Efficacy Of Brief Alcohol Interventions Research Articles

Beyond BASICS: A scoping review of novel intervention content to enhance the efficacy of brief alcohol interventions for emerging adults.

Brief motivational interventions (BMIs) that include personalized drinking feedback delivered in a motivational interviewing (MI) style have demonstrated reductions in drinking across numerous clinical trials with emerging adults (EAs) ages 18-25. However, effect sizes for these BMIs are generally small to moderate and drinking reductions are often not maintained beyond short-term follow-ups. Additionally, EAs may be more interested in approaches that highlight wellness, mood enhancement, or goal pursuit rather than programs focused exclusively on reducing alcohol-related risk. Thus, there is a need to evaluate novel intervention content as an alternative or supplement to BMIs in this high-risk population. This scoping review examined studies of novel intervention elements to reduce alcohol consumption among EAs. Eligible studies were published in peer-reviewed journals in English from January 2015 to September 2021 and evaluated novel brief interventions, operationalized as one to five sessions focused on alcohol-related outcomes with key content beyond what has typically been included in alcohol BMIs. Results were categorized as additions to BMIs or stand-alone interventions and were synthesized within these categories by theoretical approach. Although standard in-person BMIs have the greatest empirical support, there are a variety of alternative intervention approaches that might enhance health and wellness and that can be feasibly integrated with BMIs or offered as an appealing "gateway" to increase help-seeking among EAs who drink alcohol. More research is needed to empirically evaluate both the relative efficacy of supplements and stand-alone alternatives to BMI among higher risk EAs and their potential for widespread dissemination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Role of Tobacco Smoking in the Efficacy of Brief Alcohol Intervention: Results from a Randomized Controlled Trial.

This study investigated whether tobacco smoking affected outcomes of brief alcohol interventions (BAIs) in at-risk alcohol-drinking general hospital patients. Between 2011 and 2012 among patients aged 18–64 years, 961 patients were allocated to in-person counseling (PE), computer-based BAI containing computer-generated individual feedback letters (CO), and assessment only. PE and CO included contacts at baseline, 1, and 3 months. After 6, 12, 18, and 24 months, self-reported reduction of alcohol use per day was assessed as an outcome. By using latent growth curve models, self-reported smoking status, and number of cigarettes per day were tested as moderators. In PE and CO, alcohol use was reduced independently of smoking status (IRRs ≤ 0.61, ps < 0.005). At month 24, neither smoking status nor number of cigarettes per day moderated the efficacy of PE (IRR = 0.69, ps > 0.05) and CO (IRR = 0.85, ps > 0.05). Up to month 12, among persons smoking ≤ 19 cigarettes per day, the efficacy of CO increased with an increasing number of cigarettes (ps < 0.05). After 24 months, the efficacy of PE and CO that have been shown to reduce drinking did not differ by smoking status or number of cigarettes per day. Findings indicate that efficacy may differ by the number of cigarettes in the short term.

Social Equity in the Efficacy of Computer-Based and In-Person Brief Alcohol Interventions Among General Hospital Patients With At-Risk Alcohol Use: A Randomized Controlled Trial

BackgroundSocial equity in the efficacy of behavior change intervention is much needed. While the efficacy of brief alcohol interventions (BAIs), including digital interventions, is well established, particularly in health care, the social equity of interventions has been sparsely investigated.ObjectiveWe aim to investigate whether the efficacy of computer-based versus in-person delivered BAIs is moderated by the participants’ socioeconomic status (ie, to identify whether general hospital patients with low-level education and unemployed patients may benefit more or less from one or the other way of delivery compared to patients with higher levels of education and those that are employed).MethodsPatients with nondependent at-risk alcohol use were identified through systematic offline screening conducted on 13 general hospital wards. Patients were approached face-to-face and asked to respond to an app for self-assessment provided by a mobile device. In total, 961 (81% of eligible participants) were randomized and received their allocated intervention: computer-generated and individually tailored feedback letters (CO), in-person counseling by research staff trained in motivational interviewing (PE), or assessment only (AO). CO and PE were delivered on the ward and 1 and 3 months later, were based on the transtheoretical model of intentional behavior change and required the assessment of intervention data prior to each intervention. In CO, the generation of computer-based feedback was created automatically. The assessment of data and sending out feedback letters were assisted by the research staff. Of the CO and PE participants, 89% (345/387) and 83% (292/354) received at least two doses of intervention, and 72% (280/387) and 54% (191/354) received all three doses of intervention, respectively. The outcome was change in grams of pure alcohol per day after 6, 12, 18, and 24 months, with the latter being the primary time-point of interest. Follow-up interviewers were blinded. Study group interactions with education and employment status were tested as predictors of change in alcohol use using latent growth modeling.ResultsThe efficacy of CO and PE did not differ by level of education (P=.98). Employment status did not moderate CO efficacy (Ps≥.66). Up to month 12 and compared to employed participants, unemployed participants reported significantly greater drinking reductions following PE versus AO (incidence rate ratio 0.44, 95% CI 0.21-0.94; P=.03) and following PE versus CO (incidence rate ratio 0.48, 95% CI 0.24–0.96; P=.04). After 24 months, these differences were statistically nonsignificant (Ps≥.31).ConclusionsComputer-based and in-person BAI worked equally well independent of the patient’s level of education. Although findings indicate that in the short-term, unemployed persons may benefit more from BAI when delivered in-person rather than computer-based, the findings suggest that both BAIs have the potential to work well among participants with low socioeconomic status.Trial RegistrationClinicalTrials.gov NCT01291693; https://clinicaltrials.gov/ct2/show/NCT01291693

Effects of a brief alcohol intervention addressing the full spectrum of drinking in an adult general population sample: a randomized controlled trial.

Evidence for efficacy of brief alcohol interventions (BAIs) is mainly limited to primary care and at-risk drinkers. The aim was to test the efficacy of a BAI addressing the full spectrum of alcohol use in a general population sample and across alcohol risk groups. Two-parallel-group randomized controlled trial (allocation ratio 1:1) with post-baseline assessments at months 3, 6 and 12. One municipal registry office in Germany responsible for registration, passport and vehicle admission issues. A total of 1646 proactively recruited 18-64-year-old adults with past year alcohol use (56% women, 66% low-risk drinkers) were randomized to intervention (n=815) or control (n=831). The intervention consisted of assessment plus computer-generated individualized feedback letters at baseline and months 3 and 6. Comparator was assessment only. Primary outcome was change in the self-reported number of drinks/week from baseline to 12months. Changes at 3 and 6months were secondary outcomes. Moderator was alcohol risk group (low-risk versus at-risk drinking) according to the Alcohol Use Disorders Identification Test-Consumption, with scores from 1-3 (women) and from 1-4 (men) indicating low-risk drinking. For the whole sample, significant group differences were observed neither at 12-month follow-up [incidence rate ratio (IRR)=1.01, 95% confidence interval (CI)=0.87-1.17, Bayes factor (BE)=0.52] nor at previous assessments (month 3: IRR=1.01, 95% CI=0.92-1.12, BE=0.41; month 6: IRR=0.93, 95% CI=0.81-1.07, BE=1.10). Moderator analyses revealed that low-risk drinkers were more likely to benefit from BAI only at month 6 than at-risk drinkers (IRR=0.77, 95% CI=0.70-0.86). In a randomized controlled trial, there was no clear evidence for efficacy of a computer-based brief alcohol intervention in a general population sample, but there was some evidence of medium-term benefits in the large but understudied group of low-risk drinkers.

A randomized clinical trial of motivational enhancement therapy for alcohol problems in partner violent men

This study examined the efficacy of brief alcohol intervention in the context of community-based treatment for partner violence. In a randomized clinical trial, 228 partner-violent men with hazardous or problem drinking were recruited at three Intimate Partner Violence (IPV) treatment agencies and randomly assigned to receive one of two 4-session alcohol interventions: Motivational Enhancement Therapy (MET: N = 110) or Alcohol Education (AE: N = 118). After completing alcohol intervention, participants received standard agency counseling services for IPV. Participants completed assessments of alcohol use, drug use, and IPV at pre-treatment, post-alcohol intervention, and quarterly follow-ups for 12 months. At the end of the 4-session alcohol intervention, MET participants displayed greater acknowledgment of problems with alcohol than AE participants (Partial ή2 = 0.039, p = 0.006). Significant changes from baseline across treatment conditions (at p < 0.001) were observed for percent days of alcohol abstinence [95% empirical CI for Partial ή2 =0.226, 0.296], heavy drinking [0.292, 0.349], illicit drug use [0.096, 0.156] and partner violence [0.282, 0.334]. No significant condition differences (treatment by time interactions) were found for alcohol abstinence [95% empirical CI for Partial ή2 = 0.007, 0.036], heavy drinking [0.016, 0.055], illicit drug use [0.005, 0.035] or partner violence [0.001, 0.004]. Results encourage continued use of brief alcohol interventions in community IPV services, but do not provide evidence of a unique benefit of MET in reducing alcohol use in this population.

In-person alcohol counseling versus computer-generated feedback: Results from a randomized controlled trial.

To investigate the comparative 2-year efficacy of brief alcohol interventions delivered in-person versus through computer-generated feedback letters among general hospital inpatients with at-risk alcohol use. In 2011-2012, all general hospital inpatients aged 18-64 years on 13 wards at 4 medical departments in 1 general hospital were systematically screened for at-risk alcohol use. Nine-hundred sixty-one inpatients who screened positive for at-risk alcohol use and negative for more severe alcohol problems were randomized by timeframe to in-person counseling (PE), computer-generated feedback letters (CO) and assessment only (AO). Both interventions included 3 contacts: on the ward and 1 and 3 months later and were based on the transtheoretical model (TTM). After 6, 12, 18, and 24 months computer-assisted telephone interviews assessed self-report outcomes: gram alcohol per week (primary), at-risk alcohol use and highest blood alcohol concentration (both secondary). Latent growth models were used. After 24 months, CO resulted in a greater reduction of self-reported gram alcohol per week than AO (p = .027); PE did not differ significantly from AO (p = .503) and CO (p = .088); and group differences concerning secondary outcomes were not statistically significant (ps > 0.07). After 6 months, the odds of at-risk alcohol use were reduced by half in PE versus AO (odds ratio = 0.50, 95% confidence interval: 0.25-0.98). No significant group differences between in-person counseling and computer-generated feedback letters were found. TTM-based computer-generated feedback letters reduced self-reported gram alcohol over 2 years and can be considered a long-term effective alternative in medical settings when addressing at-risk alcohol use. (PsycINFO Database Record

Efficacy of brief alcohol interventions at general hospitals: The role of employment status

Efficacy of brief alcohol interventions at general hospitals: The role of employment status

Factors associated with alcohol consumption among medical cannabis patients with chronic pain

IntroductionChronic pain is the most common reason for medical cannabis certification. Data regarding alcohol use and risky drinking among medical cannabis patients with pain is largely unknown. Therefore, we examined the prevalence and correlates of alcohol use and risky drinking in this population. MethodsParticipants completed surveys regarding demographics, pain-related variables, anxiety, cannabis use, and past six-month alcohol consumption. Alcohol use groups were defined using the AUDIT-C [i.e., non-drinkers, low-risk drinkers, and high-risk drinkers (≥4 for men and ≥3 for women)] and compared on demographic characteristics, pain measures, anxiety, and cannabis use. ResultsOverall, 42% (n=330/780) were non-drinkers, 32% (n=251/780) were low-risk drinkers, and 26% (n=199/780) were high-risk drinkers. Compared to non-drinkers, low- and high-risk drinkers were significantly younger whereas a larger proportion of low-risk drinkers reported being African-American compared to non- or high-risk drinkers. High-risk drinkers reported significantly lower pain severity/interference compared to the other groups; high-risk drinkers were also less likely to be on disability compared to other groups. A multinomial logistic regression showed that patients reporting lower pain severity and less disability had greater odds of being classified a high-risk drinker. ConclusionsHigh-risk drinking appears common among medical cannabis patients. Future research should examine whether such use is concurrent or consecutive, and the relationship of such co-use patterns to consequences. Nevertheless, individuals treating patients reporting medical cannabis use for pain should consider alcohol consumption, with data needed regarding the efficacy of brief alcohol interventions among medical cannabis patients.

P.6.b.008 Association of family history of alcoholism, scores of CAGE, AUDIT and DSM-IV diagnostic criteria in alcohol-dependent patients

This study examined the efficacy of brief alcohol intervention in the context of community-based treatment for partner violence. In a randomized clinical trial, 228 partner-violent men with hazardous or problem drinking were recruited at three Intimate Partner Violence (IPV) treatment agencies and randomly assigned to receive one of two 4-session alcohol interventions: Motivational Enhancement Therapy (MET: N = 110) or Alcohol Education (AE: N = 118). After completing alcohol intervention, participants received standard agency counseling services for IPV. Participants completed assessments of alcohol use, drug use, and IPV at pre-treatment, post-alcohol intervention, and quarterly follow-ups for 12 months. At the end of the 4-session alcohol intervention, MET participants displayed greater acknowledgment of problems with alcohol than AE participants (Partial ή2 = 0.039, p = 0.006). Significant changes from baseline across treatment conditions (at p < 0.001) were observed for percent days of alcohol abstinence [95% empirical CI for Partial ή2 =0.226, 0.296], heavy drinking [0.292, 0.349], illicit drug use [0.096, 0.156] and partner violence [0.282, 0.334]. No significant condition differences (treatment by time interactions) were found for alcohol abstinence [95% empirical CI for Partial ή2 = 0.007, 0.036], heavy drinking [0.016, 0.055], illicit drug use [0.005, 0.035] or partner violence [0.001, 0.004]. Results encourage continued use of brief alcohol interventions in community IPV services, but do not provide evidence of a unique benefit of MET in reducing alcohol use in this population.

Testing the efficacy of brief alcohol interventions provided through different delivery channels: study design

In the past 20 years, research has shown that brief interventions are effective in reducing health risk behaviors. Now we are in the second generation of brief intervention trials, investigating how to improve efficacy, including the investigation of cost-saving communication channels. Our aim was to investigate whether motivationally tailored interventions are more effective in reducing unhealthy alcohol use when delivered by computer or in person. Proactively recruited general hospital inpatients with unhealthy alcohol use (n=975) participated in a randomized controlled trial, and were allocated to one of three groups: 1) individualized theory-based computer generated feedback letters, 2) motivational interviewing based counselling, and 3) assessment only (controls). Both intervention groups received up to three interventions. All groups are followed up at 6, 12, 18 and 24 months. Between February 2011 and December 2012, recruitment and interventions have been completed. We have assessed 10,591 inpatients aged 18-64 years for eligibility. We have screened 6,236 inpatients regarding unhealthy alcohol use, corresponding to 91.1% of those eligible. Of all inpatients with unhealthy alcohol use, 80.6% gave informed consent to participate in the trial. So far, 71.3% to 81.5% of these have participated in the follow-ups. A large study has been successfully implemented at a general hospital. Satisfactory participation rates provide a solid basis to investigate the comparative efficacy of brief alcohol interventions delivered by computer versus in person. The follow-up period of up to 24 months provides an excellent opportunity to investigate gradually increasing effects.

The impact of elevated posttraumatic stress on the efficacy of brief alcohol interventions for heavy drinking college students

Brief alcohol interventions (BAIs) have been widely adopted for use with college students and are associated with significant reductions in drinking and problems. However, many students do not respond to these approaches and little is known about risk factors for poor response. The current study investigated one possible risk factor by examining the impact of posttraumatic stress (PTS) symptoms on BAI efficacy. This study presents pooled data from two randomized clinical trials that examined the efficacy of counselor-administered BAIs compared with computerized interventions. Participants were 207 college students (53.1% women, 68.1% White/Caucasian, 16.9% with elevated post-traumatic stress) who reported past-month heavy episodic drinking. Follow-up assessments were completed six months post-intervention. Analyses testing differences in frequency of past-month heavy episodic drinking revealed a significant post-traumatic stress by time interaction (F(1,165)=8.27, p=.005) such that individuals screening positive for PTS showed larger reductions in heavy episodic drinking at follow-up. A significant three-way interaction between time, PTS, and intervention condition (F(2,167)=5.76, p=.004) was found for alcohol related consequences. Specifically, among individuals screening positive for PTS, only those that received the counselor-administered BAI showed a significant reduction in consequences at follow-up. These results suggest that overall college students with PTS may respond well to BAIs and that counselor-delivered BAIs may be more efficacious than computer-delivered interventions for reducing alcohol problems for these high-risk students.

The Mixed Evidence for Brief Intervention in Emergency Departments, Trauma Care Centers, and Inpatient Hospital Settings: What Should We Do?

This qualitative review is based on a symposia presented at the 2009 annual conference of the Research Society on Alcoholism (Baird et al., 2009; Field et al., 2009; Monti et al., 2009; Saitz et al., 2009a). The purpose is to describe the mixed evidence supporting brief interventions in the emergency department, trauma care, and in-patient medical care settings; examine potential moderators of treatment outcome in light of the mixed evidence; and identify methods to move the research and practice of brief interventions beyond their current state. By drawing upon existing reviews and selected individual studies, we provide examples that reflect the current complexity of research in this area and propose steps for advancing the field. Emergency departments, inpatient hospital settings, and trauma care settings represent three unique contexts within which brief interventions have been tested. While the general efficacy of brief alcohol interventions in these settings has been recognized, the evidence is increasingly mixed. Recent studies investigating potential moderators of treatment outcomes suggest that a more sophisticated approach to evaluating the effectiveness of brief interventions across varying patient populations is needed to further understand its effectiveness. Current dissemination efforts represent a significant advance in broadening the base of treatment for alcohol problems by providing an evidence-based intervention in health care settings and should not be curtailed. However, additional research is required to enhance treatment outcomes, refine current practice guidelines, and continue to bridge the gap between science and practice. Given the current state of research, a multisetting clinical trial is recommended to account for potential contextual differences while controlling for study design.

Correlates of AUDIT Risk Status for Male and Female College Students

Objective: The current study identified gender-specific correlates of hazardous drinker status as defined by the AUDIT. Participants: A total of 462 college student volunteers completed the study in 2006. The sample was predominantly Caucasian (75%) and female (55%). Methods: Participants completed a survey assessing demographics, alcohol use patterns, and health indices. Scores of 8 or more on the AUDIT defined the at-risk subsample. Logistic regression models determined which variables predicted AUDIT risk status for men and women. Results: The at-risk participants reported higher alcohol use and related problems, elevated sleep problems and lower health ratings. High typical blood alcohol concentration (BAC), lifetime drug use, and psychosocial problems predicted risk status for males. Binge frequency and psychosocial problems predicted risk status for females. Conclusions: Different behavioral profiles emerged for men and women identified as hazardous drinkers on the AUDIT. The efficacy of brief alcohol interventions could be enhanced by addressing these behavioral correlates.

The Healthy Moms Study: The Efficacy of Brief Alcohol Intervention in Postpartum Women

The prevention and treatment of alcohol use disorders among women of reproductive age have been well described. However, there is limited information on women specifically during the postpartum period. This period in a woman's life is a time of transition and it provides an ideal opportunity for primary care providers to intervene. The goal of this report was to present the results of a brief alcohol intervention conducted in 34 obstetrical practices with women seeking routine postpartum care. A randomized clinical trial was conducted from 2002 to 2005 in a diverse sample of women located in 15 Wisconsin counties. This report presents 6-month follow-up data. A total of 8,706 women were screened for high-risk alcohol use during routine postpartum care with 997 (12%) of these women testing positive for at-risk drinking. A total of 235 women met inclusion criteria and were randomized to either "usual care" or "brief intervention." The 4-session intervention was delivered by outpatient obstetrical nurses and research staff. The mean age of the women in the sample was 28, 19.3% were from minority groups, 60.8% were married, 53.2% reported current tobacco use, and 17.9% had used marijuana in the previous 30 days. At the 6 month follow-up appointment, there were significant reductions in mean number of total drinks in the previous 28 days (p < 0.013), number of drinking days (p < 0.024) and heavy drinking days (p < 0.019). In addition to a statistical difference between groups, there was a 19% difference in the mean number of drinks and number of drinking days, and a 36% difference in the number of heavy drinking days in favor of the intervention group. The findings of the Healthy Moms Trial support the implementation of brief alcohol intervention during the postpartum period.

Table of Contents

AbstractRandomized Trial Refutes Efficacy of Brief Alcohol Intervention in Emergency Department SettingBrief Motivational Intervention Improves Alcohol Outcomes in Young Adults in Emergency DepartmentsBrief Intervention Effective in Reducing Unhealthy Drinking Among at‐risk Emergency Department PatientsWide Range of Disorders Associated with Problem, Pathological GamblingIndividual, Environmental Factors Influence Alcohol Consumption in Young AdultsGuided Relaxation Offers Relief for Quitting SmokersImpulsivity, Sensation Seeking and Fine French Wine

Commentary] A META‐ANALYSIS OF BRIEF ALCOHOL INTERVENTIONS IN EMERGENCY DEPARTMENTS: FEW ANSWERS, MANY QUESTIONS

Commentary] A META‐ANALYSIS OF BRIEF ALCOHOL INTERVENTIONS IN EMERGENCY DEPARTMENTS: FEW ANSWERS, MANY QUESTIONS

Reduction of Alcohol Consumption by Brief Alcohol Intervention in Primary Care

Numerous trials of the efficacy of brief alcohol intervention have been conducted in various settings among individuals with a wide range of alcohol disorders. Nevertheless, the efficacy of the intervention is likely to be influenced by the context. We evaluated the evidence of efficacy of brief alcohol interventions aimed at reducing long-term alcohol use and related harm in individuals attending primary care facilities but not seeking help for alcohol-related problems. We selected randomized trials reporting at least 1 outcome related to alcohol consumption conducted in outpatients who were actively attending primary care centers or seeing providers. Data sources were the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, ISI Web of Science, ETOH database, and bibliographies of retrieved references and previous reviews. Study selection and data abstraction were performed independently and in duplicate. We assessed the validity of the studies and performed a meta-analysis of studies reporting alcohol consumption at 6 or 12 months of follow-up. We examined 19 trials that included 5639 individuals. Seventeen trials reported a measure of alcohol consumption, of which 8 reported a significant effect of intervention. The adjusted intention-to-treat analysis showed a mean pooled difference of -38 g of ethanol (approximately 4 drinks) per week (95% confidence interval, -51 to -24 g/wk) in favor of the brief alcohol intervention group. Evidence of other outcome measures was inconclusive. Focusing on patients in primary care, our systematic review and meta-analysis indicated that brief alcohol intervention is effective in reducing alcohol consumption at 6 and 12 months.