Implementation of a Culturally Adapted Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Program in Cameroon
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 690
- 试验地点
- 1
- 主要终点
- Change in Alcohol Use at 6 Months
研究概览
简要总结
**Brief Summary**
Alcohol use is a major contributor to injury burden in Cameroon, particularly among trauma patients presenting to emergency departments. Despite the strong association between alcohol use and injury, structured alcohol screening and intervention programs are not routinely integrated into trauma care in Cameroon. This study aims to evaluate a Cameroon-adapted Screening, Brief Intervention, and Referral to Treatment (SBIRT) program for trauma patients at the Limbe Regional Hospital.
The study will be conducted in three phases: (1) training emergency department healthcare providers on a culturally adapted SBIRT program; (2) evaluating the feasibility, acceptability, and fidelity of SBIRT implementation in routine emergency care; and (3) assessing the effectiveness of SBIRT in reducing harmful alcohol use among trauma patients. Healthcare workers will be trained to deliver SBIRT, and eligible trauma patients screening positive for risky alcohol use will be enrolled in a randomized waitlist-controlled trial. Participants will undergo alcohol screening using validated tools and will be followed for six months. Outcomes will include alcohol use measured by the Alcohol Use Disorders Identification Test (AUDIT), phosphatidylethanol (PEth) biomarker levels, referral uptake, implementation outcomes, and patient well-being measures.
The study is expected to generate evidence on the feasibility and effectiveness of integrating alcohol interventions into trauma care in a low-resource setting and inform future scale-up of SBIRT programs in Cameroon and similar settings.
详细描述
**Detailed Description**
Alcohol use is a major contributor to the burden of injury in Cameroon and other low- and middle-income countries (LMICs). Studies conducted in Cameroon have demonstrated high levels of alcohol use among road users and trauma patients, with substantial proportions of injured patients reporting recent alcohol consumption or testing positive for alcohol at the time of injury. Harmful alcohol use is associated with increased risk of injury, injury recurrence, disability, and mortality. Despite this burden, systematic alcohol screening and intervention services are not routinely integrated into trauma care in Cameroon.
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach designed to identify individuals with risky alcohol use, provide brief counseling to promote behavior change, and facilitate referral to treatment when indicated. SBIRT has been successfully implemented in emergency departments and trauma centers in high-income countries and has demonstrated effectiveness in reducing harmful alcohol use and alcohol-related consequences. However, little is known about the feasibility, acceptability, and effectiveness of SBIRT in resource-constrained emergency care settings in sub-Saharan Africa.
The purpose of this study is to evaluate a Cameroon-adapted SBIRT program implemented within the Emergency Department of the Limbe Regional Hospital. The intervention was developed through a participatory adaptation process involving emergency department clinicians, mental health providers, trauma researchers, implementation scientists, and other stakeholders to ensure cultural appropriateness and operational feasibility within the Cameroonian healthcare context.
The study has three primary objectives: (1) to train emergency department healthcare providers in delivery of a Cameroon-adapted SBIRT program; (2) to evaluate the feasibility, acceptability, adoption, and fidelity of SBIRT implementation in routine emergency care; and (3) to evaluate the effectiveness of SBIRT in reducing harmful alcohol use among trauma patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult trauma patients aged 18 years and older presenting to the Emergency Department of Limbe Regional Hospital.
- •Positive alcohol screening based on the Single Alcohol Screening Question (SASQ).
- •AUDIT-C score ≥4 for men or ≥3 for women.
- •Able to provide informed consent.
- •Resident within the study catchment area and available for follow-up.
- •Access to a telephone or another reliable means of contact for follow-up assessments.
排除标准
- •Severe cognitive impairment preventing participation in study procedures or - provision of informed consent.
- •Severe traumatic brain injury or other medical condition requiring immediate life-saving intervention that precludes participation.
- •Current psychosis or severe psychiatric illness preventing meaningful participation in the intervention.
- •In police custody or other circumstances limiting ability to participate in follow-up.
- •Planned relocation outside the study catchment area during the study follow-up period.
- •Previously enrolled in the study.
结局指标
主要结局
Change in Alcohol Use at 6 Months
时间窗: Baseline and 6 months
Change in harmful alcohol use from baseline to 6 months following enrollment, measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C).
Change in Phosphatidylethanol (PEth) Levels
时间窗: Baseline and 6 months
Change in alcohol consumption measured using phosphatidylethanol (PEth), a biomarker of recent alcohol use, from baseline to 6 months.
次要结局
- SBIRT Delivery Rate(Through study completion, an average of 36 months.)
- Alcohol Use at 1 Month(1 month)
- Alcohol Use at 3 Months(3 Months)
- PEth Levels at 1 Month(1 Month)
- PEth Levels at 3 months(3 month)
- Referral Uptake(Within 6 months)
- Depressive Symptoms(Baseline, 1 month, 3 months, and 6 months)
- Intervention Fidelity(Through study completion, an average of 36 months.)
研究者
Serge Ngekeng
Lecturer
University of Buea