Computer- vs. nurse practitioner-delivered brief intervention for adolescent marijuana, alcohol, and sex risk behaviors in school-based health centers

被引：16

作者：

Gryczynski, Jan ^{[1
]}

Mitchell, Shannon Gwin ^{[1
]}

Schwartz, Robert P. ^{[1
]}

Dusek, Kristi ^{[1
]}

O'Grady, Kevin E. ^{[2
]}

Cowell, Alexander J. ^{[3
]}

Barbosa, Carolina ^{[3
]}

Barnosky, Alan ^{[3
]}

DiClemente, Carlo C. ^{[4
]}

机构：

[1] Friends Res Inst, 1040 Pk Ave,Ste 103, Baltimore, MD 21201 USA

[2] Univ Maryland, Dept Psychol, 4094 Campus Dr, College Pk, MD 20742 USA

[3] RTI Int, 3040 Cornwallis Rd,POB 12194, Res Triangle Pk, NC 27709 USA

[4] Univ Maryland Baltimore Cty, Dept Psychol, Catonsville MD, 1000 Hilltop Circle, Baltimore, MD 21250 USA

来源：

DRUG AND ALCOHOL DEPENDENCE | 2021年 / 218卷

基金：

美国国家卫生研究院;

关键词：

Brief intervention; Marijuana; Alcohol; Sexual health; School-based health centers; UPDATED EVIDENCE REPORT; MOTIVATIONAL INTERVIEWING INTERVENTION; SEXUALLY-TRANSMITTED INFECTIONS; PERSON BRIEF INTERVENTION; DRUG-ABUSING ADOLESCENTS; PRIMARY-CARE; SUBSTANCE USE; SCREENING-TEST; COUNSELING INTERVENTIONS; PARENTAL CONSENT;

D O I：

10.1016/j.drugalcdep.2020.108423

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background: This study examined approaches to delivering brief interventions (BI) for risky substance use and sexual behaviors in school-based health centers (SBHCs). Methods: 300 Adolescents (ages 14-18; 54 % female) with risky marijuana and/or alcohol use identified via CRAFFT screening (scores >1) were recruited from two SBHCs and randomized to computer-delivered BI (CBI) or nurse practitioner-delivered BI (NBI). Both BIs included motivational and didactic content targeting marijuana, alcohol, and risky sexual behaviors. Assessments at baseline, 3-month, and 6-month follow-up included past 30day frequency of marijuana use, alcohol use, binge drinking, unprotected sex, and sex while intoxicated; marijuana and alcohol problems; and health-related quality-of-life (HRQoL). A focused cost-effectiveness analysis was conducted. An historical `assessment-only' cohort (N=50) formed a supplementary quasi-experimental comparison group. Results: There were no significant differences between NBI and CBI on any outcomes considered (e.g., days of marijuana use; p=.26). From a cost-effectiveness perspective, CBI was `dominant' for HRQoL and marijuana use. Participants' satisfaction with BI was significantly higher for NBI than CBI. Compared to the assessment-only cohort, participants who received a BI had lower frequency of marijuana (3-months: Incidence Rate Ratio [IRR] =.74 [.57,.97], p=.03), alcohol (3-months: IRR =.43 [.29,.64], p<.001; 6-months: IRR =.58 [.34,.98], p =.04), alcohol-specific problems (3-months: IRR =.63 [.45,.89], p=.008; 6-months: IRR =.63 [.41,.97], p =.04), and sex while intoxicated (6-months: IRR =.42 [.21,.83], p =.013). Conclusions: CBI and NBI did not yield different risk behavior outcomes in this randomized trial. Supplementary quasi-experimental comparisons suggested potential superiority over assessment-only. Both NBI and CBI could be useful in SBHCs.

引用

页数：8

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