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Gepubliceerd in:

01-12-2020

Gezinsgerichte preventie van alcoholgebruik bij Afrikaans-Amerikaanse adolescenten: een gerandomiseerde klinische studie

Auteurs: Steven M. Kogan, Dayoung Bae, Man-Kit Lei, Gene H. Brody

Gepubliceerd in: Gezinstherapie Wereldwijd | Uitgave 4/2020

Samenvatting

Doel: in deze studie is de werkzaamheid van het Strong African-American Families (SAAF) preventieprogramma voor alcoholgebruik getest. SAAF is een gezinsgericht programma van zeven sessies, waarin een vaardigheidstraining wordt aangeboden. In een eerdere studie zijn intent-to-treat-analyses (ITT) gebruikt, en dit bleek een beperking. Daarom hebben we nu een Complier Average Causal Effect (CACE) aangewend om de interventie-effecten te berekenen, en ook om de exacte dosering van de interventie te bepalen die nodig is om alcoholontmoediging te bewerkstelligen. Methode: op openbare scholen in zeven landelijke gebieden in Georgia is een steekproef van 472 Afrikaans-Amerikaanse jongeren en hun verzorgers geworven. De gezinnen zijn willekeurig toegewezen aan SAAF, of aan een controlegroep zonder behandeling. De jongeren hebben tijdens vier huisbezoeken gegevens verstrekt over hun alcoholgebruik tijdens de drie voorafgaande maanden. Het laatste huisbezoek vond 34 maanden na baseline plaats, en 28 maanden na de interventie. Resultaten: De werkzaamheid is getoetst met de latente groeicurvemodellen van Poisson. SAAF ontmoedigt de toename van alcoholgebruik in modellen met zowel ITT- als CACE-berekeningen. Uit CACE-analyses blijkt dat er bij deelnemers die het volledige aantal interventies (7 sessies) hebben ontvangen een groot behandeleffect is te zien voor afgeremde toename van alcoholgebruik (β = −0,83, p < 0,001). Dosis-responsanalyses in CACE-modellen laten een middelmatige effectgrootte zien (d [95 % CI] = 1,51 [1,25, 175]), als de deelnemers tenminste vijf van de zeven aangeboden sessies bijgewoond hebben. Conclusies: de replicatie van SAAF in een tweede gerandomiseerde preventiestudie ondersteunt de robuustheid van de programma-effecten. Maar het is van cruciaal belang dat er betrokkenheidsprotocollen voor deelnemers worden opgesteld, om hen aan te moedigen tenminste vijf van de zeven sessies bij te wonen.

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Titel: Gezinsgerichte preventie van alcoholgebruik bij Afrikaans-Amerikaanse adolescenten: een gerandomiseerde klinische studie
Auteurs: Steven M. Kogan
Dayoung Bae
Man-Kit Lei
Gene H. Brody
Publicatiedatum: 01-12-2020
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Gezinstherapie Wereldwijd / Uitgave 4/2020
Print ISSN: 1566-0206
Elektronisch ISSN: 1876-5874
DOI: https://doi.org/10.1007/s12440-020-00125-7

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