Screening and brief interventions for hazardous and harmful alcohol use among university students in South Africa: results from a randomized controlled trial.

Supa Pengpid,Karl Peltzer,Linda Skaal,Hendry Van Der Heever

doi:10.3390/ijerph10052043

Abstract

The aim of this study was to assess the effectiveness of Screening and Brief Intervention (SBI) for alcohol problems among university students in South Africa. The study design for this efficacy study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting. The unit of randomization is the individual university student identified as a hazardous or harmful drinker attending public recruitment venues in a university campus. University students were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counseling session on alcohol risk reduction, while the control group received a health education leaflet. Results indicate that of the 722 screened for alcohol and who agreed to participate in the trial 152 (21.1%) tested positive for the Alcohol Use Disorder Identification Test (AUDIT) (score 8 or more). Among the 147 (96.7%) university students who also attended the 12-month follow-up session, the intervention effect on the AUDIT score was −1.5, which was statistically significant (P = 0.009). Further, the depression scores marginally significantly decreased over time across treatment groups, while other substance use (tobacco and cannabis use), self-rated health status and Posttraumatic Stress Disorder (PTSD) scores did not change over time across treatment groups. The study provides evidence of effective brief intervention by assistant nurses with hazardous and harmful drinkers in a university setting in South Africa. The short duration of the brief intervention makes it a realistic candidate for use in a university setting.

Highlights

The use of alcohol in South Africa is among the highest in Africa, with a total adult per capita consumption of 9.5 L pure alcohol per year [1]
We identified 736 university students, of which 570 screened negative for alcohol, 11 refused to participate and three were found ineligible, resulting in 152 university students who screened 8 or more on the Alcohol Use Disorder Identification Test (AUDIT)
Self-reported outcome data suggest that brief intervention can help reduce levels of hazardous and harmful alcohol use in those students attending a brief intervention in South Africa

Summary

Introduction

The use of alcohol in South Africa is among the highest in Africa, with a total adult per capita consumption of 9.5 L pure alcohol per year [1]. In a study on the same university campus two years later found using a cut off of 6 for women and 8 for men 57.8% were found to be hazardous or harmful drinkers (men: 57.9% women: 57.8%) [7]. This pattern of alcohol consumption by university students may be typical and a cause of concern, as these youths are starting a new period of life, often leaving their homes for the first time, and experiencing freedom along with the use of alcohol and other drugs [8,9]. Attitudes and health factors associated with alcohol consumption or problem drinking in university students have been identified as social factors [10]

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Discussion

Conclusion