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Web-based self-help with and without chat counseling to reduce cocaine use in cocaine misusers: Results of a three-arm randomized controlled trial.
Internet Interventions ( IF 5.358 ) Pub Date : 2019-09-01 , DOI: 10.1016/j.invent.2019.100251
Michael P Schaub 1 , Raquel Paz Castro 1 , Andreas Wenger 1 , Christian Baumgartner 1 , Lars Stark 2 , David D Ebert 3 , Boris B Quednow 4 , Severin Haug 1
Affiliation  

Background In recent years, cocaine use has increased in many countries, but only a minority of users seek treatment. Cognitive behavioral therapy (CBT) is seen as first-choice face-to-face treatment. However, a web-based intervention might serve as an alternative. Aims To test the efficacy of a web-based self-help intervention, with and without chat counseling, grounded in CBT, at reducing cocaine use in cocaine misusers not in treatment for a substance use disorder. Methods Subjects were randomly assigned to (1) a self-help intervention with chat support, (2) a self-help intervention without chat support, or (3) a waiting list control group. The fully-automated self-help program consisted of eight modules based on motivational interviewing, self-control practices and CBT. The primary outcome was the quantity of cocaine use per week. Secondary outcomes included frequency of cocaine and other substance use and mental health symptoms. Linear regression analysis was performed to investigate changes in primary and secondary outcomes. Results In total, 416 users registered online for the trial, of whom 311 completed the baseline assessment. Participants were predominantly male (73%) and averaged 33 years old (SD = 7.6). Despite considerable efforts on our part, only 47 of 311 (15.1%) subjects completed the 6-month follow-up assessment. Frequency of cocaine use and severity of cocaine dependence decreased only in the intervention groups. No significant difference in the primary outcome was observed between the study arms, but several differences in secondary outcomes were observed by complete case analyses. Conclusions Many cocaine misusers from the general population and not otherwise in treatment could be reached and decreased their cocaine use utilizing a CBT-based online intervention. However, due to the high percentage of dropouts and serious difficulties reaching subjects for follow-up assessments, no conclusions can be drawn regarding study arm differences. Implications for future studies are discussed.

中文翻译:

基于网络的自助,有和没有聊天咨询,以减少可卡因滥用者的可卡因使用:三臂随机对照试验的结果。

背景 近年来,可卡因的使用在许多国家有所增加,但只有少数使用者寻求治疗。认知行为疗法 (CBT) 被视为首选的面对面治疗。然而,基于网络的干预可以作为替代方案。目的 测试基于 CBT 的基于网络的自助干预(有或没有聊天咨询)在减少可卡因滥用者(未接受药物滥用障碍治疗)中的可卡因使用的效果。方法 受试者被随机分配到(1)有聊天支持的自助干预组,(2)没有聊天支持的自助干预组,或(3)等待名单对照组。全自动自助程序由基于动机访谈、自我控制实践和 CBT 的八个模块组成。主要结果是每周可卡因的使用量。次要结果包括可卡因和其他物质使用的频率以及心理健康症状。进行线性回归分析以研究主要和次要结果的变化。结果 共有 416 名用户在线注册试用,其中 311 人完成了基线评估。参与者主要是男性(73%),平均年龄为 33 岁(SD = 7.6)。尽管我们付出了相当大的努力,但 311 名受试者中只有 47 名(15.1%)完成了为期 6 个月的随访评估。可卡因使用频率和可卡因依赖严重程度仅在干预组有所下降。在研究组之间未观察到主要结果的显着差异,但通过完整病例分析观察到次要结果的一些差异。结论 通过基于 CBT 的在线干预,可以接触到来自普通人群的许多可卡因滥用者,而不是其他正在接受治疗的滥用者,并减少他们的可卡因使用。然而,由于辍学率很高,而且很难对受试者进行后续评估,因此无法得出关于研究组差异的结论。讨论了对未来研究的影响。
更新日期:2019-09-01
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