Disease; Effectiveness; Effectiveness of Interventions; Emergency Medical Technicians; Emergency Medicine; Equation; Esthesia; Ethnic group; Event; Female; Funding; Generations; Guidelines; Health Promotion; Heavy Drinking; High Prevalence; Hispanics; Immigrant; Impulsivity; Individual; Injury; International; Intervention; Intervention Studies; Intervention Trial; Knowledge; Language; Lead; Leadership; Life; Literature; Logistic Regressions; Medical; Mexican; Mexico; NIH Program Announcements; National Institute on Alcohol Abuse and Alcoholism; Nurse Practitioners; Nurses; Outcome; Outcome Assessment; Patient Self-Report; Patients; Physician Assistants; Physicians; Poland; Population; Predictive Value; Prevalence; Primary Health Care; Protocols documentation; Provider; Public Health; Publishing; Quality of life; Randomized; Randomized Controlled Clinical Trials; Readiness; Recommendation; Relative (related person); Reporting; Research; Research Personnel; Risk; Risk-Taking; Screening procedure; Site; Social Characteristics; Source; Staging; Subgroup; Surveys; Techniques; Telephone; Testing; Texas; Time; Training; Translating; Translations; Trauma; Treatment Protocols; Treatment outcome; United States Substance Abuse and Mental Health Services Administration; Visit; Work; World Health Organization; Youth; age group; alcohol abuse therapy; alcohol advertising; alcohol availability; alcohol related problem; alcohol risk; alcohol screening and brief intervention; alcohol use disorder; binge drinking; breath alcohol measurement; brief alcohol intervention; brief intervention; brief motivational intervention; care seeking; convict; cost; disorder prevention; drinking; driving behavior; experience; follow-up; group intervention; hazardous drinking; high risk drinking; impaired driving performance; improved; injured; legal drinking age; male; marijuana user; motivational enhancement therapy; motivational intervention; prototype; public health relevance; recidivism; response; screening and brief intervention; screening, brief intervention, referral, and treatment; standard care; symposium; trauma centers; treatment trial; trial comparing; twelfth grade; young adult

DESCRIPTION (provided by applicant): Screening and Brief Intervention in the ED among Mexican-origin Young Adults The aims of this application "Screening and Brief Alcohol Intervention in Underage and Young Adult Populations" are to: 1) examine the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) among Mexican-origin young adults (age 18-25), using a motivational intervention delivered by a Health Promotion Advocate (promotore), relative to standard care with and without assessment, on a reduction in heavy drinking (drinking days per week, number of drinks per day, maximum number of drinks on an occasion) and alcohol-related problems (RAPS4 and SIPS +6) in the emergency department (ED) at the U.S.- Mexico border; and, 2) identify variables that are related to effectiveness of the intervention and that predict successful treatment outcome. We plan to translate motivational interventions that have been successful in primary care and which were recently implemented in the U.S. 14 Academic Emergency Medicine Collaborative (AEMC) SBIRT study to a population of young adult Mexican-origin ED patients on the Texas border in El Paso; a population which has evidenced a high prevalence of hazardous drinking and alcohol- related problems, in part due to the greater availability of alcohol and at low cost in Mexico border cities. The SBIRT study, funded by NIAAA and SAAMHSA, was the first multi-site, collaborative study of screening, brief intervention and referral for at-risk and dependent drinking in the ED. We will conduct a blinded randomized control brief motivational intervention trial in which both injured and non-injured patients will be screened for at- risk or dependent (using the RAPS4) drinking. Patients screening positive who consent to participate in the study will be randomized into one of three groups: screened only, assessed, and assessed plus brief intervention, with n=312 in each group. Intervention and assessment groups will be followed-up at 3 months and all three groups at 12 months. Modifying variables include drinking in the event, risk-taking disposition, readiness and stage of change, country of birth (U.S. vs. Mexico) and language in which the assessment and intervention were conducted (English vs. Spanish). Outcome data will be analyzed using ANOVA, logistic regression and Generalized Estimating Equations. The interaction of modifying variables on outcomes will also be analyzed. Additionally, the study will examine data relevant to key issues related to the potential translatability and public health impact of the intervention and next steps. Given the paucity of published studies of brief intervention in the ED among young adults in general, or among Mexican-origin adults, and none among Mexican-origin young adults, who may be most vulnerable to alcohol use problems and disorders, especially at the border, work to be undertaken in this application is especially important in determining the effectiveness of AEMC SBIRT protocols (which may serve as a prototype for screening, brief intervention and referral for at-risk and dependent drinking in the ED) in this context of Mexican-origin young adults. PUBLIC HEALTH RELEVANCE: This work is especially relevant to public health in relation to reducing subsequent alcohol-related ED visits and associated costs and increase quality of life among young adults. The project will inform the development and spread of more effective techniques and protocols for addressing at-risk and dependent drinking in the ED in this age group, and provide a better understanding of those factors that influence effectiveness of brief intervention and predict successful patient outcomes across ethnic and cultural groups in the U.S. Additionally, this will be the first randomized controlled clinical trial compared to standard care of brief intervention using promotores in the Mexican-origin community, which may provide a better chance of ongoing implementation of SBIRT in the ED than using ED staff providers.

DESCRIPTION (provided by applicant): Screening and Brief Intervention in the ED among Mexican-origin Young Adults The aims of this application "Screening and Brief Alcohol Intervention in Underage and Young Adult Populations" are to: 1) examine the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) among Mexican-origin young adults (age 18-25), using a motivational intervention delivered by a Health Promotion Advocate (promotore), relative to standard在有和没有评估的情况下，在美国墨西哥边境的急诊室（ED）（ED）中，有和没有评估，减少大量饮酒（每天喝酒数量，每天的饮料数量，每天的饮料数量，最多的饮料数量）和与酒精有关的问题（RAPS4和SIPS +6）； 2）确定与干预有效性相关的变量，并预测成功的治疗结果。我们计划将在初级保健中取得成功的动机干预措施转化为最近在美国的14个学术急诊医学合作（AEMC）SBIRT研究中，这些干预措施为埃尔帕索（El Paso）的德克萨斯州边境的年轻成年墨西哥 - 原始患者群体；这一人口证明了危险饮酒和与酒精有关的问题的高流行，部分原因是墨西哥边境城市的酒精供应量更高，而且成本较低。由NIAAA和Saamhsa资助的SBIRT研究是第一次多站点的合作研究，筛查，简短的干预和转诊，用于ED中的高危和依赖饮酒。我们将进行一项盲目的随机对照简短的动机干预试验，其中将筛选受伤的患者和未受伤的患者的风险或依赖（使用RAP44）饮酒。同意参加研究的阳性的患者将被随机分为三组之一：仅筛选，评估和评估以及简短的干预，每组n = 312。干预和评估组将在3个月和12个月的所有三个组中进行随访。修改变量包括在此事件中饮酒，冒险处置，准备和变化阶段，出生国（美国与墨西哥）以及进行评估和干预的语言（英语与西班牙语）。结果数据将使用方差分析，逻辑回归和广义估计方程进行分析。还将分析修改变量在结果上的相互作用。此外，该研究将研究与干预措施和下一步的潜在翻译性和公共卫生影响相关的关键问题相关的数据。 Given the paucity of published studies of brief intervention in the ED among young adults in general, or among Mexican-origin adults, and none among Mexican-origin young adults, who may be most vulnerable to alcohol use problems and disorders, especially at the border, work to be undertaken in this application is especially important in determining the effectiveness of AEMC SBIRT protocols (which may serve as a prototype for screening, brief intervention and referral for在墨西哥 - 原来的年轻人的这种情况下，ED中的危险和依赖饮酒。 公共卫生相关性：这项工作与公共卫生有关，与减少与酒精相关的ED访问及相关成本以及提高年轻人生活质量有关的公共卫生尤其重要。该项目将告知该年龄段的ED中更有效的技术和方案的开发和传播，以解决该年龄段的ED饮酒，并更好地了解那些影响短暂干预效果的因素，并预测美国跨美国跨种族和文化群体成功的患者结果，此外，这将是首次使用MESERINGE INSPORITINAL IMENTIRE INSORTINAL INIMENTINal Intimention in Emertional Inspording Anemotig of Mecorig的MECOTIN介绍的临床疗法，这将是跨越的临床，该临床的临床能力是跨性别的临床，该临床的工具是跨性别的培养基，该临床是在跨性别的临床中进行的。在ED中的SBIRT比使用ED员工提供商。