Disorders - Alcohol Use
Kuntsche, S., Kuntsche, E.
Despite the increasing relevance of peers, parents remain important socializing agents for their adolescent children and are therefore promising agents for inclusion in prevention or intervention programs. This systematic review provides an overview of the effectiveness of parent-based programs in preventing, curbing or reducing substance use (i.e. alcohol, tobacco and cannabis) among 10 to 18-year-olds. The databases PubMed, PsychInfo, Eric and Google Scholar were used to identify randomized trials published within the past 12years evaluating effects on adolescent substance use. Of the 653 identified in the first screening, 39 publications dealing with 13 programs were included.
Clinical Psychology Review, 45 : 89-101
- Year: 2016
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Tansil, K. A., Esser, M. B., Sandhu, P., Reynolds, J. A., Elder, R. W., Williamson, R. S., Chattopadhyay, S. K., Bohm, M. K., Brewer, R. D., McKnight-Eily, L. R., Hungerford, D. W., Toomey, T. L., Hingson, R. W., Fielding, J. E., Community Preventive Services Task Force
CONTEXT: Excessive drinking is responsible for one in ten deaths among working-age adults in the U.S. annually. Alcohol screening and brief intervention is an effective but underutilized intervention for reducing excessive drinking among adults. Electronic screening and brief intervention (e-SBI) uses electronic devices to deliver key elements of alcohol screening and brief intervention, with the potential to expand population reach.
EVIDENCE ACQUISITION: Using Community Guide methods, a systematic review of the scientific literature on the effectiveness of e-SBI for reducing excessive alcohol consumption and related harms was conducted. The search covered studies published from 1967 to October 2011. A total of 31 studies with 36 study arms met quality criteria and were included in the review. Analyses were conducted in 2012.
EVIDENCE SYNTHESIS: Twenty-four studies (28 study arms) provided results for excessive drinkers only and seven studies (eight study arms) reported results for all drinkers. Nearly all studies found that e-SBI reduced excessive alcohol consumption and related harms: nine study arms reported a median 23.9% reduction in binge-drinking intensity (maximum drinks/binge episode) and nine study arms reported a median 16.5% reduction in binge-drinking frequency. Reductions in drinking measures were sustained for up to 12 months.
CONCLUSIONS: According to Community Guide rules of evidence, e-SBI is an effective method for reducing excessive alcohol consumption and related harms among intervention participants. Implementation of e-SBI could complement population-level strategies previously recommended by the Community Preventive Services Task Force for reducing excessive drinking (e.g., increasing alcohol taxes and regulating alcohol outlet density).
American Journal of Preventive Medicine, 51(5) : 801-811
- Year: 2016
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Arnaud, N., Baldus, C., Elgan, T. H. De-Paepe, N., Tonnesen, H., Csemy, L., Thomasius, R.
BACKGROUND: Mid-to-late adolescence is a critical period for initiation of alcohol and drug problems, which can be reduced by targeted brief motivational interventions. Web-based brief interventions have advantages in terms of acceptability and accessibility and have shown significant reductions of substance use among college students. However, the evidence is sparse among adolescents with at-risk use of alcohol and other drugs.
OBJECTIVE: This study evaluated the effectiveness of a targeted and fully automated Web-based brief motivational intervention with no face-to-face components on substance use among adolescents screened for at-risk substance use in four European countries.
METHODS: In an open-access, purely Web-based randomized controlled trial, a convenience sample of adolescents aged 16-18 years from Sweden, Germany, Belgium, and the Czech Republic was recruited using online and offline methods and screened online for at-risk substance use using the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) screening instrument. Participants were randomized to a single session brief motivational intervention group or an assessment-only control group but not blinded. Primary outcome was differences in past month drinking measured by a self-reported AUDIT-C-based index score for drinking frequency, quantity, and frequency of binge drinking with measures collected online at baseline and after 3 months. Secondary outcomes were the AUDIT-C-based separate drinking indicators, illegal drug use, and polydrug use. All outcome analyses were conducted with and without Expectation Maximization (EM) imputation of missing follow-up data.
RESULTS: In total, 2673 adolescents were screened and 1449 (54.2%) participants were randomized to the intervention or control group. After 3 months, 211 adolescents (14.5%) provided follow-up data. Compared to the control group, results from linear mixed models revealed significant reductions in self-reported past-month drinking in favor of the intervention group in both the non-imputed (P=.010) and the EM-imputed sample (P=.022). Secondary analyses revealed a significant effect on drinking frequency (P=.037) and frequency of binge drinking (P=.044) in the non-imputation-based analyses and drinking quantity (P=.021) when missing data were imputed. Analyses for illegal drug use and polydrug use revealed no significant differences between the study groups (Ps>.05).
CONCLUSIONS: Although the study is limited by a large drop-out, significant between-group effects for alcohol use indicate that targeted brief motivational intervention in a fully automated Web-based format can be effective to reduce drinking and lessen existing substance use service barriers for at-risk drinking European adolescents.
TRIAL REGISTRATION: International Standard Randomized Controlled Trial Registry: ISRCTN95538913; http://www.isrctn.com/ISRCTN95538913 (Archived by WebCite at http://www.webcitation.org/6XkuUEwBx).
Journal of Medical Internet Research, 18(5) : e103
- Year: 2016
- Problem: Substance Use Disorders (any), Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Balestrieri, S. G., Miller, M. B., DiBello, A. M., Merrill, J. E., Benz, M. B., Lowery, A. D., Carey, K. B.
Living arrangement has recently been identified as a correlate of heavy drinking among college students, such that off-campus students drink more heavily and experience more consequences than their on-campus counterparts. Studies to date have not documented the efficacy of brief alcohol interventions among this high-risk population; thus, we implemented a randomized controlled trial of a computer-delivered, brief alcohol intervention with a group of college students at a private university in the Northeast (N = 381). Students who were moving to off-campus housing in the Fall 2015 semester and endorsed having a heavy episodic drinking episode in the last 30 days were randomly assigned to an assessment only control condition (n = 190) or the College Drinkers Check Up (n = 191; Hester, Delaney & Campbell, 2009). Drinking quantity, drinking frequency, heavy episodic drinking frequency, and consequences were assessed at baseline and the one-month follow-up. Hierarchical linear regression was used to examine the unique utility of treatment condition in predicting 1-month outcomes; for all models, baseline levels of the variable and gender were included in Step 1 and treatment condition was added in Step 2. After controlling for baseline drinking levels and gender, completion of the CDCU (as opposed to assessment only) predicted fewer drinks consumed per typical week [B = -1.57, SE = 0.63, p = 0.01, DELTAR2 = 0.01; F(3, 277) = 93.01, p < 0.001], fewer drinking days per typical week [B = -0.47, SE = 0.14, p = 0.001, DELTAR2 = 0.03; F(3, 276) = 34.55, p < 0.001], fewer heavy drinking episodes in the past 30 days [B = -0.50, SE = 0.23, p = 0.03, DELTAR2 = 0.01; F(3, 266) = 94.14, p < 0.001], and fewer alcohol-related consequences [B = -0.84, SE = 0.32, p = 0.01, DELTAR2 = 0.02; F(3, 262) = 50.83, p < 0.001]. Our findings suggest that the CDCU is efficacious in reducing alcohol use and alcohol-related consequences in the short-term among off-campus college students. These results replicate those from two previous randomized controlled trials of the CDCU (Hester, Delaney, & Campbell, 2012). We extend these findings by applying this intervention to a population not previously targeted for alcohol interventions: off-campus college students. Our results support the practice of engaging upperclassmen in alcohol misuse prevention interventions at the point of moving to off-campus housing.
Alcoholism: Clinical & Experimental Research, 40 : 62A
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Bedendo, A., Andrade, A. L. M., Noto, A. R.
Purpose: To evaluate participant's characteristics associated with adherence and most effective components of a web-based Personalized Normative Feedback intervention for alcohol use among college students. Methods: College students were recruited through e-mail invitations, social media and via an institutional website. Students were randomized to 4 groups: Control, Personalized Normative Feedback (PNF), Normative Feedback (NF) or Consequences Feedback (CF) and were followed by 1 month. Analysis included students aged 18-30 years and with lifetime alcohol use. Participants were classified as non-risky and risky drinkers (AUDIT-C: >4 for men, >3 for women). Assessment included AUDIT, RAPI and motivation to know about alcohol use (measure by a likert scale). Logistic regression models were used to predict adherence to the intervention (N = 13,897). General Mixed Models were conducted to evaluate the intervention's effectiveness and the most effective component (N = 2,524). Primary outcomes were: AUDIT score, total number of consequences (RAPI), money spent with alcohol and maximum number of drinks/hour. Results: Students from private universities (OR: 1.26, IC95%: 1.13-1.41) and reporting being more motivated to know about their alcohol use were more likely to assess the intervention after 1 month (OR: 1.04, IC95%: 1.03-1.06). Participants with more alcohol-related consequences were less likely to adhere to the one-month follow-up (OR: 0.94, IC95%: 0.91-0.97). At one-month follow-up and compared to control, all interventions were effective in reducing the number of consequences among risky drinkers (PNF: B = -0.31, 95% IC: -0.54 to-0.09, p > 0.01; NF: B = -0.29, 95% IC: -0.52 to -0.07, p = 0.01; CF: = -0.25, 95% IC: -0.47 to -0.04, p = 0.02). PNF group also reduced AUDIT score (B = -0.68, 95% IC: -1.23 to-0.12, p = 0.02). However, non-risky drinkers receiving PNF increased the maximum number drinks/hour compared to control (B = 0.19, 95% IC: 0.05-0.32, p > 0.01). Conclusions: Students from private universities and those more motivated to know about their alcohol use were more likely to access the website at follow-up. PNF were the most effective intervention, but only with college students at risky drinking. One month after intervention, PNF were effective in reducing AUDIT score and the number of consequences among risky drinkers. However, among non-risky drinkers PNF increased maximum number drinks consumed per hour. NF and CF were effective only in reducing alcohol-related consequences.
Alcoholism: Clinical & Experimental Research, 40 : 62A
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Blevins, C E., Stephens, R S.
Motives for alcohol use are associated with distinct antecedents and consequences. Drinking alcohol to cope with negative affect is consistently associated with the most problematic patterns of use. Interventions targeting drinking to cope are needed. This randomized controlled treatment trial is an initial attempt to evaluate the impact of a brief coping motive-specific personalized feedback intervention on motives and problematic outcomes associated with drinking. The study randomized 170 participants to receive either a brief Standard Feedback Condition (SFC; n = 83) or a Motives Feedback Condition (MFC; n = 87) that added education and feedback on drinking to cope as well as alternative coping strategies. Significant reductions in drinking to cope with anxiety and with depression were greater in the MFC at the 2-month follow-up. Significant reductions in drinking and negative consequences were observed but did not differ significantly by condition. Indirect tests showed that the MFC, relative to SFC, was associated with outcomes of drinking and negative consequences through change in drinking to cope with depression. Moderation analyses revealed that there were no differential outcomes according to baseline level of coping. This study is a promising new direction in motives research, providing support for brief personalized feedback interventions incorporating motives-related feedback. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Addictive Behaviors, 58 : 68-73
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Bock, BC., Barnett, N P., Thind, H.,
Background: Students at community colleges comprise nearly half of all U.S. college students and show higher risk of heavy drinking and related consequences compared to students at 4-year colleges, but no alcohol safety programs currently target this population. Objective: To examine the feasibility, acceptability, and preliminary efficacy of an alcohol risk-reduction program delivered through text messaging designed for community college (CC) students. Methods: Heavy drinking adult CC students (N = 60) were enrolled and randomly assigned to the six-week active intervention (Text Message Alcohol Program: TMAP) or a control condition of general motivational (not alcohol related) text messages. TMAP text messages consisted of alcohol facts, strategies to limit alcohol use and related risks, and motivational messages. Assessments were conducted at baseline, week 6 (end of treatment) and week 12 (follow up). Results: Most participants (87%) completed all follow up assessments. Intervention messages received an average rating of 6.8 (SD = 1.5) on a 10-point scale. At week six, TMAP participants were less likely than controls to report heavy drinking and negative alcohol consequences. The TMAP group also showed significant increases in self-efficacy to resist drinking in high risk situations between baseline and week six, with no such increase among controls. Results were maintained through the week 12 follow up. Conclusions: The TMAP alcohol risk reduction program was feasible and highly acceptable indicated by high retention rates through the final follow up assessment and good ratings for the text message content. Reductions in multiple outcomes provide positive indications of intervention efficacy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Addictive Behaviors, 63 : 107-113
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Boendermaker, W. J., Sanchez-Maceiras, S., Boffo, M., Wiers, R. W.
Objective Young adults often experiment with heavy use of alcohol, which poses severe health risks and increases the chance of developing addiction problems. In clinical patients, cognitive re-training of automatic appetitive processes, such as selective attention towards alcohol (known as "Cognitive Bias Modification of Attention", or CBM-A), has been shown to be a promising add-on to treatment, helping to prevent relapse. To prevent escalation of regular use into problematic use in youth, motivations appear to play a pivotal role. As CBM-A is often viewed as long and boring, we present this training in the form of a serious game, as a novel approach aimed at enhancing motivation to train. Methods: 96 Heavy drinking undergraduate students carried out either a regular CBM-A training, a gamified version (called "Shots"), or a placebo training version over four training sessions. Measures of motivation to change their behavior, motivation to train, attentional bias for alcohol and drinking behavior were included before and after training. Results: Alcohol attentional bias was reduced after training only in the regular training condition. Self-reported drinking behavior went down slightly in all conditions, but motivation to train also decreased in all conditions, suggesting that the motivational features of the Shots game were not enough to fully counteract the tiresome nature of the training. Moreover, some of the motivational aspects decreased slightly more in the Game condition, which may indicate potential detrimental effects of disappointing gamification. Conclusions: We therefore stress that caution is advised when using gamification, as well as underscore the importance of careful scientific evaluation.
Alcoholism: Clinical & Experimental Research, 40 : 63A
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Borsari, B., Magill, M., Mastroleo, N. R., Hustad, J. T., Tevyaw, T. O, Barnett, N. P., Kahler, C. W., Eaton, E., Monti, P. M.
OBJECTIVE: Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to 2 interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-min brief advice (BA) session (Step 1) and a 60- to 90-min brief motivational intervention (BMI) delivered by trained interventionists (Step 2).
METHOD: Analyses were completed in 2 stages. First, 3 types of variables (screening variables, alcohol-related cognitions, mandated student profile) were examined in a logistic regression model as putative predictors of lower risk drinking (defined as 3 or fewer heavy episodic drinking [HED] episodes and/or 4 or fewer alcohol-related consequences in the past month) 6 weeks following the BA session. Second, we used generalized estimating equations to examine putative moderators of BMI effects on HED and peak blood alcohol content compared with assessment only (AO) control over the 3-, 6-, and 9-month follow-ups.
RESULTS: Participants reporting lower scores on the Alcohol Use Disorders Identification Test, more benefits to changing alcohol use, and those who fit the "Bad Incident" profile at baseline were more likely to report lower risk drinking 6 weeks after the BA session. Moderation analyses revealed that Bad Incident students who received the BMI reported more HED at 9-month follow-up than those who received AO.
CONCLUSION: Current alcohol use as well as personal reaction to the referral event may have clinical utility in identifying which mandated students benefit from treatments of varying content and intensity.
Copyright (c) 2016 APA, all rights reserved).
Journal of Consulting & Clinical Psychology, 84(2) : 103-12
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions
Carey, K. B., Walsh, J. L., Merrill, J. E., Lust, S. A., Reid, A. E., Kalichman, S. C., Carey, M. P.
Counselor-delivered brief motivational interventions (BMIs) reliably reduce drinking and related problems but effects are not always maintained among students who have violated campus alcohol policies. Few studies have tested effects of boosters after college drinking interventions, with equivocal findings. This study tested whether theory-based, low-cost email boosters (e-boosters) will magnify or sustain the effects of a BMI. Participants were 568mandated students (72%male, 84%white, 73%underclassmen). All completed a baseline assessment, received a counselor-delivered BMI (M = 67 min), and completed a 1-month follow-up assessment. Then participants were randomly assigned to one of two structurally-equivalent sets of 12 e-boosters, delivered 29/week between the 1- and 3-month post-BMI follow-ups. In the alcohol norms condition, e-booster content targeted hypothesized mechanisms of change: they reinforced the normative feedback component of the BMI and expanded content to include injunctive as well as descriptive norms, using university-specific normative data when available. The control condition received health promotion messages. Participants completed follow-up assessments at 3-, 5-, 8-, and 12-months;measured outcomes were drinks per week, drinks per drinking day, peak BAC, binge frequency (combined as a latent consumption variable), and alcohol-related problems. Latent growth curve analyses evaluated outcomes over the follow-up period as a function of condition. Conditions were equivalent at baseline and at 1M (all ps > 0.05). The BMI produced significant reductions on all outcomes (ps < 0.01). Exposure to email content did not significantly differ by condition (p > 0.05): participants viewed an average of 76%of the emails. Latent growth curve models revealed no main effects of condition on the latent consumption variable (B = 0.01 (0.01), p > 0.05). Unexpectedly, there was a main effect of the intervention on changes in problems between 1 and 12 months (B = 0.03 (0.01), p = 0.01); intervention participants increased self-reported problems more than controls. Neither of the outcomes was moderated by sex, baseline or 1-month consumption, or email exposure. Contrary to predictions, delivering e-boosters with corrective norms content did not improve outcomes over parallel e-boosters containing general health information. However, there is some evidence suggesting that continued contact, even if non-specific, may help to maintain gains achieved by a BMI.
Alcoholism: Clinical & Experimental Research, 40 : 310A
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Champion, K. E., Newton, N. C., Stapinski, L., Slade, T., Barrett, E. L., Teesson, M.
OBJECTIVE: Replication is an important step in evaluating evidence-based preventive interventions and is crucial for establishing the generalizability and wider impact of a program. Despite this, few replications have occurred in the prevention science field. This study aims to fill this gap by conducting a cross-validation trial of the Climate Schools: Alcohol and Cannabis course, an Internet-based prevention program, among a new cohort of Australian students.
METHOD: A cluster randomized controlled trial was conducted among 1103 students (Mage: 13.25 years) from 13 schools in Australia in 2012. Six schools received the Climate Schools course and 7 schools were randomized to a control group (health education as usual). All students completed a self-report survey at baseline and immediately post-intervention. Mixed-effects regressions were conducted for all outcome variables. Outcomes assessed included alcohol and cannabis use, knowledge and intentions to use these substances.
RESULTS: Compared to the control group, immediately post-intervention the intervention group reported significantly greater alcohol (d = 0.67) and cannabis knowledge (d = 0.72), were less likely to have consumed any alcohol (even a sip or taste) in the past 6 months (odds ratio = 0.69) and were less likely to intend on using alcohol in the future (odds ratio = 0.62). However, there were no effects for binge drinking, cannabis use or intentions to use cannabis.
CONCLUSION: These preliminary results provide some support for the Internet-based Climate Schools: Alcohol and Cannabis course as a feasible way of delivering alcohol and cannabis prevention. Intervention effects for alcohol and cannabis knowledge were consistent with results from the original trial; however, analyses of longer-term follow-up data are needed to provide a clearer indication of the efficacy of the intervention, particularly in relation to behavioral changes.
Copyright © The Royal Australian and New Zealand College of Psychiatrists 2015.
Australian & New Zealand Journal of Psychiatry, 50(1) : 64-73
- Year: 2016
- Problem: Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Carey, K. B., Scott-Sheldon, L. A. J., Garey, L., Elliott, J. C., Carey, M. P.
Objective: When college students violate campus alcohol policies, they typically receive disciplinary sanctions that include alcohol education or counseling. This meta-analysis evaluated the efficacy of these "mandated interventions" to prevent future alcohol misuse. Method: Studies were included if they evaluated an individual-or group-level intervention, sampled students mandated to an alcohol program, used a pretest-posttest design, and assessed alcohol use as an outcome. Thirty-one studies with 68 separate interventions (N = 8,621 participants; 35% women; 85% White) were coded by independent raters with respect to sample, design, methodological features, and intervention content; the raters also calculated weighted mean effect sizes, using random-effects models. A priori predictors were examined to explain variability in effect sizes. Results: In the 5 studies that used assessment-only control groups, mandated students reported significantly less drinking relative to controls (between-groups contrasts), d+ ranged from 0.13-0.20 for quantity and intoxication outcomes. In the 31 studies that provided within-group contrasts, significant effects were observed for all outcomes in the short-term (i.e., < 3 months postintervention), with d+ ranging from 0.14-0.27; however, fewer significant effects appeared at longer follow-ups. Four commercially available intervention protocols (i.e., BASICS, e-CHUG, Alcohol 101, and Alcohol Skills Training Program) were associated with risk reduction. Conclusions: Providing mandated interventions to students who violate campus alcohol policies is an effective short-term risk reduction strategy. Continued research is needed to maintain initial gains, identify the most useful intervention components, and determine the cost-effectiveness of delivery modes. Copyright © 2016 American Psychological Association.
Journal of Consulting & Clinical Psychology, 84(7) : 619-632
- Year: 2016
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Creative expression: music, dance, drama, art