对急诊科青少年和初成人酒精滥用和暴力行为的适应性干预：一项顺序多任务随机对照试验的结果

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-02-21 DOI:10.1016/j.drugalcdep.2025.112615

Maureen A. Walton , Laura Seewald , Patrick M. Carter , Quyen Ngo , Frederic C. Blow , Carrie Bourque , Claire Pearson , Katherine A. Battisti , Larry An , Mari Wank , Yanruyu Zhu , Kelley M. Kidwell

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引用次数: 0

摘要

利用技术提供行为健康干预，以减少酒精使用和攻击行为，可以降低青少年的发病率。本文描述了一项针对急诊科（ED）青少年（14-20岁）的连续、多任务、随机试验（SMART）测试干预措施的结果。方法400名ED筛查阳性的青少年（n = 400）接受了SafERteens简短干预（BI），并随机分配到：短信（TM）或健康教练（HC）(第一阶段；周1 - 4)。参与者完成了8周的调查，在4个月和8个月时评估结果。第一阶段后，确定反应/无反应（例如，酗酒或攻击）。应答者被重新随机分配到持续或最小化状态；无应答者被重新随机分配到持续或强化状态(第二阶段；周5 - 8)。分析检查了初始随机化的结果；以及反应者和无反应者在初级（酒精消费、攻击）、次级（酒精后果、暴力后果）和探索性（酒精滥用、受害、药物使用、药物后果）结果上的比较。结果无应答组和应答组的1期和2期疗效无显著性差异。然而，随着时间的推移，在所有参与者中观察到显著的变化，戒酒的几率在4个月（OR 3.97, 95% CI 2.46-6.41）和8个月（OR 4.36, 95% CI 2.11-9.02）时增加，而攻击的几率（OR 0.39, 95% CI 0.16-0.94）在8个月时下降；其他结果也观察到显著下降。结论：研究结果支持数字健康干预对酗酒和攻击性青少年的承诺。

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Adaptive interventions for alcohol misuse and violent behaviors among adolescents and emerging adults in the emergency department: Outcomes from a sequential multiple assignment randomized controlled trial

Introduction

Harnessing technology for delivery of behavioral health interventions to reduce alcohol use and aggression may reduce morbidity among youth. This paper describes the outcomes from a sequential, multiple assignment, randomized trial (SMART) testing interventions for youth (ages 14–20) in the emergency department (ED).

Methods

Youth (n = 400) in the ED screening positive for binge drinking and aggression received the SafERteens brief intervention (BI) and were randomly assigned to boosters: Text Messages (TM) or Health Coach (HC) (1st stage; weeks 1–4). Participants completed 8 weekly surveys, with outcomes assessed at 4- and 8-months. After the 1st stage, response/non-response was determined (e.g., binge drinking or aggression). Responders were re-randomized to continued or minimized condition; non-responders were re-randomized to continued or intensified condition (2nd stage; weeks 5–8). Analyses examined outcomes from the initial randomization; and comparisons between responders and non-responders on primary (alcohol consumption, aggression), secondary (alcohol consequences, violence consequences) and exploratory (alcohol misuse, victimization, drug use, drug consequences) outcomes.

Results

There were no significant differences in outcomes between 1st stage boosters or 2nd stage boosters for non-responder or responder groups. However, significant changes over time were observed across all participants, with the odds of abstaining from alcohol increased at 4 (OR 3.97, 95 % CI 2.46–6.41) and 8-months (OR 4.36, 95 % CI 2.11–9.02), while the odds of aggression (OR 0.39, 95 % CI 0.16–0.94) decreased at 8-months; significant decreases were also observed for other outcomes.

Conclusions

Findings support the promise of digital health interventions for youth with binge drinking and aggression.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.