Short‐ to Midterm Effectiveness of a Brief Motivational Intervention to Reduce Alcohol Use and Related Problems for Alcohol Intoxicated Children and Adolescents in Pediatric Emergency Departments: A Randomized Controlled Trial

Arnaud, Nicolas; Diestelkamp, Silke; Wartberg, Lutz; Sack, Peter‐Michael; Daubmann, Anne; Thomasius, Rainer

doi:10.1111/acem.13126

“…[61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76] The majority (n = 13) were studies conducted in the USA, 61,[64][65][66][67][69][70][71][72][73][74][75][76] with one in Germany, 68 one in Mexico 63 and one in Western Australia. 62 The setting was mainly emergency departments (n = 8), 62,66,68,[70][71][72][73]75 with three in universities, 61,67,74 one with homeless adolescents, 76 one with young people referred from not-for-profit agencies, 65 one based in the community 64 and two based in schools. 63,69 The ASBIs used largely followed a manual and/or used MI techn...…”

Section: Alcohol Screening and Brief Interventionsmentioning

confidence: 99%

Brief alcohol intervention for risky drinking in young people aged 14–15 years in secondary schools: the SIPS JR-HIGH RCT

Giles

¹

,

McGeechan

²

,

Coulton

³

et al. 2019

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Background Adverse effects from young people’s alcohol consumption manifest in a range of physical and psychosocial factors, including neurological issues, cognitive impairment and risk-taking behaviours. The SIPS JR-HIGH pilot trial showed alcohol screening and brief intervention (ASBI) to be acceptable to young people and schools in the north-east of England. Objectives To conduct a two-arm, individually randomised controlled trial to evaluate the effectiveness and cost-effectiveness of ASBI for risky drinking in young people aged 14–15 years in the school setting, to monitor the fidelity of ASBI and to explore the barriers to, and facilitators of, implementation with staff, young people and parents. Design A baseline survey with a 12-month follow-up. Interviews with 30 school staff, 21 learning mentors and nine teachers, and 33 young people and two parents. Setting Thirty state schools in four areas of England: north-east, north-west, Kent and London. Participants Year 10 school pupils who consented to the study (aged 14–15 years, recruited between November 2015 and June 2016), school-based staff and parents of the young people who took part in the study. Interventions Young people who screened positively on a single alcohol screening question and consented were randomised to the intervention or control arm (blinded). The intervention was a 30-minute one-to-one structured brief intervention with a trained learning mentor and an alcohol leaflet. The control group received a healthy lifestyle leaflet (no alcohol information). Main outcome measures The primary outcome measure was total alcohol consumed in the last 28 days. Secondary outcomes related to risky drinking, general psychological health, sexual risk-taking, energy drink consumption, age of first smoking, quality of life, quality-adjusted life-years, service utilisation and demographic information. Results A total of 4523 young people completed the baseline survey, with 1064 screening positively (24%) and 443 being eligible to take part in the trial. Of those 443, 233 (53%) were randomised to the control arm and 210 were randomised to the intervention arm. Of the 443, 374 (84%) were successfully followed up at 12 months (intervention, n = 178; control, n = 196). The results were that the intervention showed no evidence of benefit for any alcohol-related measure when compared with the control arm. At 12 months we found a reduction from 61.9% to 43.3% using the Alcohol Use Disorders Identification Test cut-off point of 8 and cut-off point of 4 (69.0% to 60.7%). These results were not significant. A cost-effectiveness analysis showed that the average net cost saving of the brief intervention was £2865 (95% confidence interval –£11,272 to £2707) per year compared with usual practice, with the intervention showing a 76% probability of being cost saving compared with usual practice. The interview findings showed that school was an acceptable setting to carry out ASBI among staff and young people. Limitations Recruitment of parents to take part in interviews was poor. Only 18 ASBI sessions were recorded, making it difficult to assess internal validity. Conclusions Although the intervention was ineffective in reducing risky drinking in young people aged 14–15 years, it was well received by the young people and school staff who participated. Future work Uniform reporting of the outcomes used for ASBI would generate more robust conclusions on the effectiveness of ASBI in the future. Pilot feasibility studies should include more than one geographical area. Future work on involving parents is needed. Trial registration Current Controlled Trials ISRCTN45691494. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 9. See the NIHR Journals Library website for further project information.

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“…Im Handlungsfeld Gesundheitsversorgung trägt die deutsche Erfahrung mit motivierender Kurzintervention bei Jugendlichen im Kliniksetting zur international uneinheitlichen Einschätzung bei. Arnaud et al [57] stellten nach 3 und 6 Monaten einen Rückgang des Alkoholkonsums in der Interventions-wie auch in der Kontrollgruppe fest, ohne signifikante Unterschiede zwischen den Gruppen. Damit kann das international überwiegend positive Urteil nicht bestätigt werden.…”

Section: Vergleich Internationale Und Nationale Evidenzunclassified

Evidenzbasierte Alkoholprävention – Was empfiehlt die Wirksamkeitsforschung?

Bühler

¹

,

Thrul

²

,

Matos

³

2021

Bundesgesundheitsbl

0

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Zusammenfassung Hintergrund Der riskante Alkoholkonsum einer substanziellen Gruppe von Jugendlichen und jungen Erwachsenen weist auf einen alkoholpräventiven Handlungsbedarf hin. Die BZgA-Expertise zur Suchtprävention 2020 liefert das wissenschaftliche Wissen zur Wirksamkeit von suchtpräventivem Handeln mit jungen Menschen. Fragestellung Welche Ansätze haben in den jeweiligen Handlungsfeldern der Suchtprävention alkoholpräventive Effekte? Methode Eine systematische Literatursuche im Juni 2017 in 7 internationalen Datenbanken resultierte in 28.949 Treffern. Einschlusskriterien waren: Studientyp Review oder Metaanalyse, Erscheinungsdatum 2012–2017, Zielgruppe universell oder selektiv und Alter bis 25 Jahre, Zielverhalten Alkoholkonsum. Ausschlusskriterien waren: Zielgruppe Menschen mit diagnostizierten Störungen, Zielverhalten Risikofaktoren. 34 alkoholbezogene Arbeiten wurden von den 3 Autoren systematisch ausgewertet und mittels AMSTAR (A MeaSurement Tool to Assess systematic Reviews) methodisch bewertet. Im Konsensverfahren wurden Schlussfolgerungen und Empfehlungen formuliert. Ergebnisse Basierend auf 53 Schlussfolgerungen zur Wirksamkeit von Alkoholprävention lassen sich je nach Handlungsfeld (Familie, Schule, Hochschule, Medien, Gesundheitssystem, Kommune) und Zielgruppe u. a. empfehlen: Familienprogramme und Elterntrainings, verhaltensbezogene Programme, die bestimmte personale und soziale Kompetenzen fördern, Kurzinterventionen mit Feedback, Mentorenprogramme. Neuere Arbeiten zu verhältnispräventiven alkoholpolitischen Maßnahmen auf kommunaler oder nationaler Ebene konnten nicht identifiziert werden. Diskussion Verhaltensbezogene Alkoholprävention ist wirksam. Je nach Handlungsfeld und Zielgruppe empfiehlt sich ein sehr differenziertes Vorgehen. Benötigt wird ein Konsens, mit welcher Art von Evidenz die kausale Wirksamkeit von Verhältnisprävention nachgewiesen werden kann.

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“…Some studies evaluated the effectiveness of a motivational intervention to reduce drinking and associated problems encountered pediatric emergency departments in Germany, with good results. [6] Other researches focused on the importance of motivational therapy interventions in order to increase physical activity and level of satisfaction in children with cerebral palsy. [7] Limited evidence shows that a motivational interviewing approach may be an effective behavioral intervention to prevent dental caries in children, [8] to reduce the depression scale scores in adolescents with obesity and overweight, [9] to maintain a good diet among obese patients, and for the correct management of dyslipidemic children.…”

Section: Original Articlementioning

confidence: 99%