Suchergebnisse

<b><i>Background/Aims:</i></b> Only rather few data on the validity of screening questionnaires to detect problem drinking in adolescents exist. The aim of this study was to compare the performance of the Alcohol Use Disorders Identification Test (AUDIT), its short form AUDIT-C, the Substance Module of the Problem Oriented Screening Instrument for Teenagers (POSIT), and CRAFFT (acronym for car, relax, alone, forget, family, and friends). <b><i>Methods:</i></b> The questionnaires were filled in by 9th and 10th graders from two comprehensive schools. All students received an interview using the alcohol section of the Composite International Diagnostic Interview. Alcohol abuse and alcohol dependence according to DSM-IV as well as episodic heavy drinking served as criteria to validate the screening instruments. <b><i>Results:</i></b> All 9th and 10th graders (n = 225) of both schools participated. No significant differences were found for areas under the receiver operating characteristic curves ranging from 0.810 to 0.872. Cronbach's alpha was satisfactory (0.77–0.80) but poor for CRAFFT (0.64). Different cut-offs are discussed. <b><i>Conclusions:</i></b> Considering validity as well as reliability, AUDIT, AUDIT-C and POSIT performed well; however, the POSIT is quite lengthy. AUDIT-C showed good psychometric properties and has clear advantages because of its brevity.

<b><i>Introduction:</i></b> The aim of this study was to test whether brief alcohol interventions at general hospitals work equally well for males and females and across age-groups. <b><i>Methods:</i></b> The current study includes a reanalysis of data reported in the PECO study (testing delivery channels of individualized motivationally tailored alcohol interventions among general hospital patients: in PErson vs. COmputer-based) and is therefore of exploratory nature. At-risk drinking general hospital patients aged 18–64 years (<i>N</i> = 961) were randomized to in-person counseling, computer-generated individualized feedback letters, or assessment only. Both interventions were delivered on the ward and 1 and 3 months later. Follow-ups were conducted at months 6, 12, 18, and 24. The outcome was grams of alcohol/day. Study group × sex and study group × age interactions were tested as predictors of change in grams of alcohol/day over 24 months in latent growth models. If rescaled likelihood ratio tests indicated improved model fit due to the inclusion of interactions, moderator level-specific net changes were calculated. <b><i>Results:</i></b> Model fit was not significantly improved due to the inclusion of interaction terms between study group and sex (χ²[6] = 5.9, <i>p</i> = 0.439) or age (χ²[6] = 5.5, <i>p</i> = 0.485). <b><i>Discussion:</i></b> Both in-person counseling and computer-generated feedback letters may work equally well among males and females as well as among different age-groups. Therefore, widespread delivery of brief alcohol interventions at general hospitals may be unlikely to widen sex and age inequalities in alcohol-related harm.

Zusammenfassung. Ziel: Persönliche Beratungen können bei stationären Krankenhauspatienten Alkoholkonsum und Mortalität reduzieren. Sie sind jedoch mit hohen Kosten verbunden, wenn aus Public-Health-Erfordernis viele Menschen einer Bevölkerung erreicht werden müssen. Computerbasierte Interventionen stellen eine Alternative dar. Jedoch ist ihre Wirksamkeit im Vergleich zu persönlichen Beratungen und im Allgemeinkrankenhaus noch unklar. Eine quasi-randomisierte Kontrollgruppenstudie "Die Bedeutung der Vermittlungsform für Alkoholinterventionen bei Allgemeinkrankenhauspatienten: Persönlich vs. Computerisiert" soll dies untersuchen. Design und Methoden werden beschrieben. Methode: Über 18 Monate sind alle 18- bis 64-jährigen Patienten auf Stationen der Universitätsmedizin Greifswald mittels Alcohol Use Disorder Identification Test (AUDIT) zu screenen. Frauen/Männer mit AUDIT-Consumption ≥ 4/5 und AUDIT < 20 werden einer von drei Gruppen zugeordnet: persönliche Intervention (Beratungen zur Konsumreduktion), computerbasierte Intervention (individualisierte Rückmeldebriefe und Broschüren) und Kontrollgruppe. Beide Interventionen erfolgen im Krankenhaus sowie telefonisch bzw. postalisch nach 1 und 3 Monaten. In computergestützten Telefoninterviews nach 6, 12, 18 und 24 Monaten wird Alkoholkonsum erfragt. Schlussfolgerung: Das Studienvorhaben, sofern erfolgreich umgesetzt, ist geeignet die längerfristige Wirksamkeit einer persönlichen und computerbasierten Intervention im Vergleich zu untersuchen.

Ziel: Ziel dieses Positionspapieres ist, Konsequenzen aus Befunden zu alkoholbezogener Mortalität für Prävention und Versorgung in Deutschland zu erörtern. Ergebnis: Evidenz offenbart u. a., dass Teilnahme an Entwöhnungsbehandlung nicht mit längerem Überleben verknüpft war als Nichtteilnahme und dass bei Todesursachen auch Tabakkonsum zu berücksichtigen ist. Schlussfolgerungen: Es wird das Fazit gezogen, dass ein System zu Hilfen realisiert werden sollte, das sieben Anforderungen erfüllt. Dazu zählen Hilfen der Prävention und integrierten Versorgung mit proaktiver Kontaktierung der Bevölkerung und stärkerer Berücksichtigung von Tabakrauchen als bisher. So sollen mehr Lebensjahre der Betroffenen erhalten werden als bei dem bestehenden Fokus auf Behandlung von Alkoholproblemen.

<b><i>Background:</i></b> A pre-post pilot study was conducted to test the feasibility, acceptability, and potential effectiveness of a fully automatized computer-based intervention targeting hazardous drinking and depressiveness in proactively recruited health care patients (HCPs). To address the importance of the sample selection when testing interventions, HCPs were compared to media recruited volunteers (MVs). <b><i>Method:</i></b> In a multicenter screening program 2,773 HCPs were screened for hazardous drinking and depressive symptoms. MVs were recruited via media solicitation. Over a period of 6 months, study participants received 6 individualized counseling letters and weekly short messages. Pre-post data were analyzed for 30 participants (15 HCPs, 15 MVs). Intervention acceptability was assessed in post-intervention interviews conducted with 32 study participants. <b><i>Results:</i></b> MVs showed higher problem severity and motivation to change than HCPs. Over the course of the intervention both subsamples reduced regular binge drinking (HCPs: <i>p</i> = 0.016; MVs: <i>p</i> = 0.031) and depressiveness (HCPs: <i>p</i> = 0.020; MVs: <i>p</i> &#x3c; 0.001). MVs further reduced average daily alcohol consumption (<i>p</i> = 0.034). The intervention received positive ratings from both subsamples, the alcohol module was rated more favorably by MVs than by HCPs (<i>p</i> = 0.012). Subsamples further differed in terms of intervention usage (<i>p</i> = 0.013). <b><i>Conclusion:</i></b> The intervention was technically and logistically feasible, well accepted, and may have the potential to reduce hazardous drinking and depressive symptoms in different populations. Subsamples differed in terms of problem severity, motivation to change, intervention usage, pre-post changes, and attitudes toward the intervention, showing that intervention development should involve the intended target populations to avoid biased conclusions on intervention effectiveness and acceptability.