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Introduction: The negative impact of unmanaged psychological distress on quality of life and outcome in breast cancer survivors has been demonstrated. Fortunately, studies indicate that distress can effectively be addressed and even prevented using evidence-based interventions. In Germany prescription-based mobile health apps, known as DiGAs (digital health applications), that are fully reimbursed by health insurances, were introduced in 2020. In this study, the effectiveness of an approved breast cancer DiGA was investigated: The personalized coaching app PINK! Coach supports and accompanies breast cancer patients during therapy and follow-up. Methods: PINK! Coach was specifically designed for breast cancer (BC) patients from the day of diagnosis to the time of Follow-up (aftercare). The app offers individualized, evidence-based therapy and side-effect management, mindfulness-based stress reduction, nutritional and psychological education, physical activity tracking, and motivational exercises to implement lifestyle changes sustainably in daily routine. A prospective, intraindividual RCT (DRKS00028699) was performed with n = 434 patients recruited in 7 German breast cancer centers from September 2022 until January 2023. Patients with BC were included independent of their stage of diseases, type of therapy andmolecular characteristics of the tumor. Patients were randomized into one of two groups: The intervention group got access to PINK! over 12 weeks; the control group served as awaiting-list comparison to "standard of care." The primary endpoint was psychological distress objectified by means of Patient Health Questionnaire-9 (PHQ-9). Subgroups were defined to investigate the app's effect on several patient groups such as MBC vs. EBC patients, patients on therapy vs. in aftercare, patients who received a chemotherapy vs. patients who did not. Results: Efficacy analysis of the primary endpoint revealed a significant reduction in psychological distress (least squares estimate -1.62, 95% confidence interval [1.03; 2.21]; p<0.001) among intervention group patients from baseline to T3 vs, control group. Subgroup analysis also suggested improvements across all clinical situations. Conclusion: Patients with breast cancer suffer from psychological problems including anxiety and depression during and after therapy. Personalized, supportive care with the app PINK! Coach turned out as a promising opportunity to significantly improve psychological distress in a convenient, accessible, and low-threshold manner for breast cancer patients independent of their stage of disease (EBC/MBC), therapy phase (aftercare or therapy) or therapy itself (chemotherapy/other therapy options). The app is routinely available in Germany as a DiGA. Clinical Trial Registration: DRKS Trial Registry (DRKS00028699). [ABSTRACT FROM AUTHOR]

Purpose: Regarding how the public regulation of human services is perceived within welfare organizations and how the latter cope with it, the role of emotions (as mediators between structure and agency) proves highly relevant while often being hidden beneath the surface. This article shows how a specific approach to such regulation – here: managerialism – may impact on "emotional regimes" at the organizational and individual level, affecting the attainment of organizational goals and workers' health. Design/methodology/approach: The article primarily draws on multiple qualitative case studies across two welfare sectors (four organizations) in Germany (continuing education/active inclusion; long-term care). The study research was conducted between 2020 and 2022 and based on 36 interviews with caseworkers and managers, focus group interviews and expert dialogues at industry level. Findings: The results suggest that the managerialist regulation of welfare services breeds complex and ambiguous emotional regimes. Business-like management techniques elicit various emotions, affecting the motivational basis of human service work. While the experience of hard challenges may raise positive feelings, coping patterns often put strain on organizations and staff alike. In the short run, related emotional regimes tend to make service delivery proceed smoothly, yet in the long run they may have corrosive effects and problematic repercussions on macro-level developments. Originality/value: The study highlights the role of emotions in publicly regulated human service settings by intermingling macro- and micro-level processes and thereby broadens the perspective of welfare state research as it reveals the impact of (managerialist) regulation on the dynamic organizational chemistry of such settings. [ABSTRACT FROM AUTHOR]

The existence and nature of pandemic fatigue–defined as a gradually emerging subjective state of weariness and exhaustion from, and a general demotivation towards, following recommended health-protective behaviors, including keeping oneself informed during a pandemic–has been debated. Herein, we introduce the Pandemic Fatigue Scale and show how pandemic fatigue evolved during the COVID-19 pandemic, using data from one panel survey and two repeated cross-sectional surveys in Denmark and Germany (overall N = 34,582). We map the correlates of pandemic fatigue and show that pandemic fatigue is negatively related to people's self-reported adherence to recommended health-protective behaviors. Manipulating the (de)motivational aspect of pandemic fatigue in a preregistered online experiment (N = 1584), we further show that pandemic fatigue negatively affects people's intention to adhere to recommended health-protective behaviors. Combined, these findings provide evidence not only for the existence of pandemic fatigue, but also its psychological and behavioral associations. In this study the authors introduce a measure of pandemic fatigue and report the existence of, and changes in, pandemic fatigue during the COVID-19 pandemic. They also identify correlates of pandemic fatigue and show that those who experienced more pandemic fatigue were less likely to adhere to various health-protective behaviors. [ABSTRACT FROM AUTHOR]

Introduction: Adopting an active lifestyle is an important goal, but can be difficult to achieve for people with depressive disorders. Current guidelines recommend the integration of physical activity in the multimodal treatment of depressive disorders. However, the possibilities to provide individual support for physical activities are frequently limited. The aim of our study was to examine how physical activity can be increased in a real-world setting by combining physical training and psychological interventions. Materials and methods: In this randomized-controlled interventional study, 31 outpatients diagnosed with moderate to severe depression were recruited from the region of Hannover. The intervention group (n=16) was offered six weekly individual sessions lasting between 60 and 90 min with a sports scientist, including Motivational Interviewing and accompanied exercise activities. The control group (n=15) received a written booklet with information on steps toward becoming more active. Moderate-to-vigorous physical activity (MVPA) as the primary outcome was analyzed using activity sensors before and after the 6-week intervention, and 3 months subsequently. Secondary outcomes included the Six-Minute Walk Test (6MWT), Sit-to-Stand test (STS), and mental health assessed with self-rating questionnaires. Results: In the intervention group, MVPA increased significantly between baseline and the first follow-up and remained at an increased level at the second follow-up in comparison to decreased levels in the control group (difference of 15.5 min/day between groups over time, SE=6.2 min/day, 95%-CI[2.7, 28.3], p=0.020). The increased activity level was associated with markers of increased fitness (6MWT and STS) in the intervention group. Both groups showed comparable improvements in depressive symptoms, while the number of patients receiving antidepressants increased in the control group and decreased in the intervention group. Two patients dropped out of the intervention group during the trial. Conclusion: The intervention proved to be a feasible and effective aid to promote a physically active lifestyle for patients diagnosed with depression. Furthermore, the higher level of physical activity was maintained for the follow-up period. Given the success of the approach evaluated in this project, individual support for physical activity should be investigated in larger sample sizes and potentially be considered in the multimodal treatment of depression. Clinical trial registration: [https://clinicaltrials.gov/], identifier [DRKS00023257]. [ABSTRACT FROM AUTHOR]

Peer support approaches are gaining increasing importance within the mental health sector as an effective way to assist people with mental and addictive disorders. This article explores peer support volunteers' motives for voluntary engagement in a model project in Germany. It aims to gain a deeper understanding of peer support approaches and their underlying motivations in an innovative context. Twenty-three qualitative interviews with peer support volunteers were analyzed according to Mayring's qualitative content analysis. Results showed that voluntary engagement fulfills a heterogeneous range of functions for peer support volunteers. Alongside "typical" volunteers' motives, there were peer-specific functions such as motivation due to own personal experiences and the objective of changing societal attitudes toward mental health. Furthermore, the context of employment promotion played a motivational role: Many interview partners aimed to transform counseling structures within the institutions they had experienced as clients themselves. [ABSTRACT FROM AUTHOR]

The growing number of children in primary schools in Germany who have German as their second language (L2) has raised questions about the fairness of performance assessment. Fair tests are a prerequisite for distinguishing between L2 learning delay and a specific learning disability. We evaluated five commonly used reading and spelling tests for measurement invariance (MI) as a function of first language (German vs. other). Multi-group confirmatory factor analyses revealed strict MI for the Weingarten Basic Vocabulary Spelling Tests (WRTs) 3+ and 4+ and the Salzburger Reading (SLT) and Spelling (SRT) Tests, suggesting these instruments are suitable for assessing reading and spelling skills regardless of first language. The MI for A Reading Comprehension Test for First to Seventh Graders – 2nd Edition (ELFE II) was partly strict with unequal intercepts for the text subscale. We discuss the implications of this finding for assessing reading performance of children with L2. [ABSTRACT FROM AUTHOR]

Background: Smoking is a major risk factor of cardiovascular diseases, notably peripheral arterial disease (PAD). Despite this link, research on smoking cessation interventions in PAD patients remains scarce and inconclusive regarding the efficacy of such interventions. Therefore, elucidating it is crucial and should address both individuals who smoke that are motivated to quit and individuals who smoke heavily lacking the motivation to quit., Methods/design: The Aachen Smoking Cessation and Harm Reduction (ASCHR) trial is a prospective randomized controlled study (RCT) on the benefits of telemedical-psychological support for smoking cessation in patients with PAD, funded by the "Innovation Fund" of the Joint Federal Committee in Germany. This trial aims to scientifically assess the efficacy, feasibility, acceptance, and efficiency of a multi-stage smoking cessation program based on the recommendations of the German guideline for smoking cessation tailored to patients with PAD, compared to a control group receiving no intervention. Central to the program is psychological counseling utilizing motivational interviewing techniques, delivered through telemedicine via video consultations. The primary endpoint of the ASCHR trial is the smoking cessation rate after 8 months of intervention, with a secondary endpoint evaluating sustained abstinence at a further 6 months follow-up. Smoking cessation is defined as a carbon monoxide level in exhaled air of less than 6 ppm. We hypothesize that the group receiving the multi-stage cessation program will yield a cessation rate at least 10 percentage points higher than that of usual care. Anticipating a dropout rate of around 35%, the planned sample size is at least N = 1032 study participants., Discussion: Should the trial demonstrate significant positive outcomes, efforts should be made to integrate the program into routine care in Germany, potentially offering a promising base for future smoking cessation support among PAD patients., (© 2024. The Author(s).)

Background: Arrhythmia recurrence after pulmonary vein isolation (PVI) is common. We conducted a multicenter, randomized trial to determine the impact of increased physical activity on atrial fibrillation recurrence after PVI., Methods: From 2018 to 2020, we randomly assigned 200 patients with atrial fibrillation to the ACTION or NO-ACTION group in 4 different centers in the local country of Brandenburg, Germany. Patients were eligible if they were scheduled to undergo PVI, aged ≥50 to ≤77 years, body mass index ≥23 to ≤35 kg/m 2 , and accepted wearing an activity tracker allowing 24-hour activity monitoring via mobile app. Patients in the ACTION group were actively remote-controlled via transmitted activity data by a physiotherapist, and individual motivational interviewing call sessions were scheduled with each ACTION patient every 2 weeks. The primary end point was the composite of recurrence of any atrial arrhythmia >30 seconds, additional ablation procedure, cardioversion, and new onset of antiarrhythmic drugs earliest after 90 days after index PVI over 12 months., Results: Overall, the median age of patients was 66 (interquartile range, 61-71) years, 33.5% were women, and 52% had persistent atrial fibrillation. The number of steps per day increased in both groups of patients from baseline to 12 months ( P <0.001). The absolute increase in steps per day did not differ between patients in the ACTION group with +3205 steps (597-4944) compared with those in the NO-ACTION group +2423 steps (17-4284), P =0.325. Unadjusted intention-to-treat analysis showed no difference in the primary composite end point in the ACTION group (27.3%) versus the NO-ACTION group (32.7%), P =0.405., Conclusions: Physical activity improved in patients after PVI. The present randomized controlled trial shows that activity tracker and motivational calls to increase physical activity versus activity tracker alone did not reduce the occurrence of the primary composite end point of atrial fibrillation recurrence or the absolute increase in steps per day., Registration: URL: https://www.cochranelibrary.com; Unique identifier: DRKS00012914., Competing Interests: None.

Introduction: This workshop report explores the application of Motivational Interviewing (MI) in Climate-sensitive Health Counselling (CSHC) within the context of primary health care. As there is a growing interest in the connection of individual health and climate change mitigation, we provide practical guidance on integrating MI techniques in CSHC., Methods: In June 2023, a 2-day workshop on MI was conducted at the Institute of General Medicine, University of Cologne. The workshop, facilitated by a certified MI trainer, combined theoretical content with practical group exercises. In a second workshop the staff of the Institute of General Medicine discussed the application of MI in CSHC., Results: We identified and specified five tools to apply MI in CSHC: A) risk assessment scores, B) relevance assessment scales, C) decision matrices, D) confidence assessment scales, and E) SMART goals. These tools provide practical insights for integrating MI into primary care consultations, offering a time-efficient approach to CSHC., Discussion: Our results present a promising approach for healthcare professionals to incorporate climate-related aspects into health counselling of patients. Feasibility and effects of MI in CSHC are still unclear and require further research., Conclusion: The tools identified provide practical guidance for the application of MI in climate-sensitive health counselling (CSHC) as well as guidance on conducting appropriate studies., (Copyright © 2024. Published by Elsevier GmbH.)

We do not know if the delivery of Motivational Interviewing (MI) differs across countries. In an international study targeting Elderly people with Alcohol Use Disorder, The Elderly Study, MI was part of the treatment applied. Treatment delivery was measured by means of the Motivational Interviewing Treatment Integrity code version 4 (MITI 4). Mixed effects models explored potential differences in delivery of MI between the countries. Delivery of MI differed significantly between participating countries: Denmark, Germany and the US. These findings are important to consider when comparing measures of MI integrity across studies from different cultures. [ABSTRACT FROM AUTHOR]

Images might provide richer and more objective information than text answers to open‐ended survey questions. Little is known, nonetheless, about the consequences for data quality of asking participants to answer open‐ended questions with images. Therefore, this paper addresses three research questions: (1) What is the effect of answering web survey questions with images instead of text on breakoff, noncompliance with the task, completion time and question evaluation? (2) What is the effect of including a motivational message on these four aspects? (3) Does the impact of asking to answer with images instead of text vary across device types? To answer these questions, we implemented a 2 × 3 between‐subject web survey experiment (N = 3043) in Germany. Half of the sample was required to answer using PCs and the other half with smartphones. Within each device group, respondents were randomly assigned to (1) a control group answering open‐ended questions with text; (2) a treatment group answering open‐ended questions with images; and (3) another treatment group answering open‐ended questions with images but prompted with a motivational message. Results show that asking participants to answer with images significantly increases participants' likelihood of noncompliance as well as their completion times, while worsening their overall survey experience. Including motivational messages, moreover, moderately reduces the likelihood of noncompliance. Finally, the likelihood of noncompliance is similar across devices. [ABSTRACT FROM AUTHOR]

As intangible experiences are crucial for approach tendencies toward a destination, this research proposes the CI-MI-R framework linking cognitive image (CI) to response (R) via mental imagery (MI). Cosmopolitanism, escapism, and cognitive thinking style are examined as moderators in the relationship between cognitive image and mental imagery. Two studies from USA and Germany confirmed the role of mental imagery as a mediator between cognitive image and tourist response. The three segmentation-based moderators decrease the strength of the link between cognitive image and mental imagery, suggesting that targeting tourists, who are low (high) in cosmopolitanism, escapism, and cognitive thinking style, with cognitive images will be more (less) effective in increasing their mental imagery of the destination and subsequently approach responses. [ABSTRACT FROM AUTHOR]

Aims: To perform an economic evaluation of guided and unguided internet-based interventions to reduce problematic alcohol consumption in employees compared with a waiting-list control condition (WLC) with unrestricted access to treatment-as-usual. Design: A cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) from a societal and a cost-benefit analysis from the employer's perspective with a 6-month time horizon. Setting: Open recruitment in the German working population. Participants: Employees (178 males, 256 females, mean age 47 years) consuming at least 14 (women) or 21 (men) standard units of alcohol (SUAs) per week and scoring = 8 (men) or 6 (women) on the Alcohol Use Disorders Identification Test. Measurements: On-line questionnaires administered to assess SUAs and assess quality of life (AQoL-8D) and resource use. Outcome measure was responder (= 14/= 21 SUAs) for the CEA and quality-adjusted life years (QALYs) for the CUA. Net benefit regression was used to estimate cost-effectiveness for each study arm. Bootstrapping and sensitivity analyses were performed to account for uncertainty. Interventions: Five weekly modules including personalized normative feedback, motivational interviewing, goal setting, problem-solving and emotion regulation, provided with adherence-focused guidance [n = 142; responders: n = 73 (51.4%); QALYs = 0.364, standard error (SE) = 0.006] or without guidance [n = 146; n = 66 (45.2%); 0.359, 0.007]. Controls were on a waiting-list [n = 144; n = 38 (26.4%); 0.342, 0.007]. Findings: From a societal perspective, the guided intervention had a probability of 55% (54%) of being the most efficient strategy at a willingness-to-pay (WTP) of €0 per responder (QALY) gained, compared with the unguided intervention and the control condition. At a WTP of €20 000 per QALY gained, the probability was 78%. From an employer's perspective, the guided intervention had a higher probability of a positive return on investment (81%) compared with the unguided intervention (58%). Conclusion: A guided internet-based intervention to reduce problematic alcohol consumption in employees appears to be both cost-beneficial and cost-effective. [ABSTRACT FROM AUTHOR]

Abstract: Among current cannabis users, about 15 % show problematic consumption behaviour. The proportion of clients with a cannabis use disorder has risen significantly in recent years, both in addiction and psychiatric care. Internationally, a variety of intervention programs have been developed for the counseling and treatment of cannabis addicts. Studies have shown that more intensive interventions showed better effects than brief interventions. Motivational interviewing and behavioral therapy interventions proved to be particularly effective. In the case of adolescent cannabis use, family therapy approaches are considered to be most effective. In Germany, several counselling and treatment programs have been developed, evaluated, and implemented in the field since the 2000s. Nevertheless, cannabis clients still seek professional help too late. In particular, family-oriented counselling and treatment services should be expanded to include parents and families of cannabis-using adolescents. [ABSTRACT FROM AUTHOR]

Background: Maintaining mobility in old age is crucial for healthy ageing including delaying the onset and progress of frailty. However, the extent of an individuals´ mobility relies largely on their personal, social, and environmental resources as outlined in the Life-Space Constriction Model. Recent studies mainly focus on facilitating habitual out-of-home mobility by fostering one type of resources only. The MOBILE trial aims at testing whether tablet-assisted motivational counselling enhances the mobility of community-dwelling older adults by addressing personal, social, and environmental resources.Methods: In the MOBILE randomized controlled trial, we plan to enrol 254 community-dwelling older adults aged 75 and older from Havelland, a rural area in Germany. The intervention group will receive a tablet-assisted motivational counselling at the participant´s home and two follow-up telephone sessions. Main focus of the counselling sessions lays on setting and adapting individual mobility goals and applying action planning and habit formation strategies by incorporating the personal social network and regional opportunities for engaging in mobility related activities. The control group will receive postal general health information. The primary mobility outcome is time out-of-home assessed by GPS (GPS.Rec2.0-App) at three points in time (baseline, after one month, and after three months for seven consecutive days each). Secondary outcomes are the size of the GPS-derived life-space convex hull, self-reported life-space mobility (LSA-D), physical activity (IPAQ), depressive symptoms (GDS), frailty phenotype, and health status (SF-12).Discussion: The MOBILE trial will test the effect of a motivational counselling intervention on out-of-home mobility in community-dwelling older adults. Novel aspects of the MOBILE trial include the preventive multi-level intervention approach in combination with easy-to-use technology. The ecological approach ensures low-threshold implementation, which increases the benefit for the people in the region.Trial Registration: The MOBILE trial is prospectively registered at DRKS (Deutsches Register Klinischer Studien, German Registry of Clinical Trials) DRKS00025230 . Registered 5 May 2021. [ABSTRACT FROM AUTHOR]

Objective: Telephone based health coaching (TBHC) seems to be a promising approach to foster self-management in patients with chronic conditions. The aim of this study was to evaluate the effectiveness of a TBHC on patient-reported outcomes and health behavior for people living with chronic conditions in Germany. Methods: Patients insured at a statutory health insurance were randomized to an intervention group (IG; TBHC) and a control group (CG; usual care), using a stratified random allocation before giving informed consent (Zelen's single-consent design). The TBHC was based on motivational interviewing, goal setting, and shared decision-making and carried out by trained nurses. All outcomes were assessed yearly for three years. We used mixed effects models utilizing all available data in a modified intention-to-treat sample for the main analysis. Participants and study centers were included as random effects. All models were adjusted for age, education and campaign affiliation. Results: Of the 10,815 invited patients, 4,283 returned their questionnaires at baseline. The mean age was 67.23 years (SD = 9.3); 55.5% were female. According to the model, TBHC was statistically significant superior to CG regarding 6 of 19 outcomes: physical activity in hours per week (p =.030) and in metabolic rate per week (p =.048), BMI (p =.009) (although mainly at baseline), measuring blood pressure (p<.001), patient activation (p<.001), and health literacy (p<.001). Regarding stages of change (p =.005), the IG group also showed statistically different results than the CG group, however the conclusion remains inconclusive. Within-group contrasts indicating changes from baseline to follow-ups and significant between-group comparisons regarding these changes supported the findings. Standardized effect sizes were small. TBHC did not show any effect on mental QoL, health status, alcohol, smoking, adherence, measuring blood sugar, foot monitoring, anxiety, depression and distress. Campaign-specific subgroup effects were detected for 'foot monitoring by a physician' and 'blood sugar measurement'. Conclusion: TBHC interventions might have small effects on some patient reported and behavioral outcomes. Practice implications: Future research should focus on analyzing which intervention components are effective and who profits most from TBHC interventions. Registration: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS): DRKS00000584 [ABSTRACT FROM AUTHOR]

Background: In Germany, evidence-based outpatient smoking cessation therapies are widely available. Long-term abstinence rates, however, are limited. Studies suggest that short-term residential therapy enables a higher level of environmental control, more intense contact and greater support among patients and from therapists, which could result in higher abstinence rates. The aim of the current START-study is to investigate the long-term efficacy of a short-term residential therapy exclusively for smoking cessation, conducted by a mobile team of expert therapists.Methods: A randomized controlled trial (RCT) is conducted to examine the efficacy of residential behavior therapeutic smoking cessation therapy compared to standard outpatient behavior therapeutic smoking cessation group therapy. Adult smokers consuming 10 or more cigarettes per day, who are willing to stop smoking, are randomized in a ratio of 1:1 between therapy groups. The primary endpoint is sustained abstinence for 6-month and 12-month periods. Secondary endpoints include smoking status after therapy, 7-day point abstinence after the 6-month and 12-month follow-ups, level of physical dependence, cost-effectiveness, use of nicotine replacement products, health-related quality of life, self-efficacy expectation for tobacco abstinence, motivational and volitional determinants of behavior change, self-reported depressive symptom severity, adverse events and possible side effects. Assessments will take place at baseline, post-therapy, and at 6-month and 12-month intervals after smoking cessation.Discussion: There is a high demand for long-term effective smoking cessation therapies. This study represents the first prospective RCT to examine the long-term efficacy of a residential smoking cessation therapy program compared to standard outpatient group therapy as an active control condition. The residential therapeutic concept may serve as a new model to substantially enhance future cessation therapies and improve the understanding of therapeutic impact factors on tobacco abstinence. Utilizing a mobile team, the model could be applied efficiently to medical centers that do not have permanent and trained personnel for smoking cessation at their disposal.Trial Registration: German Register for Clinical Trials (Deutsches Register für Klinische Studien), DRKS00013466. Retrospectively registered on 1 April 2019. https://www.drks.de/drks_web/navigate.do?navigationId=start. [ABSTRACT FROM AUTHOR]

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• We explore main motivational mechanisms behind the intention to adopt MaaS. • We combine inductive exploration with quantitative deductive research and PLS-SEM. • Adoption intention is equally driven by usefulness perceptions and hedonic motives. • Important role of psychological needs and habit related cognitive schemata. Based on digital transformation processes, public mobility is experiencing tremendous and far-reaching change. The use of information and communication technology (ICT) enables disruptive mobility solutions that have recently became known as mobility as a service (MaaS). MaaS promises great economic potential and supports the idea of a more efficient allocation of transport resources. However, the main motivational mechanisms behind travelers' adoption intention are still unknown. This research identifies key motivational determinants and investigates their structural interrelations. Based on a literature review we first identify the fundamental characteristics of MaaS. Building on this common understanding, we conduct qualitative in-depth interviews with potential end-users to explore motivational acceptance factors. We draw from our inductive findings to postulate a structural causal equation model that captures motivational mechanisms behind the intention to adopt MaaS. Finally, the model will be quantitatively validated based on a comprehensive survey and the use of partial least squares (PLS) analysis. We show that psychological needs play a crucial role in the acceptance of MaaS. The results demonstrate that anticipated advantages of autonomy, competence and the feeling of being related to a social peer group affect hedonic motivation and the expected usefulness of MaaS offerings, which equally affect behavioral intention. We also introduce a novel theoretical construct and show that – in the present disruptive context – cognitive congruency between existing habit schemata and anticipated MaaS usage patterns significantly affect the judgment process and behavioral intention. Finally, important implications for market strategy, product development and policy measures will be discussed. [ABSTRACT FROM AUTHOR]

This study investigates the relationships between professional knowledge, self‐concept, and interest of pre‐service physics teachers. In order to support student learning and interest development alike, teachers need a profound professional knowledge and respective motivational orientations. Developing both professional knowledge and motivational orientations in teachers is therefore a key challenge of teacher education. Prior research has focused on the development of content knowledge (CK) and pedagogical content knowledge (PCK) within teacher education, but the role of motivational orientations such as self‐concept and interest have mostly been neglected areas of study. As individuals develop domain‐specific motivational orientations, they compare their achievement in an external frame to the achievement of their peers, and they compare their achievements in an internal frame across domains. The effects of these psychological processes on domain‐specific motivational orientations are described by the generalized internal/external frame of reference model (GI/E model). We assessed the professional knowledge (CK and PCK) and motivational orientations (self‐concept and interest) of N = 200 pre‐service physics teachers from 12 teacher education institutes in Germany. To investigate the predictions of the GI/E model, we utilized structural equation modeling. In line with the GI/E model, the analysis revealed that pre‐service teachers use social comparisons. Pre‐service teachers with a higher CK/PCK also showed a higher CK/PCK self‐concept. We also identified instances of internal comparisons as we found that a high level of CK corresponds with a lower PCK self‐concept. While we could not identify the same effects from professional knowledge on interest, self‐concept mediated the effects from professional knowledge on interest. The results suggest that interdependencies between professional knowledge and motivational orientation should be given more consideration in teacher education research and should also be addressed more explicitly in teacher education. [ABSTRACT FROM AUTHOR]

Background: Little is known about the impact of brief alcohol interventions on mental and general health. The aim was to investigate whether brief interventions for general hospital inpatients with at-risk drinking can improve mental and general health over 2 years; and whether effects are dependent on how they are delivered: in-person or through computer-generated feedback letters (CO). Methods: Three-arm randomized controlled trial with 6-, 12-, 18-, and 24-month follow-ups. Data were collected on 13 general hospital wards from four medical departments (internal medicine, surgical medicine, trauma surgery, and ear-nose-throat) of one university hospital in northeastern rural Germany. A consecutive sample of 961 18- to 64-year-old general hospital inpatients with at-risk alcohol use was recruited through systematic screening. Inpatients with particularly severe alcohol problems were excluded. Participants were allocated to: in-person counseling (PE), CO, and assessment only (AO). PE and CO included three contacts: on the ward, 1, and 3 months later. Mental and general health were assessed using the five-item mental health inventory (0–100) and a one-item general health measure (0, poor – 4, excellent). Results: Latent growth models including all participants revealed: after 24 months and in contrast to AO, mental and general health were improved in PE (change in mean difference, Δ M mental = 5.13, p = 0.002, Cohen's d = 0.51; Δ M general = 0.20, p = 0.005, d = 0.71) and CO (Δ M mental = 6.98, p < 0.001, d = 0.69; Δ M general = 0.24, p = 0.001, d = 0.86). PE and CO did not differ significantly. Conclusions: Beyond drinking reduction, PE and CO can improve general hospital inpatients' self-reported mental and general health over 2 years. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tobacco use is associated with various severe health risks. Therefore, the need to decrease smoking rates is a great public health concern. The workplace has capability as a setting through which large groups of smokers can be reached to encourage smoking cessation. OBJECTIVE: The aim of the present study was to evaluate effects of a multi behavioral worksite health promotion intervention. The primary outcome was the change of smoking rate. Secondary outcomes were changes in smoking attitudes and readiness to stop smoking among employees over an intervention period of 12 months. METHOD: 112 and 110 employees were enrolled in the intervention and control arm respectively. The intervention group received a 12-month multicomponent health promotion intervention. One of the main elements of the multicomponent intervention was a smoking cessation and counseling program. During the pilot year, participants completed a self-evaluation questionnaire at baseline and again after 12 months to related outcomes and changes. RESULTS: Results showed that participants' quit behavior and smoking behavior changed over time in the intervention group (IG). Readiness to quit smoking also increased in the IG compared to the comparison group (CG). Some positive intervention effects were observed for cognitive factors (e.g., changes attitudes towards smoking). Baseline willingness to change smoking behavior was significantly improved over time. CONCLUSIONS: This study showed initial results of a long-term multicomponent worksite health promotion program with regard to changes in smoking behavior, attitudes towards smoking and readiness to quit smoking. The evaluation suggests that a worksite health promotion program may lead to improvements in smoking behavior for a number of workers. [ABSTRACT FROM AUTHOR]

Parents addicted to methamphetamine ("crystal meth") are likely to be impaired in meeting parental responsibilities, and the developmental settings can be highly disadvantageous for children. Therefore, parenting by methamphetamine‐addicted mothers and fathers needs further exploration, while considering the impact on children affected by parental substance use. In our study, we analysed parenting practices and parental stress as well as children's behavioural problems using standardized assessments. The sample consisted of 87 methamphetamine‐addicted parents in recovery. We obtained data on parents' current substance use and on their psychological distress. Multiple regression analysis was performed to identify predictors of children's overall problems. Parents reported high levels of parental and psychological distress, even after achieving abstinence. Especially depressive perceptions of parenthood appeared problematic. While recovering from methamphetamine addiction, parents exhibited a precarious psychosocial situation and problematic parenting behaviour. Dysfunctional parenting practices were evident in both indifferent and overreactive tendencies. Children were at risk of behavioural and emotional problems. Variables associated with parenting showed significant predictive value for children's overall problems, beyond current substance use, and psychological distress. These findings are discussed in terms of a family‐oriented perspective in order to promote parenting capabilities of methamphetamine‐addicted parents and to prevent problematic development of their children. [ABSTRACT FROM AUTHOR]

Abstract Problematic school absenteeism is defined as absence from school occurring with a clinical-level mental disorder. It represents a higher-order term for school refusal, school truancy, and the combination thereof and is associated with an increased risk for school dropout, prolonged mental disorders, and unemployment. This article describes the manualized modular treatment of problematic school absenteeism (MT) by a multiprofessional team. The manual was developed to target a broad spectrum of mental disorders characterized by internalizing but also externalizing behavior. The therapeutic focus is on the reintegration into school and on the cognitive behavioral treatment of the mental disorder. The MT is based on a multilevel model of problematic school absenteeism. The treatment is informed by an extensive case-conceptualization and addresses motivational aspects by offering a low-threshold therapeutic design and motivational interviewing. Core interventions are represented in four modules: cognitive behavioral therapy, family counseling, school counseling, and a psychoeducational physical exercise program. A case vignette provides an illustration of the treatment and the specific graduated approach for school reintegration. The current modular approach is discussed in relation to other cognitive-behavioral manuals targeting a broad spectrum of mental disorders or school refusal. Highlights • A modular treatment for problematic school absenteeism is described. • The main treatment module is based on cognitive behavioral therapy. • Additional modules cover family counselling, school counselling, and psychoeducational sports. • Motivational interviewing supports treatment motivation and engagement. • The effectiveness of the modular treatment for different types of school absenteeism is discussed. [ABSTRACT FROM AUTHOR]

Objective: In this randomized controlled trial, we evaluated the effectiveness of a telephone-delivered intervention based on the Health Action Process Approach (HAPA) after discharge from inpatient rehabilitation to address behavior change, emotional status, and glycemic control in patients with Type 2 diabetes. Design: In a German rehabilitation center, 249 patients with Type 2 diabetes were separated into randomized groups, either a 12-month telephone follow-up support group or the usual care group. The counselor identified personal target areas and intervention modules and developed with the patient an individualized action plan for the telephone support. To enhance motivational processes, they used motivational interviewing techniques. Counselors called patients monthly to support the implementation of the personal plans into the patients' daily routines and to screen for emotional problems. Assessments measured exercise, diet, medication adherence, psychological variables, body mass index, HbA1c, and cardiovascular risk. Results: Twelve months after inpatient rehabilitation, the telephone group's rate of physical activity rose by 26% compared with the usual care group's 10%. Patients in the intervention group exhibited greater improvements in terms of their illness burden, psychological well-being, and depression. HbA1c fell in the telephone group but increased in the usual care group (-0.68% vs. 0.12%). The intervention group's cardiovascular risk fell, whereas the usual care group's rose (-0.57 vs. 0.23). Conclusion: A theory-based telephone-delivered follow-up intervention utilizing motivational interviewing techniques and focusing on personalized action planning demonstrated improvements in patients' level of activity and health status 12-months postrehabilitation discharge and may be a beneficial supplement to rehabilitation programs. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To test the efficacy of a web‐based alcohol intervention with and without guidance. Design: Three parallel groups with primary end‐point after 6 weeks. Setting: Open recruitment in the German working population. Participants: Adults (178 males/256 females, mean age 47 years) consuming at least 21/14 weekly standard units of alcohol (SUA) and scoring ≥ 8/6 on the Alcohol Use Disorders Identification Test. Intervention: Five web‐based modules including personalized normative feedback, motivational interviewing, goal setting, problem‐solving and emotion regulation during 5 weeks. One intervention group received an unguided self‐help version (n=146) and the second received additional adherence‐focused guidance by eCoaches (n=144). Controls were on a waiting list with full access to usual care (n=144). Measurements: Primary outcome was weekly consumed SUA after 6 weeks. SUA after 6 months was examined as secondary outcome, next to numbers of participants drinking within the low‐risk range, and general and work‐specific mental health measures. Findings: All groups showed reductions of mean weekly SUA after 6 weeks (unguided: −8.0; guided: −8.5; control: −3.2). There was no significant difference between the unguided and guided intervention (P=0.324). Participants in the combined intervention group reported significantly fewer SUA than controls [B=−4.85, 95% confidence interval (CI)=−7.02 to −2.68, P < 0.001]. The intervention groups also showed significant reductions in SUA consumption after 6 months (B=−5.72, 95% CI=−7.71 to −3.73, P < 0.001) and improvements regarding general and work‐related mental health outcomes after 6 weeks and 6 months. Conclusions: A web‐based alcohol intervention, administered with or without personal guidance, significantly reduced mean weekly alcohol consumption and improved mental health and work‐related outcomes in the German working population. [ABSTRACT FROM AUTHOR]

Objectives The proportion of children and adolescents receiving emergency care for acute alcohol intoxication ( AAI) in Germany has sharply increased over the past years. Despite this, no randomized controlled trials ( RCTs) have studied guideline- and evidence-based interventions to prevent future alcohol misuse within this population. The objective of our investigation was to evaluate the effectiveness of a brief motivational intervention (b- MI) to reduce drinking and associated problems within pediatric emergency departments ( PED) in Hamburg, Germany. Methods This stratified cluster- RCT compared a widely established but modified targeted b- MI and treatment as usual ( TAU) for patients recruited and treated on Fridays, Saturdays, or Sundays from July 2011 to January 2014 for AAI in EDs of six pediatric hospitals in Hamburg, Germany. Patients under the age of 18 years and their caregivers were included in the study. Intervention was delivered by trained hospital-external staff. The intervention group ( n = 141) received a single-session b- MI with a telephone booster after 6 weeks and a brief consultation for caregivers. All intervention material was manual-based. The TAU control group ( n = 175) received youth-specific written information on alcohol use and contact information for community resources. Primary outcomes were changes in binge drinking frequency, number of alcoholic drinks on a typical occasion, and alcohol-related problems using the brief Rutgers Alcohol Problem Index. Outcomes were measured by research assistants not involved in intervention delivery. Baseline data were collected in person at the PED, and follow-up data were collected via telephone 3 and 6 months after baseline. Secondary outcome was postenrollment health service utilization. Analyses were based on linear mixed models and intent to treat. Results A total of 86.1% (87.5%) of patients in the b- MI group and 82.4% (86.9%) in the TAU group provided valid outcome data after 3 (6) months, respectively. The differences between groups for all outcomes were statistically nonsignificant at both follow-ups (p > 0.05). After 3 months the mean change in binge drinking frequency was -1.36 (95% confidence interval [ CI] = -1.81 to -0.91), a reduction of 62.1% in the b- MI group, and -1.29 (95% CI = -1.77 to -0.95), a reduction of 49.0% in the TAU group. The mean change in number of alcoholic drinks on a typical occasion was -2.24 (95% CI = -3.18 to -1.29), a reduction of 37.5% in the b- MI group, and -1.34 (95% CI = -2.54 to -0.14), a reduction of 26.4% in the TAU group. The mean change of alcohol-related problems was -6.72 (95% CI = -7.68 to -5.76), a reduction of 60.5% in the b- MI group, and -6.43 (95% CI = -7.37 to -5.49), a reduction of 58.3% in the TAU group. The differences in mean changes between groups were similar after 6 months for all outcomes. Conclusion This study provides new information on the effectiveness of b- MIs delivered at discharge of young AAI patients in emergency care. Both trial groups reduced alcohol use and related problems but the b- MI was not associated with significant effects. Although the intervention approach appears feasible, further considerations of improving the outcomes for this relevant target group are required. [ABSTRACT FROM AUTHOR]

Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Therefore, a randomized controlled trial with 280 community-dwelling older German adults was conducted to test the effects of a theory-based social-cognitive intervention against a passive waiting-list control group and an active control intervention designed to motivate physical activity. Self-reports of weekly volunteering minutes were assessed at baseline (5 weeks before the intervention) as well as 2 and 6 weeks after the intervention. Participants in the treatment group increased their weekly volunteering minutes to a greater extent than participants in the control groups 6 weeks after the intervention. We conclude that a single, face-to-face group session can increase volunteering among older community-dwelling adults. However, the effects need some time to unfold because changes in volunteering were not apparent 2 weeks after the intervention. [ABSTRACT FROM AUTHOR]

BackgroundPrevious research has demonstrated an association between low motivation to change and an unfavorable treatment outcome in patients with an eating disorder. Consequently, various studies have examined the effects of motivational enhancement therapy (MET) on motivation to change and treatment outcome in eating disorders. In each of these studies, MET was administered in a face-to-face setting. However, because of its anonymity and ease of access, the internet provides several advantages as the format for such an intervention. Therefore, the current study investigated the effects of an internet-based program (‘ESS-KIMO’) to enhance motivation to change in eating disorders.MethodIn total, 212 females were accepted for participation and assigned randomly to the intervention condition (n = 103) or waiting-list control condition (n = 109). The intervention consisted of six online MET sessions. Before and after the intervention or waiting period respectively, participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the Stages of Change Questionnaire for Eating Disorders (SOCQ-ED), the Pros and Cons of Eating Disorders Scale (P-CED), the Self-Efficacy Scale (SES), and the Rosenberg Self-Esteem Scale (RSES). A total of 125 participants completed the assessment post-treatment. Completer analyses and intent-to-treat analyses were performed.ResultsSignificant time × group interactions were found, indicating a stronger increase in motivational aspects and self-esteem, in addition to a stronger symptom reduction on some measures from pre- to post-treatment in the intervention group compared to the control group.ConclusionsInternet-based approaches can be considered as useful for enhancing motivation to change in eating disorders and for yielding initial symptomatic improvement. [ABSTRACT FROM AUTHOR]

The Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP) is an online database of mental health and substance- abuse interventions that have undergone an independent review process to rate their quality of research and readiness for dissemination. Originally conceived as a U.S.-based national registry, NREPP has effectively become an international resource on evidence-based programs and practices, containing information on interventions from around the world and drawing an international audience. The objectives of this descriptive study were to determine how many interventions in the registry (1) have been implemented outside the United States, (2) have materials translated into one or more languages, (3) have received funding from a non-U.S. source, and (4) have been evaluated in studies conducted outside the United States. The growing interest in other countries for tools to assist in the identification and implementation of evidence-based programs suggests that NREPP will become increasingly relevant and useful to international mental health constituencies. [ABSTRACT FROM AUTHOR]

Background : To overcome the problem of a high prevalence of undiscovered or untreated arterial hypertension in people of working age, the effects of behavioral change counseling in occupational health (OH) services should be investigated. The technique of motivational interviewing (MI) to support health-related lifestyle changes by physicians and/or occupational nurses ('health coach') has been shown to be successful in patients with chronic diseases. In 2010, we planned a randomized controlled trial (RCT) with employees who suffer from mild arterial hypertension. A preliminary feasibility study was performed in a large manufacturing company in Germany. Methods : All employees with elevated blood pressure measured by the OH-service were invited to undergo validation by 30 self-measurements. Persons with validated elevated values and without medical treatment received either usual hypertension counseling (control group, CG) or intensified MI-counseling (intervention group, IG) by the occupational health physician. Subsequently, the IG received MI-support from the 'health coach' in four telephone counseling sessions. Assessed feasibility factors included organizational processes, the acceptance of the validation procedure and the MI-counseling, and as primary outcome for an RCT the extent to which participants made health-related changes to their lifestyles. Results : Initially, 299 individuals were included in Study Part A (screening). At the end of Study Part B (intervention), out of 34 participants with validated and non-treated mild hypertension, only 7 (IG) and 6 (CG) participants completed the intervention including documentation. The high drop-out rate was due to the frequent lack of willingness to perform the 30 self-measurements at home with their own equipment. Acceptance was little higher when we changed the method to two repeated measurements in the OH service. MI-counseling, especially by the health coach, was evaluated positively. Conclusions : Despite the promising counseling approach, the feasibility study showed that an RCT with previous screening in the operational setting can only be implemented with high financial and personnel effort to reach an appropriate number of subjects. This substantial result could only be achieved through this comprehensive feasibility study, which investigated all aspects of the planned future RCT.

Background: An increasing prevalence of having survived a myocardial infarction increases the importance of medical secondary prevention. Although preventive medication reduces mortality, prescribing and adherence are known to be frequently insufficient. General practitioners are the most important prescriber. However, their perspective on prescribing and medical non-adherence following myocardial infarction has not yet been explored. Thus, the aim of this study was to explore the general practitioners' perspective on long-term care after myocardial infarction focussing on medical prevention., Methods: In this qualitative interview study we conducted episodic interviews with sixteen general practitioners from rural and urban surgeries in Germany. Framework analysis with focus on general practitioners' prescribing and patients' non-adherence was performed., Results: Almost all general practitioners reported following guidelines for myocardial infarction aftercare and prescribing the medication that was initiated in the hospital; however, they described deviating from guidelines because of drugs' side effects or patients' intolerances. Some questioned the benefits of medical secondary prevention for the oldest of patients. General practitioners perceived good adherence among their patients who had had an MI while they regarded their methods for assessing medical non-adherence as limited. They perceived diverse reasons for non-adherence, particularly side effects, patients' freedom from symptoms and patients' indifference to health. They attributed mainly negative characteristics, like lack of knowledge and understanding, to non-adherent patients. These characteristics contribute to the difficulty of convincing these patients to take medications as prescribed. General practitioners improved adherence by preventing side effects, explaining the medication's necessity, facilitating intake and involving patients in decision-making. However, about half of the general practitioners reported threatening their patients with negative consequences of non-adherence., Conclusions: General practitioners should be aware that discharge medication can be insufficient and thus, should always check hospital recommendations for accordance with guideline recommendations. Improving physicians' communication skills and informing and motivating patients in an adequate manner, for example in simple language, should be an important goal in the hospital and the general practitioner setting. General practitioners should assess patients' motivations through motivational interviewing, which no general practitioner mentioned during the interviews, and talk with them about adherence and long-term treatment goals regularly.

Background: The first 1000 days after conception are a critical period to encourage lifestyle changes to reduce the risk of childhood obesity and early programming of chronic diseases. A healthy lifestyle during pregnancy is also crucial to avoid high post-partum weight retention. Currently, lifestyle changes are not consistently discussed during routine health services in Germany. The objective of this study is to evaluate a novel computer-assisted lifestyle intervention embedded in prenatal visits and infant check-ups. The intervention seeks to reduce lifestyle-related risk factors for overweight and obesity among expecting mothers and their infants., Methods: The study is designed as a hybrid effectiveness-implementation trial to simultaneously collect data on the effectiveness and implementation of the lifestyle intervention. The trial will take place in eight regions of the German state Baden-Wuerttemberg. Region were matched using propensity score matching. Expecting mothers (n = 1860) will be recruited before 12 weeks of gestation through gynecological practices and followed for 18 months. During 11 routine prenatal visits and infant check-ups gynecologists, midwives and pediatricians provide lifestyle counseling using Motivational Interviewing techniques. The primary outcome measure is the proportion of expecting mothers with gestational weight gain within the recommended range. To understand the process of implementation (focus group) interviews will be conducted with providers and participants of the lifestyle intervention. Additionally, an analysis of administrative data and documents will be carried out. An economic analysis will provide insights into cost and consequences compared to routine health services., Discussion: Findings of this study will add to the evidence on lifestyle interventions to reduce risk for overweight and obesity commenced during pregnancy. Insights gained will contribute to the prevention of early programming of chronic disease. Study results regarding implementation fidelity, adoption, reach and cost-effectiveness of the lifestyle intervention will inform decisions about scale up and public funding., Trial Registration: German Clinical Trials Register (DRKS00013173). Registered 3rd of January 2019, https://www.drks.de.

Objectives This study aims to assess medical students' interest in a Motivational Interviewing (MI), the objective need for a special training, and students' satisfaction with and the effectiveness of such a course. Methods A mandatory MI course was implemented for sixth-semester medical students. Their interest in learning MI was evaluated, along with their satisfaction with the course, which was delivered in a blended-learning teaching approach. Participants' baseline MI skills and general communication skills were assessed. MI non-adherent behavior, like persuading and confronting patients, was noted. Successful learning was measured with a multiple-choice test administered before and after the course that assessed subjective knowledge and skills. Results Students were highly interested in learning MI. At baseline, they showed good communication skills but moderate MI skills. Satisfaction with the course was high. The course was effective, as subjective and objective knowledge and skills improved significantly. Conclusions This pilot study suggests that basic MI skills can be successfully taught in a blended-learning teaching approach. Further research should investigate sustainability and transfer to clinical practice. Practice implications Medical schools should consider providing students with special training in MI to help students counsel patients towards behavioral changes., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents' utilisation of psychological health care for symptoms of anxiety or depression., Methods/design: In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session., Discussion: This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents' long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood., Trial Registration: German Trials Register (DRKS), DRKS00014043 . Registered on 26 April 2018. Düsseldorf University study ID: 2017114504.

The article offers information on treatment of smoking habit in the people and it is also presenting the efforts of the government regarding the smoking cessation. It informs that the advertising bans, rising cost of cigarettes, and laws to protect nonsmokers by the governmaent helped a lot in smoking cessation. It also informs that physician's motivational interviewing to smoker helped a lot in controlling smoking habit.

Background: Alcohol misuse among youth is a major public health concern and numbers of adolescents admitted to the emergency department for acute alcoholic intoxication in Germany are recently growing. The emergency setting offers an opportunity to reach at-risk alcohol consuming adolescents and provide brief interventions in a potential "teachable moment". However, studies on brief interventions targeting adolescents in emergency care are scarce and little is known about their effectiveness when delivered immediately following hospitalization for acute alcohol intoxication. In this protocol we present the HaLT-Hamburg trial evaluating a brief motivational intervention for adolescents treated in the emergency department after an episode of acute alcoholic intoxication., Methods: The trial design is a parallel two-arm cluster randomized-controlled trial with follow-up assessment after 3 and 6 months. N = 312 participants aged 17 years and younger will be recruited Fridays to Sundays in 6 pediatric clinics over a period of 30 months. Intervention condition is a manual-based brief motivational intervention with a telephone booster after 6 weeks and a manual-guided intervention for caregivers which will be compared to treatment as usual. Primary outcomes are reduction in binge drinking episodes, quantity of alcohol use on a typical drinking day and alcohol-related problems. Secondary outcome is further treatment seeking. Linear mixed models adjusted for baseline differences will be conducted according to intention-to-treat (ITT) and completers (per-protocol) principles to examine intervention effects. We also examine quantitative and qualitative process data on feasibility, intervention delivery, implementation and receipt from intervention providers, receivers and regular emergency department staff., Discussion: The study has a number of strengths. First, a rigorous evaluation of HaLT-Hamburg is timely because variations of the HaLT project are widely used in Germany. Second, prior research has not targeted adolescents in the presumed teachable moment following acute alcohol intoxication. Third, we included a comprehensive process evaluation to raise external validity. Fourth, the study involved important stakeholders from the start to set up organizational structures for implementation and maintaining project impact., Trial Registration: Current Controlled Trials ISRCTN31234060 (April 30th 2012).