Randomized Controlled Trial of Web-Based Alcohol Screening and Brief Intervention in Primary Care

OBJECTIVES: This study examined the efficacy of emergency department (ED)-based brief interventions (BIs), delivered by a computer or therapist, with and without a post-ED session, on alcohol consumption and consequences over 12 months. METHODS:Patients (ages 14-20 years) screening positive for risky drinking were randomized to: BI (n = 277), therapist BI (n = 278), or control (n = 281). After the 3-month follow-up, participants were randomized to receive a post-ED BI session or control. Incorporating motivational interviewing, the BIs addressed alcohol consumption and consequences, including driving under the influence (DUI), and alcohol-related injury, as well as other concomitant drug use. The computer BI was an offline, Facebook-styled program.RESULTS: Among 4389 patients screened, 1054 patients reported risky drinking and 836 were enrolled in the randomized controlled trial. Regression models examined the main effects of the intervention conditions (versus control) and the interaction effects (ED condition 3 post-ED condition) on primary outcomes. The therapist and computer BIs significantly reduced consumption at 3 months, consequences at 3 and 12 months, and prescription drug use at 12 months; the computer BI reduced the frequency of DUI at 12 months; and the therapist BI reduced the frequency of alcohol-related injury at 12 months. The post-ED session reduced alcohol consequences at 6 months, benefiting those who had not received a BI in the ED.CONCLUSIONS: A single-session BI, delivered by a computer or therapist in the ED, shows promise for underage drinkers. Findings for the fully automated stand-alone computer BI are particularly appealing given the ease of future implementation. WHAT'S KNOWN ON THIS SUBJECT:Intervention strategies are needed to reduce underage drinking. Meta-analyses of youth alcohol brief interventions (BIs) conclude that therapist-delivered BIs are efficacious; however, to maximize public health impact, recommendations include using technology to streamline intervention delivery, for which evidence is lacking. WHAT THIS STUDY ADDS:A single-session BI, delivered by a computer or therapist in the emergency department, shows promise for underage drinkers. Findings for the stand-alone computer BI are particularly appealing given the ease of future implementation. Dr Cunningham was responsible for the study concept, design, acquisition, analysis, and interpretation of data; administrative, technical, or material support of the study; study supervision; and drafting of the manuscript, including both the initial draft and subsequent revisions. Dr Chermack was responsible for the study concept and design, study supervision, and critical revisions to the manuscript; Drs Ehrlich, Blow, and Barry were responsible for the study concept and design and critical revisions to the manuscript; Dr Carter was responsible for analysis and interpretation of data and critical revisions to the manuscript; and Dr Booth was responsible for the study concept, design, acquisition, analysis, and inter...

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“…Previous data on the efficacy of a follow-up booster are inconsistent, perhaps reflecting variation in participation and content. [78][79][80] In terms of future translation and implementation, the Project UConnect BI seems to be efficacious delivered by either a computer or a therapist, and a post-ED session at The reference group is the control group. Zero-inflated negative binomial for DUI, zero-inflated Poisson for alcohol-related injury, zero-inflated Poisson for prescription drug use (and thus have both prevalence and frequency).…”

Section: Discussionmentioning

confidence: 99%

Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial

2015

PEDIATRICS

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OBJECTIVES: This study examined the efficacy of emergency department (ED)-based brief interventions (BIs), delivered by a computer or therapist, with and without a post-ED session, on alcohol consumption and consequences over 12 months. METHODS:Patients (ages 14-20 years) screening positive for risky drinking were randomized to: BI (n = 277), therapist BI (n = 278), or control (n = 281). After the 3-month follow-up, participants were randomized to receive a post-ED BI session or control. Incorporating motivational interviewing, the BIs addressed alcohol consumption and consequences, including driving under the influence (DUI), and alcohol-related injury, as well as other concomitant drug use. The computer BI was an offline, Facebook-styled program.RESULTS: Among 4389 patients screened, 1054 patients reported risky drinking and 836 were enrolled in the randomized controlled trial. Regression models examined the main effects of the intervention conditions (versus control) and the interaction effects (ED condition 3 post-ED condition) on primary outcomes. The therapist and computer BIs significantly reduced consumption at 3 months, consequences at 3 and 12 months, and prescription drug use at 12 months; the computer BI reduced the frequency of DUI at 12 months; and the therapist BI reduced the frequency of alcohol-related injury at 12 months. The post-ED session reduced alcohol consequences at 6 months, benefiting those who had not received a BI in the ED.CONCLUSIONS: A single-session BI, delivered by a computer or therapist in the ED, shows promise for underage drinkers. Findings for the fully automated stand-alone computer BI are particularly appealing given the ease of future implementation. WHAT'S KNOWN ON THIS SUBJECT:Intervention strategies are needed to reduce underage drinking. Meta-analyses of youth alcohol brief interventions (BIs) conclude that therapist-delivered BIs are efficacious; however, to maximize public health impact, recommendations include using technology to streamline intervention delivery, for which evidence is lacking. WHAT THIS STUDY ADDS:A single-session BI, delivered by a computer or therapist in the emergency department, shows promise for underage drinkers. Findings for the stand-alone computer BI are particularly appealing given the ease of future implementation.

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“…Ukrepi imajo poleg kratkotrajnega učinka učinek tudi po več mesecih (17-20, 23, 25), medtem ko se ponavljanje intervencij ni pokazalo za učinkovitejše (18). Pomembno pa je ukrepanje dovolj zgodaj (23).…”

Section: Trajanje Učinka Ukrepovunclassified

Ukrepi Za Zmanjšanje Tveganega In Škodljivega Pitja Alkohola V Populaciji Študentov: Sistematični Pregled Literature / Measures to Reduce Risky and Heavy Alcohol Drinking in the Population of Students: A Systematic Literature Review

Makivić¹,

Kersnik²,

Kolšek³

2013

Slovenian Journal of Public Health

3

0

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Randomized Controlled Trial of Web-Based Alcohol Screening and Brief Intervention in Primary Care

Abstract: Single-dose e-SBI reduces hazardous drinking, and the effect lasts 12 months. Additional sessions seem not to enhance the effect. Trial Registration www.anzctr.org.au Identifier:ACTRN012607000103460.

Cited by 169 publications

References 22 publications

Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial

Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial

Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial

Ukrepi Za Zmanjšanje Tveganega In Škodljivega Pitja Alkohola V Populaciji Študentov: Sistematični Pregled Literature / Measures to Reduce Risky and Heavy Alcohol Drinking in the Population of Students: A Systematic Literature Review

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