Alcohol Brief Intervention Research Articles

A Brief Alcohol Intervention (BAI) to reduce alcohol use and improve PrEP outcomes among men who have sex with men in Vietnam: study protocol for a randomized controlled trial

BackgroundIn Vietnam and other global settings, men who have sex with men (MSM) have become the population at greatest risk of HIV infection. Although HIV pre-exposure prophylaxis (PrEP) has been implemented as a prevention strategy, PrEP outcomes may be affected by low persistence and adherence among MSM with unhealthy alcohol use. MSM have a high prevalence of unhealthy alcohol use in Vietnam, which may affect PrEP outcomes.MethodsDesign: We will conduct a two-arm hybrid type 1 effectiveness-implementation randomized controlled trial of a brief alcohol intervention (BAI) compared to the standard of care (SOC) at the Sexual Health Promotion (SHP) clinic Hanoi, Vietnam.Participants: Sexually active MSM (n=564) who are newly initiating PrEP or re-initiating PrEP and have unhealthy alcohol use will be recruited and randomized 1:1 to the SOC or BAI arm. A subgroup of participants (n=20) in each arm will be selected for longitudinal qualitative interviews; an additional subset (n=48) in the BAI arm will complete brief quantitative and qualitative interviews after completion of the BAI to assess the acceptability of the intervention. Additional implementation outcomes will be assessed through interviews with clinic staff and stakeholders (n=35).Intervention: Study participants in both arms will receive standard care for PrEP clients. In the BAI arm, each participant will receive two face-to-face intervention sessions and two brief booster phone sessions, based on cognitive behavioral therapy and delivered in motivational interviewing informed style, to address their unhealthy alcohol use.Outcomes: Effectiveness (PrEP and alcohol use) and cost-effectiveness outcomes will be compared between the two arms. Intervention implementation outcomes (acceptability, feasibility, adoption) will be assessed among MSM participants, clinic staff, and stakeholders.DiscussionThis proposed trial will assess an alcohol intervention for MSM with unhealthy alcohol use who initiate or re-initiate PrEP, while simultaneously preparing for subsequent implementation. The study will measure the effectiveness of the BAI for increasing PrEP persistence through reducing unhealthy alcohol use in a setting where excessive alcohol consumption is a normative behavior. If effective, implementation-focused results will inform future scale-up of the BAI in similar settings.Trial registrationNCT06094634 on clinicaltrials.gov. Registered 16 October 2023.

Identifying Patients at Risk for Alcohol-Exposed Pregnancies: The Importance of Addressing Multiple Risk Factors.

The increasing prevalence of fetal alcohol spectrum disorders is a critical public health issue. Two behaviors, consuming alcohol and using less effective pregnancy prevention, may result in alcohol-exposed pregnancies (AEPs) in individuals who can become pregnant. In the context of alcohol screening and brief intervention (SBI) services, cutoff scores on widely used alcohol risk assessments (eg, Alcohol Use Disorders Identification Test, U.S. version [USAUDIT]) may fail to identify individuals whose relatively low alcohol consumption may still put them at risk for an AEP due to their pregnancy prevention method. To identify this gap in alcohol SBI service delivery, we examined data from 2 reproductive healthcare systems implementing alcohol SBI, to explore the prevalence of individuals who met both of the following risk conditions: reported any alcohol use on the USAUDIT and a pregnancy prevention method less than 88% effective. Electronic health records for individuals aged 18 to 49 presenting for preventive care in 2021 were analyzed. Of 11 567 screened, 7638 reported some alcohol use, but screened at a lower-risk level and were not flagged to receive an alcohol-focused brief intervention (BI). Of these, 1477 were using a method of pregnancy prevention that was less than 88% effective. In addition, 118 of the 1676 who screened positive on the USAUDIT were using less effective contraception and did not receive a BI. In summary, the number of individuals at risk of an AEP who did not receive an alcohol BI was 1595 (13.8%) of the total patients screened for at-risk alcohol use. There is a need for system modifications to assess multiple behaviors simultaneously and alert providers when a combination of behaviors increases a specific health risk, such as an AEP. Tailored alcohol BIs that include the risks/benefits of various pregnancy prevention methods to reduce AEPs provide opportunities to enhance the reach of standard alcohol SBI services.

Scaling up a brief alcohol intervention to prevent HIV infection in Vietnam: a cluster randomized, implementation trial

BackgroundEvidence-based interventions (EBIs) often address normative behaviors. If a behavior is also common among clinicians, they may be skeptical about the necessity or effectiveness of an EBI. Alternatively, clinicians’ attitudes and behaviors may be misaligned, or they may lack the knowledge and self-efficacy to deliver the EBI. Several EBIs address unhealthy alcohol use, a common and often culturally acceptable behavior. But unhealthy alcohol use may be particularly harmful to people with HIV (PWH). Here, we present an implementation trial using an experiential implementation strategy to address clinicians’ knowledge, attitudes, and behaviors. Clinicians receive the experiential intervention before they begin delivering an evidence-based brief alcohol intervention (BAI) to PWH with unhealthy alcohol use.MethodsDesign: In this hybrid type 3 implementation-effectiveness cluster randomized controlled trial, ART clinics (n = 30) will be randomized 1:1 to facilitation, a flexible strategy to address implementation barriers, or facilitation plus the experiential brief alcohol intervention (EBAI). In the EBAI arm, clinicians, irrespective of their alcohol use, will be offered the BAI as experiential learning. EBAI will address clinicians’ alcohol-related attitudes and behaviors and increase their knowledge and confidence to deliver the BAI.Participants: ART clinic staff will be enrolled and assessed at pre-BAI training, post-BAI training, 3, 12, and 24 months. All PWH at the ART clinics who screen positive for unhealthy alcohol use will be offered the BAI. A subset of PWH (n = 810) will be enrolled and assessed at baseline, 3, and 12 months.Outcomes: We will compare implementation outcomes (acceptability, fidelity, penetration, costs, and sustainability) and effectiveness outcomes (viral suppression and alcohol use) between the two arms. We will assess the impact of site-level characteristics on scaling-up the BAI. We will also evaluate how experiencing the BAI affected clinical staff’s alcohol use and clinic-level alcohol expectations in the EBAI arm.DiscussionThis trial contributes to implementation science by testing a novel strategy to implement a behavior change intervention in a setting in which clinicians themselves may engage in the behavior. Experiential learning may be useful to address normative and difficult to change lifestyle behaviors that contribute to chronic diseases.Trial RegistrationNCT06358885 (04/10/2024), https://clinicaltrials.gov/study/NCT06358885.

Assisted Versus Unassisted Domiciliary Alcohol Detoxification: A Randomized Controlled Trial

Background: Detoxification stands as a crucial phase in the treatment of alcohol use disorders (AUD), yet only limited data is available on the outcomes of home-based detoxification. Assisted domiciliary detoxification involves monitoring an individual’s withdrawal progress, while offering psychosocial support and detoxification services in the comfort of their home. Aim: To study outcomes of assisted over routine domiciliary alcohol detoxification in randomized controlled trials. Methodology: 100 consenting male patients who were advised of domiciliary detoxification were randomized into intervention ( n = 49) and control ( n = 51) groups. A predesigned semi-structured questionnaire was used to assess the socio-demographic and drinking-related variables. Both groups received routine care for alcohol withdrawal from respective treating doctors. Additionally, the intervention group received two sessions of brief intervention for alcohol and daily phone call assistance. Records were kept for adverse events. Phone calls were discontinued once detoxification was completed. Outcomes were measured for successful completion of detoxification and abstention from alcohol at the end of one month. Results: The intervention group had significantly higher successful detoxification rates (85.7% vs. 62.7%, p = .008) and significantly higher abstinence days at the end of one month compared to the control group (22 vs. 10 days, p < .001) with an effect size of 1.2 (confidence interval (CI) 0.69–1.53). Conclusion: This study demonstrates that receiving assistance in the acute phase of domiciliary detoxification helps in a successful detoxification and achieving a significant level of abstinence at the end of one month compared to the control group.

Identifying Adolescent Vaping With Screening to Brief Intervention and Brief Screener for Tobacco, Alcohol, and Drugs Screening Tools

PurposeThis study aimed to determine whether the modified Screening to Brief Intervention (S2BI) and Brief Screener for Tobacco, Alcohol, and Drugs (BSTAD) that included e-cigarettes/vaping as examples could identify all nicotine and cannabis use or whether additional questions specifically about vaping are needed. MethodsBetween July 2020 and February 2022, adolescents recruited from primary care or an outpatient adolescent substance use disorder program were randomized to complete S2BI or BSTAD followed by specific questions about vaping. Screen questions were updated to include "vaping" in the parenthetical examples of nicotine and cannabis use. ResultsData from 502 adolescent participants who completed both the S2BI or BSTAD and vaping questions were analyzed. The S2BI and BSTAD identified 92% (23/25) and 100% (16/16) of nicotine vaping and 100% (16/16) and 95.5% (21/22) of cannabis vaping, respectively. DiscussionThe S2BI and BSTAD tools accurately identify nicotine and cannabis use without specific questions about vaping.

A Brief Intervention With Instant Messaging or Regular Text Messaging Support in Reducing Alcohol Use

Alcohol use is prevalent among university students. Mobile instant messaging apps could enhance the effectiveness of an alcohol brief intervention (ABI), but the evidence is scarce. To evaluate the effectiveness of an ABI plus 3 months of mobile chat-based instant messaging support for alcohol reduction in university students at risk of alcohol use disorder. In this randomized clinical trial, 772 students at risk of alcohol use disorder (Alcohol Use Disorders Identification Test [AUDIT] score ≥8) were recruited from 8 universities in Hong Kong between October 15, 2020, and May 12, 2022. Participants were randomly assigned 1:1 to either the intervention or control group. Both groups received the same ABI at baseline, which consisted of face-to-face or video conferencing with research nurses who delivered personalized feedback based on the participant's AUDIT risk level, along with a 12-page booklet describing the benefits of alcohol reduction and the harmful effects of alcohol on health and social well-being. The intervention group then received 3 months of chat-based instant messaging support on alcohol reduction guided by behavioral change techniques. The control group received 3 months of short message service (SMS) messaging on general health topics. All outcomes were self-reported. The primary outcome was alcohol consumption in grams per week at 6 months of follow-up. By definition, 1 alcohol unit contains 10 g of pure alcohol. Secondary outcomes at the 6-month follow-up included changes in AUDIT score, weekly alcohol consumption, intention to drink in the next 30 days, drinking frequency and any binge or heavy drinking in the past 30 days, and self-efficacy of quitting drinking. The primary analysis followed the intention-to-treat principle, and linear regression (reported as unstandardized coefficient B) and logistic regression (reported as odds ratios) were used to compare the primary and secondary outcomes between the intervention and control groups. The study included 772 students (mean [SD] age, 21.1 [3.5] years; 395 females [51.2%]) who were randomly assigned to either the intervention (n = 386) or control (n = 386) group. In the intention-to-treat analysis, the intervention group had lower alcohol consumption in grams per week (B, -11.42 g [95% CI, -19.22 to -3.62 g]; P = .004), a lower AUDIT score (B, -1.19 [95% CI, -1.63 to -0.34]; P = .003), reduced weekly alcohol unit consumption (B, -1.14 [95% CI, -1.92 to -0.36]; P = .004), and less intention to drink (odds ratio, 0.66 [95% CI, 0.47 to 0.92]; P = .01) at the 6-month follow-up compared with the control group. In analyses adjusted for baseline characteristics, interacting at least once with the research nurse on the instant messaging application resulted in lower estimated alcohol consumption in grams per week (adjusted B, -17.87 g [95% CI, -32.55 to -3.20 g]; P = .01), lower weekly alcohol unit consumption (adjusted B, -1.79 [95% CI, -3.25 to -0.32]; P = .02), and a lower AUDIT score (adjusted B, -0.53 [95% CI, -1.87 to -0.44]; P = .01) at 6 months. Results of this randomized clinical trial indicate that mobile chat-based instant messaging support for alcohol reduction in addition to an ABI was effective in reducing alcohol consumption in university students in Hong Kong at risk of alcohol use disorder. ClinicalTrials.gov Identifier: NCT04025151.

Behavioral economic and wellness-based approaches for reducing alcohol use and consequences among diverse non-student emerging adults: study protocol for Project BLUE, a randomized controlled trial

BackgroundEmerging adults (EAs) who are not 4-year college students nor graduates are at elevated risk for lifetime alcohol use disorder, comorbid drug use, and mental health symptoms, compared to college graduates. There is a need for tailored brief alcohol intervention (BAI) approaches to reduce alcohol risk and to facilitate healthy development in this high-risk population. Most BAIs include a single session focused on discussing risks associated with drinking and correcting normative beliefs about drinking rates. EAs may benefit from additional elements that enhance general wellness. The substance-free activity session (SFAS) aims to clarify life goals and values and increase goal-directed activities that provide alternatives to alcohol use, and the relaxation training (RT) session teaches relaxation and stress reduction skills.MethodsThe present study is a randomized 3-group (BAI + SFAS vs. RT + SFAS vs. education control) trial with 525 EAs (175 per group; estimated 50% women and 50% African American) who report recent risky drinking and who are not students or graduates of 4-year colleges. Participants will have the option of completing the intervention sessions in person or via a secure video teleconference. Levels of drinking and alcohol-related problems will be evaluated at baseline and 1, 3, 6, and 12 months post-intervention. The primary hypothesis is that both BAI + SFAS and RT + SFAS participants will report significantly greater reductions in alcohol use and problems relative to education control participants, with no differences in outcomes between the two active treatment conditions.DiscussionThe results of this study will inform alcohol prevention efforts for high-risk community dwelling emerging adults.Trial registrationClinicalTrials.gov Identifier: NCT04776278.

Brief interventions for smoking and alcohol associated with the COVID-19 pandemic: a population survey in England

BackgroundFollowing the onset of the COVID-19 pandemic, in March 2020 health care delivery underwent considerable changes. It is unclear how this may have affected the delivery of Brief Interventions (BIs) for smoking and alcohol. We examined the impact of the COVID-19 pandemic on the receipt of BIs for smoking and alcohol in primary care in England and whether certain priority groups (e.g., less advantaged socioeconomic positions, or a history of a mental health condition) were differentially affected.MethodsWe used nationally representative data from a monthly cross-sectional survey in England between 03/2014 and 06/2022. Monthly trends in the receipt of BIs for smoking and alcohol were examined using generalised additive models among adults who smoked in the past-year (weighted N = 31,390) and those using alcohol at increasing and higher risk levels (AUDIT score 38, weighted N = 22,386), respectively. Interactions were tested between social grade and the change in slope after the onset of the COVID-19 pandemic, and results reported stratified by social grade. Further logistic regression models assessed whether changes in the of receipt of BIs for smoking and alcohol, respectively, from 12/2016 to 01/2017 and 10/2020 to 06/2022 (or 03/2022 in the case of BIs for alcohol), depended on history of a mental health condition.ResultsThe receipt of smoking BIs declined from an average prevalence of 31.8% (95%CI 29.4–35.0) pre-March 2020 to 24.4% (95%CI 23.5–25.4) post-March 2020. The best-fitting model found that after March 2020 there was a 12-month decline before stabilising by June 2022 in social grade ABC1 at a lower level (~ 20%) and rebounding among social grade C2DE (~ 27%). Receipt of BIs for alcohol was low (overall: 4.1%, 95%CI 3.9–4.4) and the prevalence was similar pre- and post-March 2020.ConclusionsThe receipt of BIs for smoking declined following March 2020 but rebounded among priority socioeconomic groups of people who smoked. BIs for alcohol among those who use alcohol at increasing and higher risk levels were low and there was no appreciable change over time. Maintaining higher BI delivery among socioeconomic and mental health priority groups of smokers and increasing and higher risk alcohol users is important to support reductions in smoking and alcohol related inequalities.

The selection of statistical models for reporting count outcomes and intervention effects in brief alcohol intervention trials: A review and recommendations.

Understanding the efficacy and relative effectiveness of a brief alcohol intervention (BAI) relies on obtaining a credible intervention effect estimate. Outcomes in BAI trials are often count variables, such as the number of drinks consumed, which may be overdispersed (i.e., greater variability than expected based on a given model) and zero-inflated (i.e., greater probability of zeros than expected based on a given model). Ignoring such distribution characteristics can lead to biased estimates and invalid statistical conclusions. In this critical review, we identified and reviewed 64 articles that reported count outcomes from a systematic review of BAI trials for adolescents and young adults from 2013 to 2018. Given many statistical models to choose from when analyzing count outcomes, we reviewed the models used and reporting practices in the BAI trial literature. A majority (61.3%) of analyses with count outcomes used linear models despite violations of normality assumptions; 75.6% of outcome variables demonstrated clear overdispersion. We provide an overview of available count models (Poisson, negative binomial, zero-inflated or hurdle, and marginalized zero-inflated Poisson regression) and formulate practical guidelines for reporting outcomes of BAIs. We provide a visual step-by-step decision guide for selecting appropriate statistical models and reporting results for count outcomes. We list accessible resources to help researchers select an appropriate model with which to analyze their data. Recent advances in count distribution-based models hold promise for evaluating count outcomes to gauge the efficacy and effectiveness of BAIs and identify critical covariates in alcohol epidemiologic research. We recommend that researchers report the distributional properties of count outcomes, such as the proportion of zero counts, and select an appropriate statistical analysis for count outcomes using the provided decision tree. By following these recommendations, future research may yield more accurate, transparent, and reproducible results.

Do in-person and computer-based brief alcohol interventions reduce tobacco smoking among general hospital patients? Secondary outcomes from a randomized controlled trial

BackgroundAt-risk alcohol use and tobacco smoking often co-occur. We investigated whether brief alcohol interventions (BAIs) among general hospital patients with at-risk alcohol use may also reduce tobacco smoking over 2 years. We also investigated whether such effects vary by delivery mode; i.e. in-person versus computer-based BAI.MethodsA proactively recruited sample of 961 general hospital patients with at-risk alcohol use aged 18 to 64 years was allocated to three BAI study groups: in-person BAI, computer-based BAI, and assessment only. In-person- and computer-based BAI included motivation-enhancing intervention contacts to reduce alcohol use at baseline and 1 and 3 months later. Follow-ups were conducted after 6, 12, 18 and 24 months. A two-part latent growth model, with self-reported smoking status (current smoking: yes/no) and number of cigarettes in smoking participants as outcomes, was estimated.ResultsSmoking participants in computer-based BAI smoked fewer cigarettes per day than those assigned to assessment only at month 6 (meannet change = − 0.02; 95% confidence interval = − 0.08–0.00). After 2 years, neither in-person- nor computer-based BAI significantly changed smoking status or number of cigarettes per day in comparison to assessment only or to each other (ps ≥ 0.23).ConclusionsWhile computer-based BAI also resulted in short-term reductions of number of cigarettes in smoking participants, none of the two BAIs were sufficient to evoke spill-over effects on tobacco smoking over 2 years. For long-term smoking cessation effects, multibehavioural interventions simultaneously targeting tobacco smoking along with at-risk alcohol use may be more effective.Trial registration number: NCT01291693.

Factors Influencing Patient Receptivity to Brief Alcohol Interventions in Primary Care: An Application of Conjoint Analysis

Background : Brief alcohol interventions (BAIs) are an evidence-based practice for addressing hazardous alcohol use in primary care settings. However, numerous barriers to implementation of BAIs in routine practice have been identified, including concerns about patient receptivity to BAIs. Despite this being a commonly identified barrier to BAI implementation, little BAI implementation research has focused on patient receptivity. Objectives : This study aimed to identify the treatment preferences of primary care patients who screened positive for hazardous alcohol use and to evaluate factors that may influence patients’ receptivity to BAIs delivered in primary care. We conducted a mailed survey of primary care patients (N = 245) who screened positive for hazardous alcohol use on annual screening measures based on electronic medical record data. Patients completed measures assessing treatment preferences and a conjoint analysis questionnaire designed to evaluate the relative importance of three factors (focus of the BAI, tailoring of the BAI, and familiarity with the provider delivering the BAI) for patient receptivity. Results : Conjoint analysis results revealed that familiarity with provider (with patients preferring BAIs delivered by providers they have previously met) was the most important factor in predicting patients’ receptivity to BAIs. Additionally, patients preferred to discuss alcohol use in the context of another concern (focus of the BAI) and preferred personalized information tailored based on their specific health concerns (tailoring of the BAI), although these factors were not statistically significant when accounting for familiarity with provider. Conclusions : Findings of the present study have potential to inform future research on implementation of BAIs.

Alcohol and smoking brief interventions by socioeconomic position: a population-based, cross-sectional study in Great Britain.

Alcohol and smoking brief interventions (BIs) in general practice have been shown to be effective in lowering alcohol and smoking-related harm. To assess prevalence of self-reported BI receipt among increasing or higher-risk drinkers and past-year smokers in England, Scotland, and Wales, and associations between intervention receipt and socioeconomic position. Cross-sectional study using data from a monthly population-based survey in England, Scotland, and Wales. The study comprised 47 799 participants (15 573 increasing or higher-risk drinkers [alcohol use disorders identification test consumption score ≥5] and 7791 past-year smokers) surveyed via telephone in 2020-2022 (during the COVID-19 pandemic). All data were self-reported. Prevalence of self-reported BI receipt was assessed descriptively; associations between receipt and socioeconomic position were analysed using logistic regression. Among adults in England, Scotland, and Wales, 32.2% (95% confidence interval [CI] = 31.8 to 32.7) reported increasing or higher-risk drinking and 17.7% (95% CI = 17.3 to 18.1) past-year smoking. Among increasing or higher-risk drinkers, 58.0% (95% CI = 57.1 to 58.9) consulted with a GP in the past year, and of these, 4.1% (95% CI = 3.6 to 4.6) reported receiving BIs. Among past-year smokers, 55.8% (95% CI = 54.5 to 57.1) attended general practice in the past year; of these, 41.0% (95% CI = 39.4 to 42.7) stated receiving BIs. There was a tendency for patients from socioeconomically disadvantaged backgrounds to receive more alcohol (adjusted odds ratio [aOR] 1.38, 95% CI = 1.10 to 1.73) or smoking BIs (aOR 1.11, 95% CI = 0.98 to 1.26), but for the latter the results were statistically non-significant. Results did not differ notably by nation within Great Britain. BIs in general practice are more common for smoking than for alcohol. A greater proportion of BIs for alcohol were found to be delivered to people who were from socioeconomically disadvantaged backgrounds and who were increasing or higher-risk drinkers.

Multifaceted intervention to increase the delivery of alcohol brief interventions in primary care: a mixed-methods process analysis.

Brief interventions (BIs) are effective for reducing harmful alcohol consumption, but their use in primary care is less frequent than clinically indicated. The REducing AlCohol- related Harm (REACH) project aimed to increase the delivery of BIs in primary care. To assess the effectiveness of the REACH programme in increasing alcohol BIs in general practice and explore the implementation factors that improve or reduce uptake by clinicians. This article reports on a sequential, explanatory mixed-methods study of the implementation of the REACH project in six general practice clinics serving low-income communities in Melbourne, Australia. Time-series analyses were conducted using routinely collected patient records and semi-structured interviews, guided by the consolidated framework for implementation research. The six intervention sites significantly increased their rate of recorded alcohol status (56.7% to 60.4%), whereas there was no significant change in the non-intervention practices (344 sites, 55.2% to 56.4%). REACH resources were seen as useful and acceptable by clinicians and staff. National policies that support the involvement of primary care in alcohol harm reduction helped promote ongoing intervention sustainability.

Effectiveness of Brief Alcohol Intervention in Reducing Alcohol Consumption Among Patients With Alcohol-Related Facial Trauma in the Emergency Department: A Systematic Review and Meta-Analysis

Facial trauma is a frequent presentation to the emergency department following alcohol-related injuries. Brief alcohol intervention (BAI) is a form of a motivational interview which is implemented in the postinjury phase to educate patients on the detrimental effects of their alcohol drinking behavior and reduce their future consumption. This systematic review and meta-analysis aims to assess the impact of BAI on alcohol drinking behavior in the emergency department setting. An extensive systematic literature review was implemented from 21 October 2020 to 23 November 2020. All clinical studies that reported the outcomes of brief alcohol intervention on alcohol consumption in patients who attended the emergency department with facial injuries were included in the systematic review. The data sources utilized include Google Scholar, PubMed, ISI, Scopus, EMBASE, SIGLE, Virtual Health Library, NYAM, ClinicalTruaks.Gov, Controlled Trials (mRCT), and ICTRP. The current systematic review included 8 articles encompassing 941 patients. Of the included patients, 304 (32.3%) patients were subjected to BAI, while the remaining 637 (67.7%) were not subjected to BAI. BAI significantly decreased the amount of alcohol consumption 3months after intervention (SMD -0.596; 95% CI -1.067, -0.126; P=.013). Patients who received BAI were 1.89 times more likely to reduce their alcohol consumption (OR 1.89; 95% CI 0.59, 6.11; P=.29). BAI is an efficacious motivational tool for patients with facial trauma in the emergency setting. It can effectively reduce the amount and rate of alcohol consumption after facial trauma in the short-term. However, a higher level of evidence is required to reach long-term conclusions.

The effect of question order on outcomes in the orbital core outcome set for alcohol brief interventions among online help-seekers (QOBCOS): Findings from a randomised factorial trial.

A core outcome set (COS) has been developed in alcohol brief intervention (ABI) research through international consensus. This study aimed to estimate order effects among questions in the COS. Individuals aged 18 or older who searched online for alcohol-related help were invited to complete the COS. The order of questions was randomised following a factorial design. Primary outcomes were order effects among the COS items and patterns of attrition. Between 21/10/2020 and 26/11/2020, we randomised 7334 participants, of which 5256 responded to at least one question and were available for analyses. Current non-drinkers were excluded. We found evidence of higher self-reported average consumption and odds of harmful and hazardous drinking was found among those who first answered questions on recent consumption and impact of alcohol use. Lower self-reported recent consumption was found among those first asked about average consumption. Quality of life (QoL) was reported lower among those who first responded to when questions on impact of alcohol use were asked first, which in turn was lower among those who first answered question on when average consumption and QoL were asked first. Attrition was lowest when average consumption was asked first, and highest when QoL or impact of alcohol use was asked first. Median completion time for the COS was 4.3 min. Question order affects outcomes and attrition. If the aim is to minimize attrition, consumption measures should be asked before QoL and impact of alcohol use; however, this order impacts self-reported alcohol consumption and so researchers should be guided by study priorities. At a minimum, all participants should be asked the same questions in the same order. The trial was prospectively registered (ISRCTN17954645).

Associations between alcohol brief intervention in primary care and drinking and health outcomes in adults with hypertension and type 2 diabetes: a population-based observational study

ObjectivesTo evaluate associations between alcohol brief intervention (BI) in primary care and 12-month drinking outcomes and 18-month health outcomes among adults with hypertension and type 2 diabetes (T2D).DesignA population-based observational...

A scoping review of brief alcohol interventions across young adult subpopulations.

Brief alcohol interventions (BAIs) have historically centered on young adults attending 4-year predominantly white institutions. The purpose of this scoping review is to determine BAIs evaluated among young adults with one or more marginalized/understudied racial, ethnic, sexual, gender, and military/Veteran identities and/or who are embedded in an understudied context based on houselessness, attending a 2-year institution, or not attending college. A secondary objective is to explore definitions of the constructs young adult and brief to inform subsequent systematic reviews. Sources had to be published in English between January 1, 1999 and December 31, 2019 and report the evaluation of an intervention ≤ 5 hr long, delivered over ≤ 4 weeks, among participants aged 18-30 years (or 16-30 in college contexts) within a specified marginalized/understudied subpopulation/context wherein alcohol use and/or consequences were a primary outcome. Systematic searches were conducted in APA PsycNet, the EBSCO Psychology and Behavioral Sciences Collection, PubMed, Sociological Abstracts, and Web of Science. Screening was independently performed by two coders who also extracted data. Of 4,825 identified records, 158 provided data; 86 described interventions fitting our definition of brief; of these, only 21 met criteria based on our definition of young adult, with nine meeting full inclusion criteria based on young adult subpopulation. Findings signify a need for additional research evaluating BAIs among young adult subpopulations and highlight the importance of carefully defining and reporting participant characteristics. Increased attention to sociocultural considerations and strengths relevant to the diverse contexts and intersecting identities of young adults may strengthen extant BAIs and equitably mitigate alcohol-related harm. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Treatment-As-Usual Control Groups in Brief Alcohol Intervention Trials: A Systematic Review and Meta-Analysis.

Brief alcohol interventions (BAIs) are evidence-based practices that can help reduce hazardous drinking among patients in medical settings. However, descriptions of the treatment-as-usual (TAU) control groups that BAIs are compared to in clinical trials often lack clarity and detail. This systematic review and meta-analysis quantified and compared descriptions of intervention and TAU control arms within reports of randomized controlled trials and examined whether treatment effects were affected by level of detail in narrative descriptions. A systematic literature search to identify eligible articles was performed. Studies were rated on methodological quality, and the Template for Intervention Description and Replication (TIDieR) checklist was used to rate the level of clarity and detail included in descriptions of the intervention and TAU conditions in eligible articles. Data were extracted from articles for use in meta-analysis and meta-regression. Twenty-one studies met inclusion criteria. Across the studies, TIDieR ratings for intervention arms were higher than ratings for control arms. BAIs were linked to reductions in drinks per week, heavy drinking episodes, and alcohol consequences over time when compared with TAU. TIDieR ratings for control groups were significantly associated with larger treatment effects on drinks per week and alcohol consequences but were not significant for heavy drinking episodes. This meta-analysis reiterated the effectiveness of BAIs in medical settings. Yet the lack of clarity in TAU descriptions raises concerns regarding the validity of BAI trials, suggesting need for more detailed reporting and use of the TIDieR guidelines for support.

Brief Alcohol Interventions are Effective through 6 Months: Findings from Marginalized Zero-inflated Poisson and Negative Binomial Models in a Two-step IPD Meta-analysis

To evaluate and optimize brief alcohol interventions (BAIs), it is critical to have a credible overall effect size estimate as a benchmark. Estimating such an effect size has been challenging because alcohol outcomes often represent responses from a mixture of individuals: those at high risk for alcohol misuse, occasional nondrinkers, and abstainers. Moreover, some BAIs exclusively focus on heavy drinkers, whereas others take a universal prevention approach. Depending on sample characteristics, the outcome distribution might have many zeros or very few zeros and overdispersion; consequently, the most appropriate statistical model may differ across studies. We synthesized individual participant data (IPD) from 19 studies in Project INTEGRATE (Mun et al., 2015b) that randomly allocated participants to intervention and control groups (N = 7,704 participants, 38.4% men, 74.7% White, 58.5% first-year students). We sequentially estimated marginalized zero-inflated Poisson (Long et al., 2014) or negative binomial regression models to obtain covariate-adjusted, study-specific intervention effect estimates in the first step, which were subsequently combined in a random-effects meta-analysis model in the second step. BAIs produced a statistically significant 8% advantage in the mean number of drinks at both 1–3 months (RR = 0.92, 95% CI = [0.85, 0.98]) and 6 months (RR = 0.92, 95% CI = [0.85, 0.99]) compared to controls. At 9–12 months, there was no statistically significant difference in the mean number of drinks between BAIs and controls. In conclusion, BAIs are effective at reducing the mean number of drinks through at least 6 months post intervention. IPD can play a critical role in deriving findings that could not be obtained in original individual studies or standard aggregate data meta-analyses.

Implementation of a brief motivational intervention for alcohol and other drug using Latinx college students.

Alcohol and other drug (AOD) use problems among college students continue to represent a public health epidemic. In 2019, historically high rates of binge-drinking and marijuana use were reported among college-age adults, and the detrimental effects of excessive AOD use in college, such as poorer academic performance, sexual assault, injury or overdoses, and a range of other negative consequences, have been well-documented. Thus, there is a continued need for effective implementation of evidence-based, cost-effective interventions aimed at reducing risks associated with collegiate AOD use. Guided Self Change (GSC) is a brief intervention involving motivational enhancement and cognitive-behavioral strategies and has demonstrated effectiveness in reducing AOD use problems. Its brevity, client-driven style, and concrete here-and-now focus are appealing to individuals struggling with mild to moderate AOD use problems. In order to successfully intervene with collegians with AOD use problems attending minority-serving institutions, GSC requires developmental and cultural tailoring. The current report describes the developmental and cultural tailoring of GSC for emerging adult Latinx collegians, as well as our consumer-driven addition of mindfulness content. Key components of our GSC program are documented through qualitative feedback, quantitative results, and case vignettes.