Comparative study of alcohol use, alcohol use disorder, and consequences among young people and adults with injuries in Northern Tanzania.

Cognitive behaviorally based interventions have broad appeal and potential for impact when treating adult alcohol and other drug use. Digitally delivered cognitive behaviorally based interventions (dCBIs) may offer this impact with the benefit of increased accessibility. Although prior reviews have indicated the benefits of dCBIs on substance use outcomes, the extension to psychosocial functioning outcomes is unknown. This meta-analysis provides an overview of dCBI effects across a range of functional end points. A literature search was conducted through October 2024. All primary and secondary reports of clinical trials of dCBI were obtained, and all available study end points were eligible for meta-analysis. Descriptive data were extracted and categorized into 1 of 13 different outcome types (eg, abstinence, quantity, cognitive, and quality of life) and into 2 broader outcome classes (ie, consumption and psychosocial). Robust variance estimation was used to conduct hypothesis tests on random effects pooled estimates with outcome class and comparison type as the primary subgroup variables of interest. The study sample included 65 randomized trials (K=110 publications; 753 effect sizes) of dCBI for adult alcohol and other drug use. With respect to efficacy, dCBI as a stand-alone treatment in contrast to a minimal treatment control showed positive and statistically significant effects for consumption (g=0.27; P<.001; I2=85.1%; k=31; kes=134) and psychosocial (g=0.16; P=.008; I2=75.2%; k=16; kes=60) outcomes. As an addition to usual care, efficacy was demonstrated for consumption (g=0.23; P<.001; I2=9.8%; k=20; kes=65), but not psychosocial functioning. Efficacy compared to another digital or in-person intervention or cognitive behaviorally based intervention delivered by a therapist was not observed. Within the dCBI condition, large effect sizes were observed for both outcome classes (ie, 60%-80% of participants showed improvement relative to baseline), and effect size magnitude and statistical heterogeneity varied by the type of outcome examined. These results show a benefit for dCBI as a stand-alone therapy and an addition to usual care. Importantly, stand-alone effects were observed for both consumption and some psychosocial outcomes. This study is the first to offer a comprehensive look at dCBI intervention effects across a range of functional end points.

Effect of the online Rethink My Drink alcohol intervention on alcohol use and cognition in older adults in Australia: a randomised controlled trial.

The potential of online alcohol interventions for older adults.

Young adults in the United States commonly report high-intensity drinking (8+ drinks for females; 10+ drinks for males) and alcohol-induced memory loss ("blackouts"). Since few young adults receive formal help for alcohol use, research is needed to better understand which remotely delivered interventions work and for whom. This study tested goal setting, sex assigned at birth, and college enrollment as moderators of outcomes for one efficacious digital alcohol intervention (the "Drinking Dashboard"). Young adults (ages 18-30 years, 58% female, 51% college students) with a history of blackout were randomized to the Drinking Dashboard (n = 74) or screen time control (n = 82). Assessments occurred at baseline, 1 month, and 3 months, as well as daily between baseline and 1-month follow-up. Multilevel generalized linear modeling tested treatment effects on high-intensity drinking and alcohol-induced blackout within moderator subgroups. Two in three participants (67%) set a goal to reduce their alcohol use or related problems in the next 30 days. Relative to control participants who set an alcohol-related change goal, intervention participants who set an alcohol goal reported greater reductions in high-intensity drinking (incident rate ratio = 0.58, 95% CI [0.35, 0.96], p = .034) but not alcohol-induced blackout (incident rate ratio = 0.74, 95% CI [0.37, 1.46], p = .384). Group × Time interactions were not significant for any other subgroup. The Drinking Dashboard reduces high-intensity drinking among young adults who set a goal to reduce their alcohol use or problems. We speculate that motivation (as indicated in this case by goal setting) may be more important than static variables like sex or college enrollment in predicting response to digital health interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective This study pilot tested a novel intervention prototype that combined bystander training to prevent sexual violence with brief alcohol intervention. Participants 40 heavy drinking young adult undergraduates. Methods Students completed 1 two-hour psychoeducational group intervention and were assessed at pre-intervention, post-intervention, and a 4 wk later. Results Groups were completed in 2 h; 88% of students rated the group as excellent. Students had increased sexual violence knowledge (η2 = .36), alcohol knowledge (η2 = .32), and bystander intentions (η2 = .11); and reduced alcohol consumption (η2 = .11), and perceived drinking norms (η2 = .14). Conclusions This intervention has potential to reduce sexual violence on college campuses by (1) moderating drinking behaviors of potential bystanders and (2) training students to use bystander strategies within heavy drinking context that has high risk for sexual violence. Future research should test this intervention in a larger controlled trial.

ABSTRACT Youth living with HIV (YLHIV) in sub-Saharan Africa experience high rates of alcohol and drug use (ADU), yet evidence-based interventions remain limited. We conducted a pilot cluster randomized trial to assess the feasibility, acceptability, and short-term outcomes of a life-skills-based Alcohol and Drug Use Risk Reduction intervention (ADURR), delivered alone or combined with economic empowerment (EE) through financial literacy training and matched savings accounts. Ninety-five YLHIV aged 18 to 24 years were enrolled from six clinics in southwestern Uganda and followed at baseline, 3 months, and 6 months using surveys and urine toxicology. Participants had a mean age of 21.9 years, and 65.3% were female. Retention at 6 months was 94.7%. Compared with ADURR-only, the ADURR+EE intervention was associated with larger declines in self-reported past-6-month drug use (−20.1 vs −5.8 percentage points), alcohol use (−17.9 vs −6.5 percentage points). Urine-confirmed drug use decreased in both arms (−30.4 vs −26.7 percentage points), while urine-confirmed alcohol use declined only in ADURR+EE (−33.1 percentage points). Psychosocial changes were modest; hopelessness decreased in ADURR+EE (−6.4%) but increased in ADURR-only (+13.0%). Qualitative findings indicated high acceptability, though savings uptake faced structural barriers. Findings support progression to a fully powered trial.

Emerging adults from minority racial and ethnic backgrounds are rarely represented in alcohol intervention research, limiting our understanding of how these interventions function across different subgroups. This study examines whether in-session distal (i.e., decision-making that is directly about behavioral change) and proximal change talk (i.e., decisions about indirect coping activities or lifestyle changes that may facilitate behavioral change) mediate motivation to change alcohol use and strategies to limit drinking after a Brief Motivational Interview session. We also explore if racial or ethnic minority status moderates the relationship between treatment and client language mediators. Analyses used the PROCESS macro for mediation and moderated-mediation analysis. Bootstrap results testing the significance of the indirect effect indicated that Proportion Change Talk Distal mediated motivation to change alcohol use at the three-month follow-up. Other mediated effects were non-significant, and racial or ethnic group (White vs. Non-White participants) did not moderate the mediation models. Additional studies are needed to confirm and refine these preliminary results.

A pilot trial of using ecological momentary intervention to deliver tetris for alcohol craving among women.

BackgroundThe highest incidence of tuberculosis disease (TB) in the world is in India, accounting for 26% of all new cases globally, with approximately 48,000 among persons with HIV (PWH). Unhealthy alcohol use can worsen the health of people who have TB or HIV and those who have both TB and HIV. Behavioral interventions that target alcohol use and are integrated into TB and HIV care may lead to better outcomes. This paper describes the protocol for HATHI, Hybrid trial for Alcohol reduction among people with TB and HIV in India, a Hybrid Type 1 effectiveness-implementation trial, that tests if a behavioral intervention integrated into TB and HIV treatment, compared to usual care, results in lower alcohol use and improved TB and HIV health outcomes among people with unhealthy alcohol use in Pune, India.MethodsHATHI is a randomized controlled trial that will recruit 450 people with unhealthy alcohol use from TB and HIV clinics in Pune, India. The aims of HATHI are to: (1) test if a four session behavioral intervention integrated into TB and HIV care results in lower alcohol use among persons with TB, HIV and TB/HIV coinfection compared to usual care as measured by phosphatidyl ethanol (PEth), an alcohol biomarker (primary outcome); (2) test if the same intervention also leads to improved TB and HIV clinical outcomes including TB and HIV medication adherence, HIV viral suppression, TB sputum/culture conversion and the composite outcome of TB treatment failure, default or death; (3) evaluate barriers and facilitators to integrating the intervention into TB and HIV care, and (4) determine the incremental costs of delivering the intervention in these clinical settings. We hypothesize that the HATHI intervention will result in lower alcohol use compared to standard of care use at 6 months among people and superior TB and HIV clinical outcomes at 12 months.DiscussionThis intervention addresses unhealthy alcohol use, a known barrier to optimal TB and HIV treatment outcomes. If HATHI proves effective, insights into barriers and facilitators for integration will inform future scale-up of this behavioral alcohol intervention in TB and HIV clinical settings.Trial registrationClinicalTrials.govNCT04230395 (first submission 1/18/2020, most recently update 2/17/25) and India Clinical trial Registry CTRI/2020/03/024141

Ealing is a municipal borough situated in West London. Ealing Borough Based Partnership is an informal local collaboration between an acute and community NHS Trust, the Local Council, Primary Care, voluntary sector and health commissioners (NWL ICB). Approach: We held a population health summit to understand public health information derived from all health and care partners, to inform our priorities. This highlighted that Ealing: - is experiencing substantial population growth residents currently access acute care in hospitals in neighbouring boroughs - life expectancy and health inequalities differ significantly across the our neighbourhoods - has the highest rate of alcohol admissions in London - has a high prevalence of diabetes and hypertension - is a net importer of residents into care homes, boasting the largest care home bed base with increasing acuity and complexity - is the most ethnically diverse borough in London has the second highest rates of homelessness in NWL. The above factors highlighted the complex health and social challenges facing our population, necessitating strategic planning of resource allocation to address the needs of its growing and diverse population. System partners and local people from heath and care met to review progress against priorities and identify key deliverables for 2025-26. This poster summarises the review of partnership activities delivered under the banner of Ealing’s (integrated) Borough Based Partnership and plans. Achievements: Homeless Pathway: £63k in savings have been achieved through step-down and community support. Bridging Care Service: reduced delays in inpatient settings to improve patient flow. Care Home Inreach and Liaison Service: deployed to manage challenging patient behaviours. High Intensity User MDTs have conducted 117 holistic case reviews, addressing unmet needs. Ealing Care Navigation Network is an active social movement with 75 members from nine partner organisations. An Alcohol Intervention Pilot has been launched. Ealing has made significant strides in Cervical Cancer Screening, achieving rates that are 64% above the NWL / London average. Ealing has co-produced and published a Public Data Dashboard empowering stakeholders to make informed decisions and track progress. Agreed priorities: Integrated Neighbourhood Teams (INTs) to serve 50-100k residents with a transparent approach that involves all health and social care services. Primary care access enhanced through partnerships with providers. Child Health Hubs are being rolled out into all INTs across Ealing, with four out of eight hubs established so far. Community Frailty Model. Healthy Ealing Team to support vulnerable groups, including migrants. System flow is optimised through continuous improvement to manage seasonal demand. Co-production is being embedded in all projects. Challenges: Limited resources to coordinate partnership activities are a significant barrier to delivering further upon our ambitions. Inadequate health care estates (aging facilities and high costs) impede the provision of high quality care, with limited opportunities for physical co-location. Ealing’s diverse community presents unique health and social care challenges, requiring investment in a diverse workforce which is culturally competent and able to communicate in multiple languages. Implications: Data informed collaboration between health and care partners can establish priorities for integration in a local borough.

Objective:Stress is an inevitable part of life that can have positive or negative effects depending on one’s beliefs about stress (stress mindset). Having a more stress-is-enhancing mindset may lead to better physical and psychological health outcomes, but its associations with alcohol-related outcomes have not been examined. This study assessed whether stress mindset was associated with problematic alcohol use and human flourishing, and whether these associations were mediated by perceived stress and loneliness.Methods:The analytic sample included 202 adults [mean age = 42.0 years old, 51.5% male, 46.0% White, and 41.6% with a history of alcohol use disorder (AUD)] who completed self-reported measures of stress mindset, perceived stress, loneliness, problematic alcohol use, and human flourishing. Correlational and path analyses were conducted.Results:Higher stress mindset scores (viewing stress as more enhancing) were correlated with lower perceived stress, lower loneliness, lower problematic alcohol use, and higher human flourishing. Perceived stress was a significant mediator of the associations between stress mindset and both outcomes, such that higher stress mindset scores were indirectly associated with lower problematic alcohol use and higher human flourishing via lower perceived stress. Loneliness mediated the association between stress mindset and human flourishing, such that higher stress mindset scores were associated with higher human flourishing via lower loneliness.Conclusions:The promotion of a stress-is-enhancing mindset is relevant to alcohol intervention as it may help individuals view stress in more adaptive ways and activate social support that has the potential to reduce problematic alcohol use and foster human flourishing.

Standard brief alcohol and drug use interventions focus on motivating reductions in use and associated harms and have shown reliable reductions in these outcomes. However, effect sizes are small, and dissemination is limited by low rates of help seeking. Incorporating intervention elements focused on enhancing wellness, mood, and goal pursuit might enhance efficacy and appeal. The substance-free activity session (SFAS) integrates behavioral economic and motivational interviewing elements to enhance goal-directed and mood-enhancing activity patterns that might provide alternatives to alcohol- and drug-related reward. We conducted a narrative review of 15 empirical studies that investigated the efficacy of the SFAS and evaluated mechanisms of behavior change. We then provide an overview of how to conduct the SFAS, including a session vignette. There is support for the efficacy of the SFAS when integrated with standard brief alcohol interventions for college students. There is also evidence that the SFAS reduces negative affective symptoms and increases self-regulation and proportionate reinforcement from substance-free activities. Evidence for cannabis use reductions is less robust. The SFAS has been successfully implemented as an adjunct to intensive alcohol and drug treatment for adults, but not in the context of adequately powered efficacy trials. The clinical vignette and intervention manual provides a model for how to motivate an individual to pursue reductions in substance use supported by increased engagement in goal-directed and enjoyable substance-free activities. The SFAS shows promise as a brief intervention that supports substance use reductions via motivating patterns of substance-free activities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective Youth with chronic medical conditions (YCMC) are at increased risk of experiencing alcohol-related health consequences compared to healthy peers. Targeting influential parent beliefs and behaviors may help address YCMC alcohol use. Method This study evaluated YCMC and parent surveys (n = 251) collected during a randomized controlled trial at an urban academic pediatric hospital evaluating “Take Good Care,” a psychoeducational intervention targeting YCMC alcohol use. Baseline and follow-up YCMC surveys assessed alcohol use, tolerance of alcohol-related risks, and knowledge of alcohol’s health effects. Baseline parent surveys evaluated parent beliefs related to YCMC alcohol use and parenting behaviors. Linear and logistic regression models assessed relationships between parent factors and follow-up YCMC outcomes after adjustment for youth age, baseline measures, parent education, and intervention receipt. Results Among YCMC, a pattern of persistently high vs persistently low or decreasing tolerance of alcohol-related risks at follow up was associated with parent beliefs that youth use is “inevitable,” “OK with supervision,” or “harmless.” Conclusions Parent alcohol-related beliefs are associated with YCMC response to an intervention to address alcohol use. A parent-focused intervention alongside TGC may provide opportunities to address parent beliefs and reinforce effects on youth risk perception and alcohol use.

Evidence on the impact of alcohol-reduction apps on mental health and quality of life are limited. This study aimed to test the effectiveness of two app-based interventions on depression, anxiety and health-related quality of life (HRQoL) among alcohol-dependent adults. In a three-armed parallel randomised controlled trial conducted between 2020 and 2023 at an outpatient addiction clinic in Stockholm, 162 adults (54% male) meeting ICD-10 criteria for alcohol dependence were randomised to treatment as usual (TAU), TAU plus a drink-counting app, or TAU plus an app-coupled breathalyser. Participants with severe psychiatric comorbidity or major social instability were excluded. Depression, anxiety (HADS), and health-related quality of life (SF-12) were assessed at baseline, 12weeks, and 26weeks. Outcomes were analysed using generalised linear models and adjusted for baseline values. Baseline levels of depression were generally low, although levels of anxiety were somewhat elevated. Mental, but not physical, HRQoL was impaired. Analyses showed no additional effectiveness of either the drink-counting app or breathalyser on depression, anxiety or HRQoL, compared to TAU only. Regardless of treatment modality, there were overall reductions in depression and anxiety levels as well as improvements in mental HRQoL. While app-based self-monitoring tools reduced alcohol consumption in the parent trial, they did not yield additional benefits for mental health or quality of life beyond standard treatment. Future adequately powered studies should examine whether targeting individuals with higher baseline symptom burden or integrating mental health-specific app components may yield broader benefits.

Young adults reporting high-intensity drinking (HID, 8+/10+ drinks for females/males) are more likely to experience negative alcohol consequences than those reporting heavy episodic drinking (HED; 4+/5+ drinks for females/males). Identifying for whom and when HID is associated with same-day negative (and positive) consequences may inform intervention approaches. We hypothesized that negative consequences would be more likely on HID vs HED days, and when HID levels were reached more quickly. Young adults reporting prior HID (N=203, 57% female) completed a 28-day ecological momentary assessment of alcohol use and consequences. Generalized hierarchical linear modeling was used to test hypothesized effects. Analyses also explored the odds of each unique negative (e.g., hangover) and positive (e.g., improved mood) consequence. HID (vs HED) was related to more same-day negative consequences. In exploratory analyses, HID was associated with increased odds of being rude/obnoxious, hurting/injuring oneself, feeling too drunk, nausea, vomiting, sleeping worse, hangover, and memory loss. HID (vs HED) was also related to more same-day positive consequences. In exploratory analyses, HID was associated with increased odds of expressing feelings more easily, feeling more energetic, improved mood, being more sociable, desirable level of intoxication, laughing with others, and a fun/exciting time. Drinking duration was not significantly related to consequences on HID days. Same-day positive consequences resulting from HID may help explain why this risky behavior recurs, despite negative consequences. From a prevention and intervention perspective, healthcare providers and clinicians are strongly encouraged to prioritize alcohol interventions for young adults reporting 8-10 drinks per occasion.

Supplemental Material for Health Goals, Sex, and College Enrollment: Impacts on Young Adult Response to Digital Alcohol Intervention

Workplaces offer a practical setting for alcohol and other drug interventions, especially in industries where impairment introduces substantial risk. Screening, brief intervention and referral to treatment has demonstrated effectiveness in health care settings and shows promise in workplace settings. However, low participation and high attrition in previous workplace studies indicate a need for deeper understanding of feasibility and acceptability. This exploratory qualitative study aimed to identify likely determinants for implementing alcohol and other drug screening, brief intervention and referral to treatment in two safety-sensitive industries in Australia. Qualitative research design based on semi-structured online interviews, focussed on the construction and manufacturing industries. Participants included 23 professionals working in health and safety roles representing 21 organisations located across six Australian jurisdictions. Interview transcripts were coded against the five domains of the updated Consolidated Framework for Implementation Research. Sixteen determinants were identified that were expected to act as barriers (n = 10) or enablers (n = 5) or have bidirectional impacts (n = 1) on the implementation of screening, brief intervention and referral to treatment in construction and manufacturing. Enabling factors included freely available tools, flexible delivery methods and delivery by trusted, external, peer-based organisations. Pervasive barriers included workers' mistrust of management, concerns about confidentiality and fear of consequences for disclosing substance use. Successful workplace implementation of screening, brief intervention and referral to treatment appears to depend on organisational cultures where workers trust management, are assured of confidentiality and are not afraid of retribution for disclosure.

Recent advances in Cognitive Bias Modification (CBM) for problematic drinking, including Alcohol Use Disorder, alongside methodological refinements, warrant an update of the Individual Participant Data (IPD) Bayesian meta-analysis. This study integrates new datasets, focuses on alcohol CBM, and applies a two-stage IPD framework to examine CBM's effects on cognitive bias, alcohol consumption, and relapse. A two-stage IPD Bayesian meta-analysis was performed, supplemented by frequentist sensitivity analyses. The first stage estimated study-specific CBM effects, the second stage pooled these to examine within-study moderators (adherence, addiction severity) and between-study moderators (CBM type, control condition, additional therapy, training congruency, and context). 23 studies with 8297 participants were included. CBM showed a small unadjusted effect on bias (d=-0.18, 95% CrI [-0.32, 0.00], BF₁₀=10.88) and relapse (log OR=-0.26, 95% CrI [-0.38, -0.14], BF₁₀=155.07; number needed to treat=18.7), but not on alcohol consumption (d=0.003, 95% CrI [0.00, 0.06], BF₁₀=0.08). Effects were attenuated after adjusting for moderators. Moderator analyses revealed that face-to-face CBM context (unadjusted and within-study adjusted) and additional psychological therapy (within-study adjusted) were associated with greater bias reduction, and higher training intensity (unadjusted) was related to better relapse prevention. Frequentist sensitivity analyses largely supported these findings. CBM reduced alcohol-related biases and relapse risk. Although overall evidence was no longer supported after adjusting for moderators, moderator analyses suggest CBM can be effective under specific conditions (e.g., face-to-face delivery, alongside therapy, higher training intensity). These findings underscore the need for refined, context-sensitive CBM protocols in alcohol interventions.

The author has no conflict of interest to disclose. Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.