Using causal mediation to examine self-efficacy as a mechanism through which continuing care interventions reduce alcohol use.

IF 3.2 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Ahnalee M Brincks, David P MacKinnon, David H Gustafson, James R McKay
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Abstract

Objective: Understanding the causal mechanisms through which telephone and mobile health continuing care approaches reduce alcohol use can help develop more efficient interventions that effectively target these mechanisms. Self-efficacy for successfully coping with high-risk alcohol relapse situations is a theoretically and empirically supported mediator of alcohol treatment. This secondary analysis aims to examine self-efficacy as a mechanism through which remote-delivered continuing care interventions reduce alcohol use.

Method: The study included 262 adults (Mage = 46.9, SD = 7.4) who had completed 3 weeks of an intensive outpatient alcohol treatment program. The sample was predominantly male (71%), African American (82%), and completed a high school education (71%). The four-arm randomized clinical trial compared three active continuing care interventions (telephone monitoring and counseling [TMC], addiction comprehensive health enhancement support system [ACHESS], and combined delivery of TMC and ACHESS) to usual care and assessed longitudinal measures of alcohol use and self-efficacy. Analyses employed the potential outcomes framework and sensitivity analyses to address threats to causal inference resulting from an observed mediator variable.

Results: Relative to usual care, the two intervention conditions that included TMC reduced alcohol use through improvements to self-efficacy. There was no evidence that self-efficacy mediated the effect of ACHESS on alcohol use.

Conclusions: Based on our findings, self-efficacy is an important mechanism through which telephone continuing care interventions affect alcohol use. Future research to identify which components of TMC influence self-efficacy and factors that mediate ACHESS effects could enhance the effectiveness of remote delivery of continuing care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

利用因果中介来研究自我效能作为持续护理干预减少酒精使用的机制。
目的:了解电话和移动健康持续护理方法减少酒精使用的因果机制,有助于开发更有效的干预措施,从而有效地针对这些机制进行干预。成功应对高风险复酒情况的自我效能感是酒精治疗的一个理论和经验支持的中介因素。本二次分析旨在研究自我效能是远程持续护理干预减少酒精使用的一种机制:研究对象包括 262 名成人(年龄 = 46.9,标准差 = 7.4),他们已完成为期 3 周的酒精强化门诊治疗项目。样本主要为男性(71%)、非裔美国人(82%)和高中毕业(71%)。这项四臂随机临床试验比较了三种积极的持续护理干预措施(电话监测和咨询 [TMC]、成瘾综合健康支持系统 [ACHESS] 以及电话监测和咨询与成瘾综合健康支持系统的联合实施)和常规护理,并对酒精使用和自我效能进行了纵向评估。分析采用了潜在结果框架和敏感性分析,以解决观察到的中介变量对因果推断造成的威胁:与常规护理相比,包含 TMC 的两种干预条件通过提高自我效能减少了酒精使用。没有证据表明自我效能在ACHESS对饮酒的影响中起中介作用:根据我们的研究结果,自我效能感是电话持续护理干预影响饮酒的一个重要机制。未来的研究将确定TMC的哪些因素会影响自我效能感,以及ACHESS效应的中介因素,从而提高远程持续护理的有效性。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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来源期刊
CiteScore
4.90
自引率
11.80%
发文量
165
期刊介绍: Psychology of Addictive Behaviors publishes peer-reviewed original articles related to the psychological aspects of addictive behaviors. The journal includes articles on the following topics: - alcohol and alcoholism - drug use and abuse - eating disorders - smoking and nicotine addiction, and other excessive behaviors (e.g., gambling) Full-length research reports, literature reviews, brief reports, and comments are published.
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