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Is Readiness to Change Drinking Related to Reductions in Alcohol Use and Consequences? A Week-to-Week Analysis.

ABSTRACT: OBJECTIVE:The literature on whether readiness to change (RTC) alcohol use translates into actual change among college students is both limited and mixed, despite the importance of understanding naturalistic change processes. Few studies have used fine-grained, prospective data to examine the link between RTC and subsequent drinking behavior, and alcohol consequences in particular. The present study involves tests of whether (a) intraindividual changes in RTC are negatively associated with alcohol use and alcohol-related consequences from week to week, (b) the effect of RTC on use and consequences is direct versus mediated by change in alcohol use, and (c) the association between RTC and drinking behavior is moderated by gender. METHOD:Participants were 96 college student drinkers who completed a baseline survey and 10 weekly web-based assessments of RTC, alcohol use, and consequences. RESULTS:Hierarchical linear models indicated that, as hypothesized, reporting greater RTC on a given week (relative to one's average level of RTC) was negatively associated with alcohol use (measured by either drinks per week or frequency of heavy episodic drinking) and alcohol consequences the following week. Changes in use fully mediated the relationship between RTC and consequences. The prospective association between RTC and both alcohol use and consequences did not differ by gender. CONCLUSIONS:Findings suggest that higher RTC translates into short-term reductions in alcohol use and in turn alcohol consequences, and highlight important avenues for future research.

SUBMITTER: Merrill JE

PROVIDER: S-EPMC4714829 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Is Readiness to Change Drinking Related to Reductions in Alcohol Use and Consequences? A Week-to-Week Analysis.

Merrill Jennifer E JE Wardell Jeffrey D JD Read Jennifer P JP

Journal of studies on alcohol and drugs 20150901 5

<h4>Objective</h4>The literature on whether readiness to change (RTC) alcohol use translates into actual change among college students is both limited and mixed, despite the importance of understanding naturalistic change processes. Few studies have used fine-grained, prospective data to examine the link between RTC and subsequent drinking behavior, and alcohol consequences in particular. The present study involves tests of whether (a) intraindividual changes in RTC are negatively associated wit ...[more]

PMID: 26402360

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Project description:BackgroundThe World Health Organization (WHO) categorizes alcohol consumption according to grams consumed into low-, medium-, high-, and very-high-risk drinking levels (RDLs). Although abstinence has been considered the ideal outcome of alcohol treatment, reductions in WHO RDLs have been proposed as primary outcomes for alcohol use disorder (AUD) trials.ObjectiveThe current study examines the stability of WHO RDL reductions and the association between RDL reductions and long-term functioning for up to 3 years following treatment.Design and participantsSecondary data analysis of patients with AUD enrolled in the COMBINE Study and Project MATCH, two multi-site, randomized AUD clinical trials, who were followed for up to 3 years post-treatment (COMBINE: n = 694; MATCH: n = 806).MeasuresAlcohol use was measured via calendar-based methods. We estimated all models in the total sample and among participants who did not achieve abstinence during treatment.Key resultsOne-level RDL reductions were achieved by 84% of patients at the end of treatment, with 84.9% of those individuals maintaining that reduction at a 3-year follow-up. Two-level RDL reductions were achieved by 68% of patients at the end of treatment, with 77.7% of those individuals maintaining that reduction at a 3-year follow-up. One- and two-level RDL reductions at the end of treatment were associated with significantly better mental health, quality of life (including physical quality of life), and fewer drinking consequences 3 years after treatment (p < 0.05), as compared to no change or increased drinking.ConclusionAUD patients can maintain WHO RDL reductions for up to 3 years after treatment. Patients who had WHO RDL reductions functioned significantly better than those who did not reduce their drinking. These findings are consistent with prior reports suggesting that drinking reductions, short of abstinence, yield meaningful improvements in patient health, well-being, and functioning.

Project description:BackgroundAbstinence and no heavy drinking days are currently the only Food and Drug Administration-approved end points in clinical trials for alcohol use disorder (AUD). Many individuals who fail to meet these criteria may substantially reduce their drinking during treatment, and most individuals with AUD prefer drinking reduction goals. One- and two-level reductions in World Health Organization (WHO) drinking risk levels have been proposed as alternative end points that reflect reduced drinking and are associated with reductions in drinking consequences, improvements in mental health, and reduced risk of developing alcohol dependence. The current study examined the association between WHO drinking risk level reductions and improvements in physical health and quality of life in a sample of individuals with alcohol dependence.MethodsSecondary data analysis of individuals with alcohol dependence (n = 1,142) enrolled in the longitudinal, prospective COMBINE study, a multi site randomized placebo-controlled clinical trial, examining the association between reductions in WHO drinking risk levels and change in blood pressure, liver enzyme levels, and self-reported quality of life following treatment for alcohol dependence.ResultsOne- and two-level reductions in WHO drinking risk level during treatment were associated with significant reductions in systolic blood pressure (p < 0.001), improvements in liver enzyme levels (all p < 0.01), and significantly better quality of life (p < 0.001).ConclusionsOne- and two-level reductions in WHO drinking risk levels predicted significant improvements in markers of physical health and quality of life, suggesting that the WHO drinking risk level reduction could be a meaningful surrogate marker of improvements in how a person "feels and functions" following treatment for alcohol dependence. The WHO drinking risk levels could be useful in medical practice for identifying drinking reduction targets that correspond with clinically significant improvements in health and quality of life.

Project description:BackgroundReductions in the World Health Organization (WHO) risk drinking levels have been proposed as an alternative primary outcome for alcohol clinical trials. Yet, little is known about whether reductions in WHO risk drinking levels can be maintained over time. The current study examined whether reductions in WHO risk drinking levels were maintained for up to 1 year following treatment, and whether reductions over time were associated with improvements in functioning.MethodsSecondary data analysis of individuals with alcohol dependence (n = 1,226) enrolled in the COMBINE study, a multisite, randomized, placebo-controlled clinical trial. Logistic regression was used to examine the maintenance of end-of-treatment WHO risk level reductions and WHO risk level reductions at the 1-year follow-up. Repeated-measures mixed models were used to examine the association between WHO risk level reductions and functional outcomes over time.ResultsAchieving at least a 1- or 2-level reduction in risk by the end of treatment was significantly associated with WHO risk level reductions at the 1-year follow-up assessment (p < 0.001). Among individuals who achieved at least a 1-level reduction by the end of treatment, 85.5% reported at least a 1-level reduction at the 1-year follow-up. Among individuals who achieved at least a 2-level reduction by the end of treatment, 77.8% reported at least a 2-level reduction at the 1-year follow-up. WHO risk level reductions were associated with significantly lower alcohol consumption, better physical health (p < 0.01), and fewer alcohol-related consequences (p < 0.001) up to 1 year following treatment.ConclusionsOne- and 2-level reductions in WHO risk levels during alcohol treatment were maintained after treatment and associated with better functioning over time. These findings support the use of the WHO risk level reductions as an outcome measure that reflects clinically significant improvement in how individuals seeking treatment for alcohol use disorder feel and function.

Dataset Information

Is Readiness to Change Drinking Related to Reductions in Alcohol Use and Consequences? A Week-to-Week Analysis.

Publications

Is Readiness to Change Drinking Related to Reductions in Alcohol Use and Consequences? A Week-to-Week Analysis.

Similar Datasets

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