Disorders - Alcohol Use
Donoghue, K., Patton, R., Phillips, T., Deluca, P., Drummond, C.
Background: Electronic screening and brief intervention (eSBI) has been shown to reduce alcohol consumption, but its effectiveness over time has not been subject to meta-analysis.; Objective: The current study aims to conduct a systematic review and meta-analysis of the available literature to determine the effectiveness of eSBI over time in nontreatment-seeking hazardous/harmful drinkers.; Methods: A systematic review and meta-analysis of relevant studies identified through searching the electronic databases PsychINFO, Medline, and EMBASE in May 2013. Two members of the study team independently screened studies for inclusion criteria and extracted data. Studies reporting data that could be transformed into grams of ethanol per week were included in the meta-analysis. The mean difference in grams of ethanol per week between eSBI and control groups was weighted using the random-effects method based on the inverse-variance approach to control for differences in sample size between studies.; Results: There was a statistically significant mean difference in grams of ethanol consumed per week between those receiving an eSBI versus controls at up to 3 months (mean difference -32.74, 95% CI -56.80 to -8.68, z=2.67, P=.01), 3 to less than 6 months (mean difference -17.33, 95% CI -31.82 to -2.84, z=2.34, P=.02), and from 6 months to less than 12 months follow-up (mean difference -14.91, 95% CI -25.56 to -4.26, z=2.74, P=.01). No statistically significant difference was found at a follow-up period of 12 months or greater (mean difference -7.46, 95% CI -25.34 to 10.43, z=0.82, P=.41).; Conclusions: A significant reduction in weekly alcohol consumption between intervention and control conditions was demonstrated between 3 months and less than 12 months follow-up indicating eSBI is an effective intervention.;
Journal of Medical Internet Research, 16(6) : e142-e142
- Year: 2014
- Problem: Alcohol Use
- Type: Systematic reviews
-
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)
Gaume, J., Magill, M., Longabaugh, R., Bertholet, N., Gmel, G., Daeppen, J. B.
Background: Brief motivational intervention (BMI) has shown promising results to reduce alcohol use in young adults. Knowledge on mechanisms that predict BMI efficacy could potentially improve treatment effect sizes through data that optimize clinical training and implementation. Particularly, little attention has been given to counselor influence on treatment mechanisms. Methods: We investigated the influence of counselors on BMI efficacy in reducing alcohol use among non-treatment-seeking young men (age 20) screened as hazardous drinkers. Participants were randomly allocated to (i) a group receiving a single BMI from 1 of 18 counselors selected to maximize differences in several of their characteristics (gender, professional status, clinical experience, and motivational interviewing [MI] experience) or (ii) a control group receiving assessment only. Drinking at 3-month follow-up was first compared between the BMI and control groups to assess efficacy. Then, the influence of counselors' characteristics (i.e., gender, professional status, clinical experience, MI experience, BMI attitudes, and expectancies) and within-session behaviors (i.e., measured by the Motivational Interviewing Skill Code) on outcome was tested in regression analyses. Results: There was a significant (p = 0.02) decrease in alcohol use among the BMI group compared to the control group. Counselors that were male, more experienced, that had more favorable BMI attitudes and expectancies, higher MI skills, but surprisingly less MI-consistent behaviors, had significantly better outcomes than the control group while their counterparts did not. Conclusions: The current study demonstrated BMI efficacy on alcohol use reduction within a sample of non-treatment-seeking young adult males. Moreover, BMI effect was related to interindividual differences among counselors, and results therefore provide recommendations for BMI training and implementation with similar populations. © 2014 Research Society on Alcoholism.
Alcoholism: Clinical & Experimental Research, 38(7) : 2138-2147
- Year: 2014
- 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
Foxcroft, David. R., Coombes, L., Wood, S., Allen, D., Almeida-Santimano, N. M. L.,
Background: Globally, harmful use of alcohol results in approximately 2.5 million deaths each year. About 9% of these deaths are young people between the ages of 15 and 29 years (WHO 2011), mainly resulting from motor vehicle accidents, homicides, suicides and drownings. Hazardous drinking levels for men (consuming over 40 g/day alcohol on average, that is 5 units) double the risk of liver disease, raised blood pressure, some cancers and violent death (because some people who have this average alcohol consumption drink heavily on some days). For women, over 24 g/day average alcohol consumption (3 units) increases the risk for developing liver disease and breast cancer. Motivational interviewing (MI) is a popular technique for addressing excessive drinking in young adults but its effectiveness has not previously been examined in a Cochrane review.; Objectives: The specific objectives were:(1) to summarise current evidence about the effects of MI intended to address alcohol and alcohol-related problems in young adults, compared with no intervention or a different intervention, on alcohol consumption and other substantive outcome measures;(2) to investigate whether the effects of MI are modified by the length of the intervention.; Search Methods: Relevant evidence was identified from (1) Cochrane Central Register of Controlled Trials (CENTRAL) (October 2013), (2) MEDLINE (January 1966 to October 2013), (3) EMBASE (January 1988 to October 2013), and (4) PsycINFO (1985 to October 2013). References of topic-related systematic reviews and the included studies were handsearched.; Selection Criteria: Randomised controlled trials and cluster randomised controlled trials of young people up to the age of 25 years in college and non-college settings comparing MIs with no intervention or a different intervention for prevention of alcohol misuse and alcohol-related problems were included.; Data Collection and Analysis: We used the standard methodological procedures expected by The Cochrane Collaboration.; Main Results: A total of 66 randomised trials (17,901 participants) were included four of which were cluster randomised. Studies with longer-term follow-up (four plus months) were of more interest when considering the sustainability of intervention effects.At four or more months follow-up, effects were found for the quantity of alcohol consumed (standardised mean difference (SMD) -0.14; 95% confidence interval (CI) -0.20 to -0.08 or a reduction from 13.7 drinks/week to 12.2 drinks/week), moderate quality of evidence; frequency of alcohol consumption (SMD -0.11; 95% CI -0.19 to -0.03 or a reduction in the number of days/week alcohol was consumed from 2.74 days to 2.57 days), moderate quality of evidence; and peak blood alcohol concentration (BAC) (SMD -0.14; 95% CI -0.23 to -0.05 or a decrease in peak BAC from 0.144% to 0.129%), moderate quality of evidence. A marginal effect was found for alcohol problems (SMD -0.08; 95% CI -0.15 to 0.00 or a reduction in an alcohol problems scale score from 8.91 to 8.18), low quality of evidence. No effects were found for binge drinking (SMD -0.05; 95% CI -0.12 to 0.01), moderate quality of evidence; or average BAC (SMD -0.08; 95% CI -0.22 to 0.06), moderate quality of evidence. We also considered other outcomes and at four or more months follow-up we found no effects on drink-driving (SMD -0.11; 95% CI -0.31 to 0.09), moderate quality of evidence; or other alcohol-related risky behaviour (SMD -0.14; 95% CI -0.30 to 0.02), moderate quality of evidence.Further analyses showed that the type of control comparison (assessment only versus alternative intervention) did not predict the outcome in a clear or straightforward way; and there was no consistent relationship between the duration of the MI intervention (in minutes) and effect size.; Authors' Conclusions: The results of this review indicate that there are no substantive, meaningful benefits of MI interventions for the prevention of alcohol misuse. Although some significant effects were found, we interpret the effect sizes as being too small, g ven the measurement scales used in the studies included in the review, to be of relevance to policy or practice. Moreover, the statistically significant effects are not consistent for all misuse measures, heterogeneity was a problem in some analyses and bias cannot be discounted as a potential cause of these findings.;
Cochrane Database of Systematic Reviews, 8 : CD007025
- Year: 2014
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Gajecki, M., Berman, A. H., Sinadinovic, K., Rosendahl, I., Andersson, C.
Brief interventions via the internet have been shown to reduce university students' alcohol intake. This study tested two smartphone applications (apps) targeting drinking choices on party occasions, with the goal of reducing problematic alcohol intake among Swedish university students. Students were recruited via e-mails sent to student union members at two universities. Those who gave informed consent, had a smartphone, and showed risky alcohol consumption according to the Alcohol Use Disorders Identification Test (AUDIT) were randomized into three groups. Group 1 had access to the Swedish government alcohol monopoly's app, Promillekoll, offering real-time estimated blood alcohol concentration (eBAC) calculation; Group 2 had access to a web-based app, PartyPlanner, developed by the research group, offering real-time eBAC calculation with planning and follow-up functions; and Group 3 participants were controls. Follow-up was conducted at 7 weeks. Among 28574 students offered participation, 4823 agreed to join; 415 were excluded due to incomplete data, and 1932 fulfilled eligibility criteria for randomization. Attrition was 22.7-39.3 percent, higher among heavier drinkers and highest in Group 2. Self-reported app use was higher in Group 1 (74%) compared to Group 2 (41%). Per-protocol analyses revealed only one significant time-by-group interaction, where Group 1 participants increased the frequency of their drinking occasions compared to controls (p = 0.001). Secondary analyses by gender showed a significant difference among men in Group 1 for frequency of drinking occasions per week (p = 0.001), but not among women. Among all participants, 29 percent showed high-risk drinking, over the recommended weekly drinking levels of 9 (women) and 14 (men) standard glasses. Smartphone apps can make brief interventions available to large numbers of university students. The apps studied using eBAC calculation did not, however, seem to affect alcohol consumption among university students and one app may have led to a negative effect among men. Future research should: 1) explore ways to increase user retention, 2) include apps facilitating technical manipulation for evaluation of added components, 3) explore the effects of adapting app content to possible gender differences, and 4) offer additional interventions to high-risk users. clinicaltrials.gov: NCT01958398.
Addiction Science & Clinical Practice, 9 : 11
- Year: 2014
- 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, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Hernandez, L., Spirito, A.
Adolescence is a developmental periodmarked by the onset and escalation of alcohol use. Recent studies have identified sibling drinking as one of the key predictors of heavy drinking in adolescence, suggesting that sibling influences are a critically important target for family-based interventions. Unfortunately, adolescence is also marked by decreases in parental monitoring and communication, parenting behaviors that serve as protective factors for alcohol abuse. Thus, programs that foster parenting behaviors and enhance family relationships are an important area of research. The purpose of the current study was to evaluate the efficacy of a sibling enhanced Family Check-Up (FCU) when applied to both an adolescent identified patient (IP) and a sibling close in age. The goal of this enhanced FCU was to provide individualized feedback that is tailored to specific parenting skills as they pertain to the IP and sibling in the family. Specific parenting skills addressed includedmonitoring and supervision, limit setting, and alcohol-related communication. A total of 92 parents and adolescents and their siblings (Mage=14.94) were recruited and randomized into one of two conditions, the FCU (n=47) or a psychoeducation (PE) intervention (n=45) which provided parents with information on the dangers of adolescent drinking. Primary analyses examined group differences across drinking outcomes for adolescents and siblings at 3, 6, and 12-month follow-ups controlling for baseline drinking, gender and age. Further, parenting-related mediators (monitoring, communication, etc.) of adolescent change were also examined across these three time points. Preliminary results revealed a significant increase between 3 and 6 months follow-ups on number of heavy drinking days for adolescents in the PE condition, and a significant reduction in the average number of drinks consumed on heavy drinking days for adolescents in the FCU condition. However, these effects were not evident at 12-month follow-up. There were no significant differences across drinking outcomes for siblings or across hypothesized parenting-relatedmediators for parents between the two conditions. The results of this study suggest the need for booster sessions tomaintain the effects of the FCU on heaving drinking, as well as suggest that the effects of this brief parent-based interventionmay be enhanced if coupled with a direct adolescent and sibling component.
Alcoholism: Clinical & Experimental Research, 38 : 307A
- Year: 2014
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Lynch, S., Dawson, A., Worth, J.
Despite a downward trend in alcohol consumption among 11-15-year-olds in recent years (Fuller, E, ed. 2013. Smoking, Drinking and Drug Use Among Young People in England in 2012. London: Health and Social Care Information Centre. http://www.hscic.gov.uk/catalogue/PUB11334), the proportion of young people seeking support from alcohol-related specialist services, and the societal and monetary costs associated with alcohol consumption, need to be addressed. Education can play an important role in this. The evaluation of the Alcohol Education Trust's Talk About Alcohol school-based intervention was conducted across England between November 2011 and October 2013 by independent evaluators. The aim was to compare the alcohol-related knowledge, awareness, and behaviour of students aged 12-14 in an intervention group with a statistically matched comparison group. Three identical surveys were carried out with approximately 4000 students to explore change over time over a 16-18-month timeframe. Multilevel modelling looked at changes in outcomes over the three time points and control for measured differences between intervention and comparison groups. There was evidence of a statistically significant delay in the age at which teenagers start to drink. There was also a significant association between the intervention and knowledge of alcohol and its effects. Although levels of frequency of drinking and binge drinking were lower than in the comparison schools, there were no statistically significant differences. Students from both groups identified personal, social, and health education lessons as a preferred source of information about alcohol and its effects. The positive impact on alcohol knowledge and the delayed onset of drinking show that the materials may support England's policy priorities around alcohol.
International Journal of Health Promotion & Education, 52(5) : 283-299
- Year: 2014
- Problem: Alcohol Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation
McKay, M., Sumnall, H., McBride, N., Harvey, S.
While evidence has accumulated suggesting that prevention initiatives may have a limited impact on alcohol use behaviour, reviews suggest that interventions with most potential for behavioural change are interactive and developmental in design. The School Health and Alcohol Harm Reduction Project (SHAHRP) is an example of such an intervention. Researchers are increasingly attempting to understand the differential effects of programmes in population subgroups. The present study is a secondary analysis of data from a non-randomised trial of SHAHRP, a classroom-based alcohol education intervention, involving school children (aged 13-16 years old) in the United Kingdom. Results showed that there were significant positive changes in knowledge about and attitudes towards alcohol in baseline abstainers, supervised drinkers and unsupervised drinkers. Significant positive behavioural effects in terms of amounts consumed, frequency of drinking and self-reported alcohol related harms, were observed almost exclusively among baseline unsupervised drinkers. These behavioural effects support those previously observed in Australia and suggest that the intervention is a viable health promotion tool in the UK.; Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Journal of Adolescence, 37(7) : 1057-1067
- Year: 2014
- Problem: Alcohol Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Harris, S. K., Knight, J. R.
Alcohol is strongly linked to the leading causes of adolescent and adult mortality and health problems, making medical settings such as primary care and emergency departments important venues for addressing alcohol use. Extensive research evidence supports the effectiveness of alcohol screening and brief interventions (SBIs) in medical settings, but this valuable strategy remains underused, with medical staff citing lack of time and training as major implementation barriers. Technology-based tools may offer a way to improve efficiency and quality of SBI delivery in such settings. This review describes the latest research examining the feasibility and efficacy of computer- or other technology-based alcohol SBI tools in medical settings, as they relate to the following three patient populations: adults (18 years or older); pregnant women; and adolescents (17 years or younger).The small but growing evidence base generally shows strong feasibility and acceptability of technology-based SBI in medical settings. However, evidence for effectiveness in changing alcohol use is limited in this young field.
Alcohol Research: Current Reviews, 36(1) : 63-79
- Year: 2014
- Problem: Alcohol Use
- Type: Systematic reviews
-
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)
Huh, D., Atkins, D. C., Larimer, M. E., Ray, A. E., White, H. R., Mun, E. Y.
Objective: For over two decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), which use an empathic and non-confrontational approach to increase motivation to change, often by providing personalized feedback (PF) designed to heighten awareness of patterns of use, norms, and related consequences, and non-in-person PF interventions delivered viamail, computer, or the web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small. Method: The present study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. Unlike typical meta-analysis based on summary data, IPD meta-analysis allows for an analysis that correctly accommodates the sampling, sample characteristics, and distributions of the pooled data. In particular, highly skewed distributions withmany zeroes that are typical for drinkingmeasures need to be accounted for, and cannot be accommodated in meta-analyses of summary statistics. The data come from Project INTEGRATE, one of the largest IPD meta-analysis projects to date in the field of alcohol intervention research, representing 8,275 individuals each with 2 to 5 repeated measures up to 12 months post-baseline. Results: We used Bayesian multilevel Hurdle Poisson and Gaussian models to estimate intervention effects on (1) drinks per week and (2) alcohol problems, respectively. Overall intervention effects were small and not statistically significant for drinks per week (Logit: OR=0. 86, CI=0. 71, 1. 06; Count: RR=0. 98, CI=0. 95, 1. 01) and alcohol problems (B=0. 01, CI=-0. 01, 0. 04) at alpha=0. 05. We conducted post hoc comparisons of three BMI types (Individual MI with PF, PF only, and GroupMI) vs. control. There were no statistically significant intervention effects for drinks per week. However, there was a small, statistically significant reduction in alcohol problems among participants who received an individual MI with PF (B=-0. 06, CI=-0. 11, 0. 00). Short-term and long-term results were similar. Conclusions: The present study questions whether the prevailing use of BMIs on campuses is cost-effective, and suggests the need for more effective intervention strategies.
Alcoholism: Clinical & Experimental Research, 38 : 211A
- Year: 2014
- 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
Hustad, John T. P., Mastroleo, N. R., Kong, L., Urwin, R., Zeman, S., Lasalle, L., Borsari, B.
Individual brief motivational intervention (iBMI) is an efficacious strategy to reduce heavy drinking by students who are mandated to receive an alcohol intervention following an alcohol-related event. However, despite the strong empirical support for iBMI, it is unknown if the results from rigorously controlled research on iBMI translate to real-world settings. Furthermore, many colleges lack the resources to provide iBMI to mandated students. Therefore, group-delivered BMI (gBMI) might be a cost-effective alternative that can be delivered to a large number of individuals. The purpose of this study was to conduct a comparative effectiveness evaluation of iBMI and gBMI as delivered by staff at a university health services center. Participants (N = 278) were college students who were mandated to receive an alcohol intervention following an alcohol-related incident. Participants were randomized to receive an individual (iBMI; n = 133) or a Group BMI (gBMI; n = 145). Results indicated that both iBMI and gBMI participants reduced their peak estimated blood alcohol concentration (BAC) and the number of negative alcohol-related consequences at 1-, 3-, and 6-months postintervention. The iBMI and gBMI conditions were not significantly different at follow-up. These findings provide preliminary support for the use of iBMI and gBMIs for college students in real-world settings.;
Psychology of Addictive Behaviors, 28(1) : 74-84
- Year: 2014
- 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
Gaume, J., McCambridge, J., Bertholet, N., Daeppen, J. B.
A growing body of evidence has shown efficacy of brief intervention (BI) for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings, and effectiveness when implemented at larger scale is disappointing. Indeed, BI comprises varying content, and exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness. We searched Medline and PsychInfo, as well as references of retrieved publications for original research or reviews on active ingredients (or components, or mechanisms) of face-to face BIs (and its subtypes, including brief advice and brief motivational interviewing [BMI]) for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among Emergency Room patients, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator ; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such. Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions. © 2014 Gaume, Mccambridge, Bertholet and Daeppen.
Frontiers in Psychiatry, 5(AUG) :
- Year: 2014
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions
Koning, I. M., Lugtig, P., Vollebergh, W. A. M.
The effects of an intervention designed to prevent onset of weekly drinking in non drinking students (PAS) were investigated in the group of students that was already drinking at baseline. A cluster randomized trial was used including 3,490 Dutch early adolescents (M age. =. 12.66, SD=. 0.49) randomized over four conditions; 1) parent intervention, 2) student intervention, 3) combined intervention and 4) control group. Outcome measures were amount and growth of weekly alcohol drinking measured 10, 22 and 34. months after baseline. The combined intervention significantly curbed the growth of drinking among both non-drinkers (the target group of the intervention) and drinkers at baseline. Overall, less strong increases of drinking over time are found among non-drinkers compared to drinkers at baseline. Thus, the combined PAS intervention is also effective in curbing adolescents' drinking behaviour in those who already were drinking at baseline. Broad implementation of the combined parent-student intervention is recommended. © 2014 Elsevier Inc.
Journal of Substance Abuse Treatment, 46(4) : 522-527
- Year: 2014
- 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