Brief Interventions For Alcohol Use Research Articles

An exploratory analysis of drinking motives and alcohol-related problems among Hispanic college students

The increase in college enrollment for Hispanic college students warrants increased attention to their health and wellness. Given that a common threat to health and well-being in college students is alcohol use and that Hispanic college students are at elevated risk for alcohol-related problems, it is essential to investigate factors that might lead to heightened alcohol-related problems among this population. The present study is a secondary data analysis of an NIAAA-funded study investigating brief interventions for alcohol use among 583 heavy-drinking college students. Specifically, we examined the relationship between Hispanic student status and alcohol-related problems measured one month later. Additionally, we examined the indirect effects of Hispanic status on alcohol-related problems through drinking motives. Analyses revealed a significant association between Hispanic status and alcohol-related problems at baseline but no association between Hispanic status and problems at 1-month, controlling for baseline problems. An indirect effect of the prospective association between Hispanic student status and alcohol-related problems was evident for only one of the four drinking motives (coping). Our findings suggest that reducing coping motives for drinking among Hispanic college students may reduce alcohol-related problems.

Screening and Brief Interventions for Alcohol Use During Pregnancy: Practices Among US Primary Care Clinicians, DocStyles 2019.

Alcohol use during pregnancy can cause birth defects and developmental disabilities. From 2018 through 2020, 13.5% of pregnant women reported current drinking. The US Preventive Services Task Force recommends evidence-based tools (eg, AUDIT-C and SASQ) for implementing screening and brief interventions to reduce excessive alcohol use among adults, including pregnant people, for whom any alcohol use is considered excessive. We used DocStyles 2019 data to conduct a cross-sectional analysis to examine current screening and brief intervention practices that primary care clinicians conduct among pregnant patients; clinicians' confidence levels in conducting screening, brief interventions, and referral to treatment; and the documentation of brief interventions in the medical record. A total of 1,500 US adult medicine clinicians completed the entire survey. Among the respondents who conduct screening (N = 1,373) and brief interventions (N = 1,357) in their practice, nearly all reported implementing screening (94.6%) and brief interventions (94.9%) with their pregnant patients for alcohol use, but fewer than half felt confident about conducting their screening practices (46.5%). Two-thirds (64%) reported using a tool that met the criteria recommended by the US Preventive Services Task Force (USPSTF). Over half documented brief interventions in electronic health record notes (51.7%) or designated space (50.7%). Pregnancy presents a unique opportunity for clinicians to incorporate screening into routine obstetric care and encourage behavior change among patients. Most providers reported always screening their pregnant patients for alcohol use, but fewer used evidence-based USPSTF-recommended screening tools. Increased clinician confidence in screening and brief intervention, the use of standardized screening tools tailored to pregnant people, and maximal use of electronic health record technology may enhance the benefits of their application to alcohol use, which ultimately can reduce adverse outcomes associated with alcohol use during pregnancy.

Characterization of Brazilian theses and dissertations that used brief intervention for alcohol use

Characterization of Brazilian theses and dissertations that used brief intervention for alcohol use

Brief interventions for alcohol use in primary care: opportunities and challenges for the case of Chile

ABSTRACT Alcohol use disorders (AUD) are associated with several mental health, family, and social consequences. This paper analyzes the few studies on BIs in primary care in Chile and Latin America through a culturally critical view. Future research should address the need of culturally appropriate BI for AUD, so that decisions on policies and programs are made based on evidence-based, culturally appropriated practices. The Chilean context presents a unique opportunity to implement BI, since primary care counts on resources and protocols already installed. Clinical social workers should play a key role in this challenge.

Comparing the effectiveness of a brief intervention to reduce unhealthy alcohol use among adult primary care patients with and without depression: A machine learning approach with augmented inverse probability weighting

BackgroundThe combination of unhealthy alcohol use and depression is associated with adverse outcomes including higher rates of alcohol use disorder and poorer depression course. Therefore, addressing alcohol use among individuals with depression may have a substantial public health impact. We compared the effectiveness of a brief intervention (BI) for unhealthy alcohol use among patients with and without depression. MethodThis observational study included 312,056 adult primary care patients at Kaiser Permanente Northern California who screened positive for unhealthy drinking between 2014 and 2017. Approximately half (48%) received a BI for alcohol use and 9% had depression. We examined 12-month changes in heavy drinking days in the previous three months, drinking days per week, drinks per drinking day, and drinks per week. Machine learning was used to estimate BI propensity, follow-up participation, and alcohol outcomes for an augmented inverse probability weighting (AIPW) estimator of the average treatment (BI) effect. This approach does not depend on the strong parametric assumptions of traditional logistic regression, making it more robust to model misspecification. ResultsBI had a significant effect on each alcohol use outcome in the non-depressed subgroup (−0.41 to −0.05, all ps < .003), but not in the depressed subgroup (−0.33 to −0.01, all ps > .28). However, differences between subgroups were nonsignificant (0.00 to 0.11, all ps > .44). ConclusionOn average, BI is an effective approach to reducing unhealthy drinking, but more research is necessary to understand its impact on patients with depression. AIPW with machine learning provides a robust method for comparing intervention effectiveness across subgroups.

Online randomised factorial trial of electronic Screening and Brief Intervention for alcohol use in pregnancy: a study protocol

IntroductionApproximately 1 in 7 pregnant women in the USA report past-month alcohol use. Strong evidence connects prenatal alcohol exposure with a range of adverse perinatal outcomes, including the spectrum of...

Effectiveness of Brief Intervention for Alcohol Use: a Randomized Trial

Effectiveness of Brief Intervention for Alcohol Use: a Randomized Trial

Perspectives of Women Living With HIV on Addressing Violence and Use of Alcohol During HIV Services: Qualitative Findings From Fishing Communities in Uganda.

The syndemic relationship between harmful alcohol use, intimate partner violence (IPV), and HIV is well established across international settings. Less is known about how these health issues are perceived by women living with HIV (WLWH), who are disproportionately affected by these intertwined epidemics. A qualitative study was undertaken with 20 WLWH in Rakai, Uganda, to assess their perceptions of how these issues have affected their lives and their communities and to assess the acceptability of integrating a screening and brief intervention for alcohol use and IPV into HIV posttest counseling. Recommendations for intervention programming arising from the results are discussed.

Documented brief intervention associated with reduced linkage to specialty addictions treatment in a national sample of VA patients with unhealthy alcohol use with and without alcohol use disorders.

Alcohol screening, brief intervention (BI) and referral to treatment is often considered stepped care, such that BI with referral links patients to treatment. A meta-analysis of randomized trials found no evidence that BI increases treatment for alcohol use disorder (AUD). This study aimed to determine whether BI is associated with receipt of treatment for AUD among patients receiving BI as part of routine care. Regression analysis. US Veterans Health Administration (VA), in which BI is supported by performance measurement and electronic clinical reminders. VA outpatients with positive Alcohol Use Disorders Identification Test Consumption screens (≥5) (n=830,825) documented nationally from 1 October 2009 to 30 May 2013. Regression models estimated the prevalence of receiving VA specialty addictions treatment within 0-365days for patients with documented BI (advice to reduce/abstain within 0-14days) compared to those without. Models clustered on patient and adjusted for demographics and mental health and substance use conditions were fit among all patients and stratified across documented past-year AUD diagnosis. Multiple secondary analyses assessed robustness of findings, including assessing repeated BI as a predictor. Among 830,825 VA outpatients with unhealthy alcohol use (1,172,606 positive screens), documented BI was associated with lower likelihood of receiving VA specialty addictions treatment [adjusted incidence rate ratio (aIRR)=0.84, 95% confidence interval (CI)=0.83-0.84]. Associations were similar for those with and without AUD (aIRR=0.83, 95% CI=0.82-0.84 and aIRR=0.86, 95% CI=0.83-0.88, respectively) and in most secondary analyses. However, among patients without AUD, documentation of more than one BI was associated with greater likelihood of treatment relative to no BI (aIRR=1.75, 95% CI=1.68-1.83). In a national sample of US Veterans Health Administration patients with unhealthy alcohol use, documented brief intervention for alcohol use was associated with lower likelihood of receiving specialty addictions treatment regardless of alcohol use disorder diagnosis.

Process for developing a culturally informed brief motivational intervention

The present study culturally enhances a standard brief intervention for alcohol use. Through an iterative process engaging key stakeholders; including patients, and expert consultants, this research sought to enhance current evidence based interventions. Five culturally informed enhancements consistent with Motivational Interviewing were introduced into standard brief interventions. These culturally informed enhancements can be refined to address the cultural risk and protective factors of other priority populations. The distinctions and advantages of this approach over prior cultural adapted interventions is discussed. Importantly, the present study outlines a process for refining the culturally informed brief intervention to other target populations.

Erratum to "Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol".

O artigo “Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol”, published on our edition January 2018 [Acta Med Port 2018 Jan;31(1):45-50] foi publicado com um erro na linha de autoria.Na página 45, onde actualmente se lê:Frederico ROSÁRIO[AC,1,2], Maria Inês SANTOS[3], Kathryn ANGUS[4], Leo PAS[5], Niamh FITZGERALD[4]Deve ler-se:Frederico ROSÁRIO[AC,1,2], Maria Inês SANTOS[3], Kathryn ANGUS[4], Leo PAS[5], Cristina RIBEIRO[1,6], Niamh FITZGERALD[4]Também nas informações de afailiação constantes em rodapé da mesma página 45, onde se lê:1. Institute of Preventive Medicine and Public Health. Faculty of Medicine. Lisbon University. Lisbon. Portugal.2. Tomaz Ribeiro Primary Health Care Center. Dão Lafões Primary Health Care Centers Grouping. Viseu. Portugal.3. Department of Pediatrics. Tondela-Viseu Hospital Center. Viseu. Portugal.4. Institute for Social Marketing (ISM). UK Centre for Tobacco &amp; Alcohol Studies. Faculty of Health Sciences &amp; Sport. University of Stirling. Stirling. United Kingdom.5.Academic Centre for General Practice. KU Leuven. Leuven. Belgium.Deve ler-se:1. Institute of Preventive Medicine and Public Health. Faculty of Medicine. Lisbon University. Lisbon. Portugal.2. Tomaz Ribeiro Primary Health Care Center. Dão Lafões Primary Health Care Centers Grouping. Viseu. Portugal.3. Department of Pediatrics. Tondela-Viseu Hospital Center. Viseu. Portugal.4. Institute for Social Marketing (ISM). UK Centre for Tobacco &amp; Alcohol Studies. Faculty of Health Sciences &amp; Sport. University of Stirling. Stirling. United Kingdom.5. Academic Centre for General Practice. KU Leuven. Leuven. Belgium.6. Quality Department. Directorate-General of Health. Lisbon. Portugal.Link para o artigo inicialmente publicado.

Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol.

Alcohol is a leading risk factor contributing to the global burden of disease. National and international agencies recommend evidence-based screening and brief interventions in primary care settings in order to reduce alcohol consumption. However, the majority of primary care professionals do not routinely deliver such interventions. To identify factors influencing general practitioners/family physicians' and primary care nurses' routine delivery of alcohol screening and brief intervention in adults. A systematic literature search will be carried out in the following electronic databases: Medline, CINAHL, CENTRAL, and PsycINFO. Two authors will independently abstract data and assess study quality using the NIH National Heart, Lung, and Blood Institute quality assessment tools for quantitative studies, and the CASP checklist for qualitative studies. A narrative synthesis of the findings will be provided, structured around the barriers and facilitators identified. Identified barriers and facilitators will be further analysed using the Behavioural Change Wheel/Theoretical Domains Framework. This review will describe the barriers to, and facilitators for, the implementation of alcohol screening and brief interventions by general practitioners/family physicians and nurses at primary care practices. By mapping the barriers and facilitators to the domains of the Behavioural Change Wheel/Theoretical Domains Framework, this review will also provide implementation researchers with a useful tool for selecting promising practitioner-oriented behavioural interventions for improving alcohol screening and brief intervention delivery in primary care. This review will provide important information for implementing alcohol screening and brief intervention in primary health care.Systematic Review Registration: PROSPERO CRD42016052681.

Effects of narrator empathy in a computer delivered brief intervention for alcohol use

Computer-delivered, brief interventions (CDBIs) have been an increasingly popular way to treat alcohol use disorders; however, very few studies have examined which characteristics of CDBIs maximize intervention effectiveness. The literature has consistently demonstrated that therapist empathy is associated with reduced substance use in in-person therapy; however, it is unclear whether this principle applies to CDBIs. Therefore, the study aimed to examine whether the presence of an empathic narrator increased intentions to reduce heavy drinking in a CDBI. Results suggest that the presence of empathy increases motivation to reduce drinking, and makes participants feel more supported and less criticized.

A systematic review of the free-pour assessment: Implications for research, assessment and intervention.

Excessive alcohol consumption is a major concern. Alcohol consumption data are typically collected via self-report questionnaires. However, research has suggested that individuals are unable to identify a standard drink size and that their self-report may be influenced by certain environmental conditions, calling into question the reliability and validity of self-report. The free-pour is an objective measure that may provide a clearer picture of current alcohol consumption trends, individuals' knowledge of standard drink sizes, and accuracy of self-report. This systematic review of existing free-pour assessment methods suggests that individuals are unable to identify and pour standard drink sizes, with the largest discrepancies occurring for liquor and wine pours and pours into larger and wider glasses. Additional variables that appear to influence pouring behavior are gender, pouring location (e.g., home or laboratory), pouring task (e.g., selecting a line or physically pouring), and drinking history; however, additional research is necessary to better understand the effects of these variables on pouring behavior. These findings have important implications for the accuracy of self-report measures, as well as clinical implications for alcohol use screenings, alcohol education courses, and brief interventions for alcohol use. The systematic review concludes with recommendations for practical applications and future research of the free-pour assessment. (PsycINFO Database Record

Technology-Based Interventions and Trainings to Reduce the Escalation and Impact of Alcohol Problems

There has been a rapid increase in the development of technological innovations to reduce the escalation and impact of alcohol problems among adolescents and adults. Technology-based interventions offer the possibility of reaching individuals who otherwise might not seek treatment, (e.g., those in remote areas, those not perceiving a need for treatment, or others who might resist treatment). This article describes 4 case examples of technology-based interventions for risky drinking: (a) a freely available and interactive Web site that provides individualized feedback and information on risky drinking patterns; (b) a brief intervention for adolescents that provides individualized feedback to teens regarding their alcohol use; (c) a computer-delivered screening and brief intervention for alcohol use among pregnant women; and (d) a simulation program for training social workers in screening and brief intervention. These case examples highlight how technology could have a role in addressing the Alcohol Misuse Grand Challenge.

A randomised trial of a computer-delivered screening and brief intervention for postpartum alcohol use.

Most women cut down or quit alcohol use during pregnancy, but return to pre-pregnancy levels of use after giving birth. Universal screening and brief intervention for alcohol use has shown promise, but has proven challenging to implement and has rarely been evaluated with postpartum women. This trial evaluated a single 20-min, electronic screening and brief intervention (e-SBI) for alcohol use among postpartum women. In this parallel group randomised trial, 123 postpartum, low-income, primarily African-American women meeting criteria for unhealthy alcohol use were randomly assigned to either a tailored e-SBI (n = 61) or a time-matched control condition (n = 62), with follow-up at 3 and 6 months. Hypotheses predicted that 7-day point-prevalence abstinence and drinking days would favour the e-SBI condition. No group differences were significant. Blinded follow-up evaluation revealed 7-day point prevalence of 75% for the e-SBI condition versus 82% for control at 3 months (odds ratio = 1.6) and 72% versus 73%, respectively, at 6 months. Drinking days in the past 90 and mean number of drinks per week also showed no significant differences. This pilot trial failed to support a single-session e-SBI for alcohol use among postpartum women, although findings at the 3-month time point suggested that greater power might confirm transient effects of the e-SBI. As efficacy is likely to vary with e-SBI content and approach, future research should leverage technology's reproducibility and modularity to isolate key components. [Ondersma SJ, Svikis DS, Thacker LR, Beatty JR, Lockhart N. A randomised trial of a computer-delivered screening and brief intervention for postpartum alcohol use. Drug Alcohol Rev 2016;35:710-718].

Brief Interventions for Alcohol Use: Where, When, and How?

* Abbreviations: BI — : brief intervention ED — : emergency department SBIRT — : screening, brief intervention, and referral to treatment More than one-third of US high school seniors report past-month alcohol consumption,1 and alcohol contributes to the top 3 causes of death among youth: unintentional injury (most of which are motor vehicle accidents), homicide, and suicide.2 Intervening early in adolescent substance use is critical because it can improve the life course trajectory of addiction and its harms.3 Because only 1 in 10 adolescents who need treatment of an alcohol use problem actually receive it,4 waiting for youth to seek help from a provider is not an effective strategy. To detect alcohol use and intervene early, major organizations,5–7 including the American Academy of Pediatrics,3 recommend routine alcohol screening, brief intervention (BI), and referral to treatment (SBIRT) for adolescents and young adults. Interpreting the evidence base for SBIRT is complex. Study designs can vary by substance (alcohol, drugs, or both), outcome (reduction in consumption, consequences of use, or both), setting (emergency department [ED], primary care, or school), sample (adolescents, young adults, or older adults), modality of the BI (given by a therapist or by a computer or mobile device), content of the BI (youth-friendly or otherwise), and timing of outcome measurement (months or even years later).8–11 Even once studies have shown efficacy, that is, improvement in … Address correspondence to Scott E. Hadland, MD, MPH, Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail: scott.hadland{at}childrens.harvard.edu

Computer-Delivered Screening and Brief Intervention for Alcohol Use in Pregnancy: A Pilot Randomized Trial.

Although screening and brief intervention (SBI) for unhealthy alcohol use has demonstrated efficacy in some trials, its implementation has been limited. Technology-delivered approaches are a promising alternative, particularly during pregnancy when the importance of alcohol use is amplified. The present trial evaluated the feasibility and acceptability of an interactive, empathic, video-enhanced, and computer-delivered SBI (e-SBI) plus 3 tailored mailings, and estimated intervention effects. We recruited 48 pregnant women who screened positive for alcohol risk at an urban prenatal care clinic. Participants were randomly assigned to the e-SBI plus mailings or to a control session on infant nutrition, and were re-evaluated during their postpartum hospitalization. The primary outcome was 90-day period prevalence abstinence as measured by timeline follow-back interview. Participants rated the intervention as easy to use and helpful (4.7 to 5.0 on a 5-point scale). Blinded follow-up evaluation at childbirth revealed medium-size intervention effects on 90-day period prevalence abstinence (OR=3.4); similarly, intervention effects on a combined healthy pregnancy outcome variable (live birth, normal birthweight, and no neonatal intensive care unit stay) were also of moderate magnitude in favor of e-SBI participants (OR=3.3). As expected in this intentionally underpowered pilot trial, these effects were nonsignificant (p=0.19 and 0.09, respectively). This pilot trial demonstrated the acceptability and preliminary efficacy of e-SBI plus tailored mailings for alcohol use in pregnancy. These findings mirror the promising results of other trials using a similar approach and should be confirmed in a fully powered trial.

Norwegian midwives' use of screening for and brief interventions on alcohol use in pregnancy

ObjectiveThis study assessed the current screening for and brief intervention (BI) on alcohol use in pregnancy among midwives in Norway, as well as perceived barriers for such practice. Design, setting and participantsAn Internet and telephone survey was conducted among all 200 registered municipal midwives in the Norwegian health regions North, West and South in the period December 2013–May 2014. Of these, 103 midwives were reached and responded (52%). Measurement and findingsMost of the midwives (97%) asked the pregnant women about their alcohol use at their first consultation. 42% of the midwives reported using a screening instrument. When asked which one, AUDIT or TWEAK was mentioned by 16%. The need for more training in screening tools was reported by 66%. Sixty-four percent of midwives working in municipalities that had received special training compared with 50% among the rest said that they intervened themselves if alcohol use was detected (χ2 = 0.32, P = .645). Motivational Interviewing was well known and frequently used. Low perceived BI competence and finding it difficult to discuss alcohol use with parents with a different ethnicity both reduced chances of carrying out a BI. Time constraints and lack of organizational support were other frequently mentioned barriers. Key conclusions and implications for practiceIt seems that the Norwegian midwives find screening and brief interventions for alcohol use to be important and part of their job, but still could use more training, stronger guidelines and more time for following up parents.

Acceptability of a Computerized Brief Intervention for Alcohol Among Abstinent But At-Risk Pregnant Women

ABSTRACTBackground: Limitations in time and training have hindered widespread implementation of alcohol-based interventions in prenatal clinics. Also, despite the possibility of underreporting or relapse, many at-risk women report that they quit drinking after pregnancy confirmation so that interventions focusing on current drinking may seem unnecessary. The Computerized Brief Intervention for Alcohol Use in Pregnancy (C-BIAP) was designed to (a) be implemented via a handheld device in prenatal clinics, and (b) use a modified brief intervention strategy with women who screen at-risk but report no current drinking. Methods: The authors administered the C-BIAP to 18 T-ACE (Tolerance, Annoyance, Cut Down, and Eye Opener)-positive pregnant African American women who provided quantitative and qualitative feedback. Results: The C-BIAP received high ratings of acceptability; qualitative feedback was also positive overall and suggested good acceptance of abstinence themes. Conclusions: Technology may be a feasible and acceptable method for brief intervention delivery with pregnant women who do not report current drinking.