Disorders - alcohol use
Murphy, J. G., Dennhardt, A. A., Borsari, B., Martens, M. P., Witkiewitz, K. A.
Purpose: Brief alcohol interventions (BAI) are associated with reductions in alcohol consumption and problems, but effect sizes are small and there is a need to increase efficacy. Behavioral economic variables such as low levels of proportionate substance-free reinforcement predict poor intervention response, and participants who successfully reduce their drinking tend to increase their participation in substance-free activities. We developed a substance-free activity session (SFAS) supplement to traditional BAIs that attempts to increase engagement in constructive alternatives to drinking by enhancing the salience of delayed rewards (academic/career success) and the patterns of behavior (academic engagement) leading to these outcomes. A pilot trial (N = 82) indicated that the SFAS was associated with incremental reductions in alcohol problems above and beyond a BAI and the current study attempted to replicate and extended those results. Methods: We conducted a randomized 3-group (BAI+SFAS vs. BAI+Relaxation Training vs. Assessment-only) trial with heavy drinking college students (N = 425) recruited from two large public universities. Participants randomized to one of the two invention conditions completed an identical BAI modeled after the BASICS programand were then randomized to either the SFAS or the Relaxation session. The SFAS is a 50-min clinician-administered session delivered in motivational interviewing style. Relaxation was also an individual session and included diaphragmatic breathing and progressive muscle relaxation. At present complete outcome data are available for 254 participants at the 6-month follow-up. Results: At 6-month follow-up the BAI + SFAS was associated with larger reductions in alcohol problems (dw = 0.78) compared to the BAI+Relaxation (dw = 0.59), and the Assessment-only (dw = 0.32) control conditions (p < 0.05). Consistent with the results of the pilot trial, the SFAS was especially efficacious (p < 0.05), relative to the two control conditions, for students who at baseline reported symptoms of depression (dws = 1.03, 0.49, & 0.18, respectively). Conclusion: The addition of a behavioral economic session focused on increasing engagement in goal-directed and future-oriented alternatives to drinking improved BAI outcomes. Given the brevity of the SFAS it has the potential to be disseminated as a way of enhancing the effects of BAI and may be especially efficacious for young adults with symptoms of depression.
Alcoholism: Clinical and Experimental Research, 40 : 310A
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Relaxation
Napper, L. E., LaBrie, J. W., Earle, A. M.
This study examined the efficacy of a personalized normative feedback (PNF) alcohol intervention for parents of students transitioning into college. A sample of 399 parent-student dyads were recruited to take part in the intervention during the summer prior to matriculation. Parents were randomly assigned to receive either normative feedback regarding student drinking and other college parents' alcohol-related communication or general college health norm information. Students completed measures of alcohol use, alcohol consequences, and parent-child alcohol-specific communication both 1 and 6 months after matriculation. The results indicated that in comparison with the control condition parents who received PNF reported immediate changes in their perceptions of other parents' behaviors; however, these changes in parent perceived norms did not translate into long-term changes in student drinking behaviors or parent-child communication. Findings highlight the need to consider content beyond normative feedback for parent based alcohol intervention. Copyright © 2016 American Psychological Association.
Psychology of Addictive Behaviors, 30(8) : 802-810
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Norman, P., Wrona-Clarke, A.
Studies testing the effects of self-affirmation on alcohol-related cognitions and behavior in university students have produced equivocal results. Because self-affirmation is a motivational technique (i.e., designed to reduce defensive processing) it may need to be supplemented with volitional techniques, such as forming if-then plans, to translate positive intentions into behavior. Participants (N = 348) were randomly assigned to conditions in a 2 (self-affirmation) x 2 (implementation intention) betweenparticipants factorial design. Participants completed a self-affirmation task (i.e., values essay) or not, read a summary about the health risks of binge drinking (8/6 units for men/women), and then completed an implementation intention task (i.e., forming if-then plans) or not. Participants then completed measures of message derogation, perceived risk, and intention as well as alcohol consumption 1 week later. All main and interaction effects for self-affirmation were nonsignificant. In contrast, participants who formed implementation intentions (vs. not) reported drinking fewer units of alcohol and engaged in binge drinking less frequently at 1-week follow-up. Additional analyses revealed that affirming a social value attenuated the effect of self-affirmation on intention, but augmented the effect of implementation intentions on behavior. Overall, the findings provide additional evidence for the positive effects of implementation intentions but question the use of self-affirmation to reduce alcohol consumption in university students. Copyright © 2015 American Psychological Association.
Psychology of Addictive Behaviors, 30(4) : 434-441
- 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
Pedersen, E. R., Parast, L., Marshall, G. N., Schell, T. L., Neighbors, C.
Young adult veterans from the wars in Iraq and Afghanistan represent a population at-risk for heavy and problematic alcohol use. Unfortunately, few seek treatment for alcohol concerns and those that do seek care may drop out from lengthy multicomponent treatments. The objective of this randomized controlled trial was to develop and pilot test a very brief alcohol intervention that can be delivered over the Internet to reach a broad population of young adult veterans to help them reduce their drinking. Veterans were recruited from Facebook and randomized to either control or a personalized normative feedback (PNF) intervention seeking to reduce perceptions of drinking of other genderspecific young adult veterans. Veteran participants (N = 784) completed a baseline survey and were randomized, 756 (96.4%) completed an immediate post-intervention survey, and 622 (79.3%) completed a one-month follow-up survey. Outcomes assessed at immediate post-intervention were changes in perceived norms and intentions to drink in the next month. One-month follow-up outcomes were changes in total drinks per week, average drinks, binge drinking, and alcohol-related consequences. At immediate post-intervention, control participants reduced their perceptions by approximately 6 drinks, while PNF participants reduced perceptions by about 17 drinks, p < 0.001. PNF participants also reported significantly greater reductions in intended drinking (about 3 less drinks per week) compared to controls (one-half less drink per week), p < 0.001. At one-month follow- up, compared to control, PNF participants reported significantly fewer drinks per week (change of about 8 drinks per week compared to 5 drinks for control), average drinks per occasion (change of about 1.5 drinks compared to change of 1 drink for control), and consequences in the past month (change of about 3 less consequences in the past month compared to 2 less consequences for control) (all p < 0.05). There were no significant differences in binge drinking changes between conditions. Though effects were modest and assessed in the short-term only, these findings have the potential to inform broader, population-level programs designed for young veterans to prevent escalation of drinking and development of long-term alcohol problems. Given the simplicity of the PNF approach, ease of administration, and broad reach via the Internet, even modest effects may have a broad public health impact on the veteran population in need.
Alcoholism: Clinical and Experimental Research, 40 : 68A
- 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)
Mun, E. Y., Garfinkle, E.
Standard meta-analysis combines aggregated data (e.g., standardized mean difference estimates) across studies and derives a single overall estimate per outcome. For this reason, standard meta-analysis is also called univariate meta-analysis. Multivariate meta-analysis, compared to standard meta-analysis, produces more desirable estimates by taking into account within-study correlations among multiple, related treatment outcomes from typical randomized clinical trials (Jackson et al., 2011).We utilized a multivariate, random-effects meta-analysis model to examine the effects of brief alcohol interventions for college students on two related endpoints: protective behavioral strategies and alcohol-related problems. Data for the current analysis come from Project INTEGRATE (Mun et al., 2015), a large-scale research synthesis project utilizing individual participant data from multiple independent trials. We analyzed the most immediate follow-up data post intervention (3,710 participants from10 studies at 1-3 month follow-up for studies 2, 9, 12, 16, 18, and 21 and at 12-month follow- up for studies 8a-c and 22). Most of the interventions were brief motivational interventions (i.e., in-person motivational interviews with personalized feedback, personalized feedback only, or group motivational interviews), and all intervention groups were compared with no treatment controls. Latent trait scores for both of the out come measures were obtained from the separate item response theory analyses conducted to make scores comparable across follow-up periods, individuals, and studies (Huo et al., 2015). We used meta SEM, an R package, to compute sample-size adjusted standardized mean difference estimates, and variance and covariance estimates, and to combine all estimates across studies. The estimated average population effect sizes for protective behavioral strategies and alcohol-related problems were 0.08 (95%CI = 0.007 to 0.154) and -0.01 (95% CI = -0.158 to 0.133), respectively. Results indicated that those who received any brief alcohol interventions, compared to controls, had significantly higher levels of protective behavioral strategies. None of the studies individually had a statistically significant intervention effect on protective behavioral strategies, suggesting that these studies lacked power to detect the effect, when it truly existed, and that the lack of an effect in individual trials should be cautiously interpreted. The results on alcohol- related problems were consistent with the previous study (Huh et al., 2015). However, between study variability surrounding the combined effect was substantial (I squared = 0.76) in the current analysis, suggesting that the effects on alcohol-related problems greatly varied across studies. The results suggest a need to examine subgroups and subsets of interventions with better effects on alcohol-related problems. Finally, the multivariate meta-analysis methods are based on a more reasonable assumption about missing data at the study level (missing at random vs. missing completely at random); is more elegant and efficient; and reduces the risk of inflated type I error, compared to the standard univariate meta-analysis methods. Despite these advantages, the implementation of the multivariate meta-analysis methods for applied research has been hampered by the difficulty of obtaining within-study correlation estimates from published studies. In the current study, we directly estimated them from individual participant data, which highlights the promise of sharing individual participant data when attempting to take advantage of innovative analytical solutions for new discoveries and to improve scientific rigor.
Alcoholism: Clinical and Experimental Research, 40 : 124A
- Year: 2016
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback
Newbury-Birch, D., McGovern, R., Birch, J., O'Neill, G., Kaner, H., Sondhi, A., Lynch, K.
PURPOSE: The purpose of this paper is to review the evidence of alcohol use disorders within the different stages of the criminal justice system in the UK. Furthermore it reviewed the worldwide evidence of alcohol brief interventions in the various stages of the criminal justice system.
DESIGN/METHODOLOGY/APPROACH: A rapid systematic review of publications was conducted from the year 2000 to 2014 regarding the prevalence of alcohol use disorders in the various stages of the criminal justice system. The second part of the work was a rapid review of effectiveness studies of interventions for alcohol brief interventions. Studies were included if they had a comparison group. Worldwide evidence was included that consisted of up to three hours of face-to-face brief intervention either in one session or numerous sessions.
FINDINGS: This review found that 64-88 per cent of adults in the police custody setting; 95 per cent in the magistrate court setting; 53-69 per cent in the probation setting and 5,913-863 per cent in the prison system and 64 per cent of young people in the criminal justice system in the UK scored positive for an alcohol use disorder. There is very little evidence of effectiveness of brief interventions in the various stages of the criminal justice system mainly due to the lack of follow-up data.
SOCIAL IMPLICATIONS: Brief alcohol interventions have a large and robust evidence base for reducing alcohol use in risky drinkers, particularly in primary care settings. However, there is little evidence of effect upon drinking levels in criminal justice settings. Whilst the approach shows promise with some effects being shown on alcohol-related harm as well as with young people in the USA, more robust research is needed to ascertain effectiveness of alcohol brief interventions in this setting.
ORIGINALITY/VALUE: This paper provides evidence of alcohol use disorders in the different stages of the criminal justice system in the UK using a validated tool as well as reviewing the worldwide evidence for short ( < three hours) alcohol brief intervention in this setting.
International journal of prison health., 12(1) : 57-70
- Year: 2016
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback
O'Rourke, L., Humphris, G., Baldacchino, A.
Previous reviews have specifically looked at computer-based or Internet-based approaches. However, there has been no systematic review focused upon electronic communication based interventions for hazardous young drinkers. Out of 3298 relevant citations, 13 papers consisting of 11 studies met the inclusion criteria. Effectiveness of intervention delivery was assessed using behavioural outcomes. Eight papers delivered interventions using the Web, three implemented text messaging, one used a mobile phone app and the remaining paper used a social networking site. The ability to provide personalized electronic feedback resulted in a reduction in alcohol consumption, frequency of binge drinking, and drinking in a non-risky way. However, intervention length did not appear to have an impact on overall effectiveness. Usage of text messaging and Social Network Sites (SNS) increased accessibility and ease of engaging in an intervention that is appealing and acceptable for young adults. Copyright © 2016 Elsevier Ltd
Neuroscience and Biobehavioral Reviews, 68 : 880-890
- Year: 2016
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Prestwich, A., Kellar, I., Conner, M., Lawton, R., Gardner, P., Turgut, L.
Objective: Past research has suggested that social influences on drinking can be manipulated with subsequent reductions in alcohol intake. However, the experimental evidence for this and the best strategies to positively change these social influences have not been meta-analyzed. This research addressed these gaps. Method: Randomized controlled trials testing social influence-based interventions on adults drinking were systematically reviewed and meta-analyzed. The behavior change techniques used in each study were coded and the effect sizes showing the impact of each intervention on (a) social influence and (b) alcohol intake were calculated. Metaregressions identified the association between these effect sizes, as well as the effect of specific behavior change techniques on social influences. Results: Forty-one studies comprising 17,445 participants were included. Changes in social influences were significantly associated with changes in alcohol intake. However, even moderate-to-large changes in social influences corresponded with only a small change in drinking behavior and changing social influences did not reduce alcohol-related problems. Providing normative information about others behavior and experiences was the most effective technique to change social influences. Conclusions: Social influences and normative beliefs can be changed in drinkers, particularly by providing normative information about how much others drink. However, even generating large changes in these constructs are likely to engender only small changes in alcohol intake. Copyright © 2016 American Psychological Association.
Journal of Consulting and Clinical Psychology, 84(10) : 845-860
- 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, Personalised feedback, normative feedback
Strohman, A. S., Braje, S. E., Alhassoon, O. M., Shuttleworth, S., Van-Slyke, J., Gandy, S.
Background: Because of their ability to reach a much wider audience than face-to-face counseling or psychoeducation, computer-delivered interventions for risky or potentially problematic use have been increasing on college campuses. However, there are very few studies that examine who benefits most from such interventions. Objectives: The purpose of this study was to determine if participation in Alcohol-Wise, a computerized intervention, is associated with changes in alcohol drinking behavior and its consequences, perceptions of college drinking norms, and expectancies. It was hypothesized that class level (i.e. freshman/sophomore versus junior/senior) would moderate the effectiveness of Alcohol-Wise. Method: College students (n = 58) were randomly assigned to one of two conditions: (i) the computer-delivered intervention or (ii) wait-list control. Measures were completed at baseline and approximately 30-days later. Results: At follow-up, freshman and sophomore students in the intervention group showed significant reduction in peak number of standard drinks and blood alcohol concentration, but the effect was not observed for juniors and seniors. The intervention group reported more accurate estimates of drinking norms at follow-up relative to controls. There were no significant changes over time in alcohol expectancies in either group. Conclusion: This study provides support for the potential usefulness of Alcohol-Wise intervention at reducing short-term drinking among underclassmen but not upperclassmen in a 4-year college setting. These findings suggest that computerized interventions may be more effective when provided early, but not later, in a students college career. Copyright © 2016 Taylor & Francis.
American Journal of Drug and Alcohol Abuse, 42(1) : 15-24
- Year: 2016
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Tucker, J. S., D'Amico, E. J., Ewing, B. A., Miles, J. N. V., Pedersen, E. R.
Purpose: Homeless young adults between the ages of 18 and 25 exhibit high rates of alcohol use, as well as drug use and sexual risk behaviors. Yet few risk reduction programs exist for this at-risk population, particularly ones that are both effective and can be easily incorporated into settings serving this population (e.g., drop-in centers). This study addresses an important gap in prevention services for homeless emerging adults by conducting a pilot cluster cross-over randomized controlled trial of AWARE, a group-MI (Motivational Interviewing) brief risk reduction intervention focusing on reducing both substance use and sexual risk behavior. Methods: AWARE consists of four 45-min sessions. Rolling admission is used so that youth can join the program at any time, regardless of session. The evaluation took place in two drop-in centers for homeless young adults in the Los Angeles area. Homeless young adults ages 18-25 (mean age = 21.8) received the AWARE program (n = 100) or usual care (n = 100). The sample was 73% male, 79% heterosexual, and 31%non-Hispanic white. Surveys were completed at baseline and 3 months after program completion. The 3-months follow-up rate for the sample was 91%. Results: Satisfaction with the program was high and nearly half (48%) of AWARE participants completed all four sessions. At follow-up, AWARE participants reported a lower frequency of alcohol use over the past 3 months (p = 0.01), were less likely to be classified as a frequent heavy drinker (compared to a non-drinker) in the past 30 days (p = 0.05), and showed a marginally significant positive difference in their confidence that they could reduce/quit their drinking (p = 0.09), compared to control participants. In addition, AWARE participants showed significant increases in both their readiness (p = 0.02) and confidence (p = 0.02) to change their drug use, compared to control participants. In terms of sex-related outcomes, AWARE participants reported greater condom use self-efficacy than the control group at follow-up (p = 0.05), but intervention effects were not found for number of partners or condomuse. Conclusion: Results from this pilot evaluation are promising, suggesting that a brief group-MI intervention can be effective in helping homeless young adults make positive changes in their alcohol use, as well as strengthen their motivation to reduce their drug use and their condom use self-efficacy.
Alcoholism: Clinical and Experimental Research, 40 : 311A
- Year: 2016
- Problem: Substance Use Disorders (any), 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
Suffoletto, B., Kristan, J., Chung, T., Jeong, K., Fabio, A., Monti, P., Clark, D. B.
Background Binge drinking is associated with numerous negative consequences. The prevalence and intensity of binge drinking is highest among young adults. This randomized trial tested the efficacy of a 12-week interactive text message intervention to reduce binge drinking up to 6 months after intervention completion among young adults. Methods and Findings Young adult participants (18-25 y; n = 765) drinking above the low-risk limits (AUDIT-C score >3/4 women/men), but not seeking alcohol treatment, were enrolled from 4 Emergency Departments (EDs) in Pittsburgh, PA. Participants were randomized to one of three conditions in a 2:1:1 allocation ratio: SMS Assessments + Feedback (SA+F), SMS Assessments (SA), or control. For 12 weeks, SA+F participants received texts each Thursday querying weekend drinking plans and prompting drinking limit goal commitment and each Sunday querying weekend drinking quantity. SA+F participants received tailored feedback based on their text responses. To contrast the effects of SA+F with self-monitoring, SA participants received texts on Sundays querying drinking quantity, but did not receive alcoholspecific feedback. The control arm received standard care. Follow-up outcome data collected through web-based surveys were provided by 78% of participants at 3- months, 63% at 6-months and 55% at 9-months. Multiple imputation-derived, intent-to-treat models were used for primary analysis. At 9-months, participants in the SA+F group reported greater reductions in the number of binge drinking days than participants in the control group (incident rate ratio [IRR] 0.69; 95% CI .59 to.79), lower binge drinking prevalence (odds ratio [OR] 0.52; 95% CI 0.26 to 0.98]), less drinks per drinking day (beta -.62; 95% CI -1.10 to -0.15) and lower alcohol-related injury prevalence (OR 0.42; 95% CI 0.21 to 0.88). Participants in the SA group did not reduce drinking or alcohol-related injury relative to controls. Findings were similar using complete case analyses. Conclusions An interactive text-message intervention was more effective than self-monitoring or controls in reducing alcohol consumption and alcohol-related injury prevalence up to 6 months after intervention completion. These findings, if replicated, suggest a scalable approach to help achieve sustained reductions in binge drinking and accompanying injuries among young adults.
PLoS ONE, 10(11) :
- Year: 2015
- 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)
Terlecki, M. A., Buckner, J. D., Larimer, M. E., Copeland, A. L.
This is the first randomized trial testing whether heavy-drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy-drinking volunteers up to 1 year postintervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; M age = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months postintervention. At 4 weeks postintervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer), BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds =.41-.92). BASICS had a large effect on decreases in alcohol problems (d =.87). At 12 months postintervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d =.56) compared with controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds =.42;.11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to 1 year postintervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students.
Psychology of Addictive Behaviors, 29(1) : 2-16
- Year: 2015
- Problem: 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, Personalised feedback, normative feedback