Intensive referral to mutual-help groups: A field trial of adaptations for rural veterans.
Kathleen M Grant, Lance Brendan Young, Kimberly A Tyler and 3 others
PMID 28756030WHAT IT FOUND
Compared with standard referral, the adapted intensive referral did not improve mutual-help group participation, substance use, or PTSD symptoms at six months.
The group that received all three sessions reported higher 30-day alcohol abstinence than the group that received none, but that was secondary.
Key findings
01Rural-adapted intensive referral did not differ from standard referral on substance use or mutual-help group participation, and abstinence rates did not differ between groups.
02In an exploratory analysis, 96% of participants who received all three rural-adapted referral sessions reported 30-day alcohol abstinence, compared with 78% who received none.
03Only 26% of participants assigned to rural-adapted intensive referral received all three sessions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Two hundred and two individuals consented, but baseline data were available for 195 and follow-up data for 140. Patients were not randomised; assignment depended on the therapist, so group differences could reflect therapist or patient factors. Implementation was inconsistent: of 106 assigned to RAIR, only 26% received all three sessions. The alcohol abstinence finding came from an exploratory comparison of participants who received all three sessions with those who received none, not the primary comparison. Those followed up were older than those not followed up. A greater percentage of RAIR participants had used cannabis at baseline. The sample was exclusively veterans, so results may not apply to other populations.
The easy way to misread this
Do not read the 96% versus 78% alcohol abstinence difference as evidence that intensive referral works. The primary comparison against standard referral was null. This result came from an exploratory analysis of participants who received all three sessions versus those who received none, and only 26% of assigned participants completed all three sessions.