Disorders - Alcohol Use
Kypri, K., Vater, T., Bowe, S. J., Saunders, J. B., Cunningham, J. A., Horton, N. J., McCambridge, J.
IMPORTANCE: Unhealthy alcohol use is a leading contributor to the global burden of disease, particularly among young people. Systematic reviews suggest efficacy of web-based alcohol screening and brief intervention and call for effectiveness trials in settings where it could be sustainably delivered. OBJECTIVE: To evaluate a national web-based alcohol screening and brief intervention program. DESIGN, SETTING, AND PARTICIPANTS: A multisite, double-blind, parallel-group, individually randomized trial was conducted at 7 New Zealand universities. In April and May of 2010, invitations containing hyperlinks to the Alcohol Use Disorders Identification Test-Consumption (AUDITC) screening test were e-mailed to 14 991 students aged 17 to 24 years. INTERVENTIONS: Participants who screened positive (AUDIT-C score ≥4) were randomized to undergo screening alone or to 10 minutes of assessment and feedback (including comparisons with medical guidelines and peer norms) on alcohol expenditure, peak blood alcohol concentration, alcohol dependence, and access to help and information. MAIN OUTCOMES AND MEASURES: A fully automated 5-month follow-up assessment was conducted that measured 6 primary outcomes: consumption per typical occasion, drinking frequency, volume of alcohol consumed, an academic problems score, and whether participants exceeded medical guidelines for acute harm (binge drinking) and chronic harm (heavy drinking). A Bonferroni-corrected significance threshold of .0083 was used to account for the 6 comparisons and a sensitivity analysis was used to assess possible attrition bias. RESULTS: Of 5135 students screened, 3422 scored 4 or greater and were randomized, and 83% were followed up. There was a significant effect on 1 of the 6 prespecified outcomes. Relative to control participants, those who received intervention consumed less alcohol per typical drinking occasion (median 4 drinks [interquartile range {IQR}, 2-8] vs 5 drinks [IQR 2-8]; rate ratio [RR], 0.93 [99.17%CI, 0.86-1.00]; P = .005) but not less often (RR, 0.95 [99.17%CI, 0.88-1.03]; P = .08) or less overall (RR, 0.95 [99.17%CI, 0.81-1.10]; P = .33). Academic problem scores were not lower (RR, 0.91 [99.17%CI, 0.76-1.08]; P = .14) and effects on the risks of binge drinking (odds ratio [OR], 0.84 [99.17%CI, 0.67-1.05]; P = .04) and heavy drinking (OR, 0.77 [99.17%CI, 0.56-1.05]; P = .03) were not significantly significant. In a sensitivity analysis accounting for attrition, the effect on alcohol per typical drinking occasion was no longer statistically significant. CONCLUSIONS AND RELEVANCE: A national web-based alcohol screening and brief intervention program produced no significant reductions in the frequency or overall volume of drinking or academic problems. There remains a possibility of a small reduction in the amount of alcohol consumed per typical drinking occasion. TRIAL REGISTRATION: anzctr.org.au Identifier: ACTRN12610000279022. Copyright 2014 American Medical Association. All rights reserved.
JAMA, 311(12) : 1218-1224
- 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, Technology, interventions delivered using technology (e.g. online, SMS)
Leeman, R. F., Wiers, R. W., Cousijn, J., DeMartini, K. S., O'Malley, S. S.
Current behavioral interventions for heavy drinking young adults typically aimto enhance inhibitory control over excessive drinking by prompting effortful behavior change. These approaches are efficacious overall but effect sizes are modest. In contrast, automatic cognition has been ignored largely in behavioral interventions. New interventions are needed to target cognitions and behaviors that support heavy drinking in this population. Automatic action tendency retraining aims to ameliorate tendencies to approach alcohol-related cues on the part of frequent heavy drinkers. The retraining procedure entails pushing away motions with a joystick in response to alcohol images over repeated trials. Automatic action tendency retraining is a theoretically supported, novel intervention with promising initial empirical support, primarily among treatment seeking, alcohol dependent adults. Less is known about the efficacy of the retraining procedure among non-treatment seeking young adults. In this study, we enrolled otherwise healthy,male and female, non-treatment-seeking, frequent heavy drinking young adults 21-25 years old. Participants were randomized to 4 daily sessions of automatic action tendency retraining or a control condition over the course of 5 days. These sessions weremade up of repeated trials consisting of photographic images of alcoholic and non-alcoholic beverages (e.g., soda) presented on a computer screen. Participants were instructed to push or pull with the joystick according to an innocuous quality of the image (i.e., whether it was tilted slightly to the left or the right). In the retraining condition, participants pushed away images of alcoholic beverages with the joystick in 90%of trials and pulled images of non-alcoholic beverages toward them with the joystick in 90% of trials. In the control condition, participants pushed and pulled images of alcoholic and non-alcoholic beverages in 50%of trials. Based on initial data collection, the retraining procedure was associated with decreased automatic approach tendencies toward alcohol cues, in comparison to a control condition. The magnitude of decrease was particularly strong among young adults with greater approach tendencies at baseline. Decreasing approach tendencies has the potential to decrease craving and alcohol use in this highrisk population.
Alcoholism: Clinical & Experimental Research, 38 : 269A
- Year: 2014
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Lee, C. M., Neighbors, C., Lewis, M. A., Kaysen, D., Mittmann, A., Geisner, I. M., Atkins, D. C., Zheng, C., Garberson, L. A., Kilmer, Jason R., Larimer, M. E.
Objective: Although recent studies have documented high-risk drinking occurring during Spring Break (SB), particularly on SB trips with friends, published intervention studies are few. In the present study, we evaluated the efficacy of event specific prevention strategies for reducing SB drinking among college students, compared to general prevention strategies and an assessment-only control group, as well as evaluated inclusion of peers in interventions and mode of intervention delivery (in-person vs. web).; Method: Participants included 783 undergraduates (56.1% women; average age = 20.5 years) intending to go on a SB trip with friends as well as to drink heavily on at least 1 day of SB. Participants completed assessments prior to SB and were randomized to 1 of 5 intervention conditions: SB in-person Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff, Baer, Kivlahan, & Marlatt, 1999), SB web BASICS, SB in-person BASICS with friend, SB web BASICS with friend, general BASICS, or an attention control condition. Follow-up assessment was completed 1 week after SB.; Results: Although the SB web BASICS (with and without friends) and general BASICS interventions were not effective at reducing SB drinking, results indicated significant intervention effects for SB in-person BASICS in reducing SB drinking, particularly on trip days. Follow-up analyses indicated that change in descriptive norms mediated treatment effect and reductions in drinking, whereas SB drinking intentions and positive expectancies did not.; Conclusions: Overall, results suggest that an in-person SB-specific intervention is effective at reducing SB drinking, especially during trips. In contrast, interventions that contain non-SB-related content, are web-based, or seek to involve friends may be less effective at reducing SB drinking.;
Journal of Consulting & Clinical Psychology, 82(2) : 189-201
- Year: 2014
- 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, comparing delivery mode (e.g. online vs. face-to-face)
Marsiglia, F. F., Booth, J. M., Ayers, S. L., Nuno-Gutierrez, B. L., Kulis, S., Hoffman, S.
This article presents the short-term effects of a pilot study of keepin'it REAL (Mantente REAL) conducted in central Mexico by a binational team of investigators. This middle school-based model program for preventing substance use was adapted for Mexico linguistically but not culturally. Two Guadalajara public middle schools were recruited and randomly assigned to either implement the prevention program or serve as a control site. The program was implemented in the treatment site by the students' regular teachers, who were trained by the research team. Seventh graders in ten classrooms in the treatment and control schools (N = 432) completed a pretest and posttest survey in Spanish similar to the survey utilized in the original efficacy trial of keepin'it REAL in the US. T-tests and OLS regressions were conducted to determine the effects of the intervention on substance use outcomes. Differences between treatment and control groups in frequency of use of alcohol and tobacco, the two substances of choice in this sample, were significant and in the desired direction. Differences in amount of use were also in the preferred direction but were not significant for alcohol and only marginally significant for tobacco. When the sample was split by gender, statistically significant treatment effects remained for females but were not observed among males. Effects of the linguistically adapted version of keepin'it REAL appears to be driven by the change in female use; however, the difference in male and female outcomes was not statistically significant. Implications for cultural adaptation and prevention in Mexico are discussed from a communication competency perspective. The promising results of the pilot study suggest that the linguistic adaptation was effective, but that a comprehensive cultural adaptation of keepin'it REAL in partnership with Mexican investigators and communities may be warranted. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract).
Prevention Science, 15(5) : 694-704
- Year: 2014
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Malmberg, M., Kleinjan, M., Overbeek, G., Vermulst, A., Monshouwer, K., Lammers, J., Vollebergh, W. A., Engels, Rutger C.
Aim: To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design: Randomized clustered trial with two intervention conditions (i.e. e-learning and integral). Setting: General population of 11-15-year-old adolescents in the Netherlands. Participants A total of 3784 students of 23 Dutch secondary schools. Measurements: Structured digital questionnaires were administered pre-intervention and at 32 months follow-up. The primary outcome measures were new incidences of alcohol (life-time and 1-month prevalence), tobacco (life-time and 1-month prevalence) and marijuana use (life-time prevalence). Findings: Main effect analyses showed no programme effects on incidences of alcohol consumption (life-time prevalence: e-learning condition: B = 0.102, P = 0.549; integral condition: B = -0.157, P = 0.351; 1-month prevalence: e-learning condition: B = 0.191, P = 0.288; integral condition: B = -0.140, P = 0.445), tobacco consumption (life-time prevalence: e-learning condition: B = 0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1-month prevalence: e-learning condition: B = 0.088, P = 0.746; integral condition: B = 0.261, P = 0.093), or marijuana consumption (life-time prevalence: e-learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P = 0.214). Conclusion: The non-significant impact of the Healthy School and Drugs programme (a Dutch school-based prevention programme for early adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract).
Addiction, 109(6) : 1031-1040
- Year: 2014
- Problem: Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training, Other Psychological Interventions
Mertens, J. R., Ward, C. L., Bresick, G. F., Broder, T., Weisner, C. M.
Aims: To assess the effectiveness of brief motivational intervention for alcohol and drug use in young adult primary care patients in a low-income population and country. Methods: A randomized controlled trial in a public-sector clinic in Delft, a township in the Western Cape, South Africa recruited 403 patients who were randomized to either single-session, nurse practitioner-delivered Brief Motivational Intervention plus referral list or usual care plus referral list, and followed up at 3 months. Results: Although rates of at-risk alcohol use and drug use did not differ by treatment arm at follow-up, patients assigned to the Brief Motivational Intervention had significantly reduced scores on ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) for alcohol-the most prevalent substance. Conclusion: Brief Motivational Intervention may be effective at reducing at-risk alcohol use in the short term among low-income young adult primary care patients; additional research is needed to examine long-term outcomes. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.
Alcohol & Alcoholism, 49(4) : 430-438
- Year: 2014
- 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
Midford, R., Ramsden, R., Lester, L., Cahill, H., Mitchell, J., Foxcroft, D. R., Venning, L.
The Drug Education in Victorian Schools program provided integrated education about licit and illicit drugs, employed a harm minimization approach that incorporated participatory, critical thinking and skill-based teaching methods, and engaged parental influence through home activities. A cluster-randomized, controlled trial of the program was conducted with a student cohort during Year 8 (13 years) and Year 9 (14 years). Twenty-one secondary schools in Victoria, Australia, were randomly allocated to the Drug Education in Victorian Schools program (14 schools, n = 1,163) or their usual drug education program (7 schools, n = 589). This study reports program effects for alcohol. There was a greater increase in the intervention students' knowledge about drugs, including alcohol; there was a greater increase in communication with parents about alcohol; they recalled receiving more alcohol education; their alcohol consumption increased less; and they experienced a lesser increase in alcohol-related harms. Among intervention group risky drinkers, consumption and harm increased less. There were no differences between study groups in attitudes toward alcohol or in the proportion of drinkers or risky drinkers. While the program did not stop students taking up drinking, it did reduce their consumption and harm. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Drug Education, 44(3-4) : 71-94
- Year: 2014
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Mastroleo, N. R., Oakley, W. C., Eaton, E. M., Borsari, B.
Little is known about the way in which mandated and heavy-drinking voluntary students comparatively respond to peer-led brief motivational interventions (BMIs) and the mediators and moderators of intervention effects. Research suggests that mandated students may be more defensive due to their involvement in treatment against their will and this defensiveness, in turn, may relate to treatment outcome. Furthermore, it is not clear how mandated and heavy-drinking voluntary students perceived satisfaction with peer-led BMIs relates to treatment outcomes. Using data from two separate randomized controlled trials, heavy drinking college students (heavy-drinking voluntary, n= 156; mandated, n= 82) completed a peer-led brief motivational intervention (BMI). Both mandated and heavy-drinking volunteer students significantly reduced drinking behaviors at 3-month follow-up, reported high levels of post-intervention session satisfaction, yet no effects for mediation or moderation were found. Findings offer continued support for using peer counselors to deliver BMIs; however, results regarding the mechanisms of change were in contrast to previous findings. Implications for treatment and future areas of research are discussed.
Journal of Substance Abuse Treatment, 47(5) : 321-328
- 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)
, Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback
Mason, M., Benotsch, E. G., Way, T., Kim, H., Snipes, D.
We tested the feasibility and effectiveness of an alcohol counseling intervention delivered via personalized text messages for college students with problem alcohol use. College students aged 18-23 completed online substance use and mental health questionnaires that served as a screening tool for problem alcohol use. We invited students who screened positive to be randomized to intervention (n = 8) or control groups (n = 10) and assessed them at 1 month after they received their last text message. The intervention group received between four and six text messages daily for 4 days that required brief participant responses during the week following the web-based baseline assessment. Participants in the intervention group could also request booster texts for additional support. We personalized all texts, using data collected at baseline. Using a repeated measures ANOVA, we found that compared to the control group, the intervention group increased in readiness to change from baseline to follow-up (p < .01). Other promising trends were an increase in the intervention relative to the control group's confidence in their ability to change drinking behavior, and an increase in intentions to reduce alcohol use. These exploratory results indicate that the automated texting program we developed works well with college students and that text messaging as a means to deliver preventive interventions is a promising delivery platform.
The journal of primary prevention, 35(1) : 47-52
- 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)
, Motivational interviewing, includes Motivational Enhancing Therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Fridberg, D., King, A.
Brief interventions (BIs) can help reduce risky alcohol use in college students, but little research has focused on the efficacy of such interventions in post- college-age young adult drinkers. Previous work by our group has shown that a large majority of binge drinkers in their mid 20 s continue with hazardous drinking to their early 30 s, and those with increased sensitivity to the stimulating and rewarding effects of alcohol are particularly at risk for future alcohol problems. In addition, co-morbid cigarette smoking was highly prevalent and largely unchanged over time among young adult binge drinkers. Thus, the present study pilot tested a novel personalized feedback of one's alcohol challenge responsesmeasured in the laboratory (stimulation, liking, wanting, and smoking urge) within the context of standard alcohol BI. Non-dependent, non- treatment-seeking young adult drinkersmokers were randomized to participate in two 30-min sessions with this brief alcohol smoking feedback intervention (BASFI; n=10) approach, or an attention control health feedback intervention (HFI; n=11) focused on improving general health behaviors. Participants were interviewed regarding drinking and smoking behavior at baseline and 1-month and 6-months post-intervention, with 100%retention at 1-month and 95% retention at 6 months. The sample was 62%male, with an average age of 24±2. 3 SD years and an average AUDIT score of 15±3. 8. Participants reported 16±6. 4 past-month drinking days at baseline, with 9±4. 3 binge drinking days, 24±6. 5 smoking days, and 15±5. 6 couse days. Generalized estimating equation analyses were used to examine between-group differences in drinking and smoking behaviors over time. At 1-month, the BASFI produced greater reductions than the HFI for binge drinking days (p=0. 02; -57%v. -29%, respectively), smoking days (p=0. 02; -31%v. +1%), and alcohol-smoking co-use days (p=0. 04; -32% v. -14%). This pattern remained at 6-months, with the BASFI producing greater reductions than the HFI relative to baseline for binge drinking days (-68%v. -22%), smoking days (-42%v. +4%), and co-use days (-48%v. -3%). Collectively, the results of this pilot study support the feasibility of incorporating personalized alcohol challenge feedback in briefmotivational interventions with young adult hazardous drinkersmokers, and warrant further research on this novel and personalized approach to early intervention in young adult heavy drinker-smokers.
Alcoholism: Clinical & Experimental Research, 38 : 211A
- Year: 2014
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Personalised feedback, normative feedback
Kenney, S. R., Napper, L. E., LaBrie, J. W., Martens, M. P.
College students' use of protective behavioral strategies (PBS; e.g., determining not to exceed a set number of drinks, avoiding drinking games) is related to lower levels of alcohol consumption and problems. The present study evaluated the efficacy of a novel brief, single-session group PBS skills training intervention aimed at increasing college students' use of PBS and reducing risky drinking and consequences. Participants (N = 226) were heavy-drinking incoming first-year college women randomized to either a PBS skills training intervention or study skills control condition. Participants attended a 45-min group session and completed online surveys pre-and postintervention (1 month and 6 months). We conducted a series of 2 × 2 × 3 repeated-measures ANCOVAs with condition and baseline mental health (anxiety/depression) as the between-subjects factors and time as the within-subjects factor. Intervention participants, relative to controls, reported significantly greater increases in PBS use and reductions in both heavy episodic drinking and alcohol consequences. The intervention was particularly effective in increasing PBS use at 1 month among participants with high anxiety. Further, tests of moderated mediation showed a significant conditional indirect effect of condition on 1-month consequences through PBS use among participants with high levels of anxiety. Findings provide preliminary support for a brief PBS-specific group intervention to reduce alcohol risk among college women, particularly anxious women. Future research is needed to strengthen the long-term effectiveness of the present approach and further explore the moderating effects of mental health.
Psychology of Addictive Behaviors, 28(4) : 1041-1051
- Year: 2014
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Skills training, Other Psychological Interventions
Neighbors, C., Lewis, M. A., LaBrie, J., DiBello, A. M., Young, C. M., Rodriguez, L. M., Rinker, D. V., Knee, C. R., Litt, D., Hamor, E., Jerabeck, J. M., Larimer, M. E.
Given widespread alcohol misuse, numerous intervention programs have been developed. One such intervention uses personalized normative feedback (PNF) regarding one's own drinking, campus drinking rates, and one's perceived norms about other students on campus. Themajority of research evaluating PNF has assumed that presentation of one's own norms perceptions is necessary to correct normative misperceptions and thereby reduce drinking. It is possible however, that simply providing social comparison information showing that one drinks more than others is sufficient. Thus, explicit presentation of one's own perceptions of others' drinking may not be necessary. The present study evaluated the efficacy of full PNF (one's own drinking, campus drinking rates, and perceived norms), partial social comparison PNF (one's own drinking and campus drinking rates), and attention control conditions in a randomized trial targeting heavy-drinking college students. Participants included 622 students (53.2%women; 62%Caucasian) who reported one or more heavy-drinking episodes in the past month. Participants were randomly assigned to conditions. Assessments occurred at baseline, with follow-ups three and six months later. Primary analyses used generalized linear models with negative binomial distributions to examine group differences across three drinking outcomes (typical drinks per week; drinks past month; frequency) at three and six month follow-ups controlling for baseline drinking. Gender was included as a covariate. Intervention contrasts were dummy coded to reflect differences between each of the feedback conditions relative to control. Results revealed significant reductions across drinking outcomes at three months in the full and partial feedback conditions compared to control. These effects were not evident at sixmonth follow-up. Furthermore, subsequent analyses indicated no differences between full and partial feedback. Mediation analyses demonstrated significant indirect effects of changes in perceived norms at three months in predicting six-month drinking. Moreover, evidence emerged for changes in drinking at threemonths as a mediator of the association between partial feedback and six month perceived norms. In sum, the present research suggests that PNF may not require explicit consideration of one's perceived norms in order to be effective and that social comparison is an alternative mechanism for PNF efficacy.
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)
, Personalised feedback, normative feedback