Combining motivational and volitional approaches to reducing excessive alcohol consumption in pre-drinkers: a theory-based intervention protocol.
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ABSTRACT:
SUBMITTER: Caudwell KM
PROVIDER: S-EPMC4715875 | biostudies-other | 2016 Jan
REPOSITORIES: biostudies-other
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Project description:Background and aimsThe global growth of mobile phone use has led to new opportunities for health interventions, including through text messaging. We aimed to estimate the effects of text messaging interventions on alcohol consumption among risky drinkers.MethodsSystematic review and meta-analysis of reports on randomized controlled trials (RCTs) published in English. Searches were conducted on 23 May 2019 in PubMed; PubMed Central; CENTRAL; CDSR; DARE; NHS-EED; Scopus; PsycINFO; PsycARTICLES; CINAHL; and Web of Science. Measurements included number of episodes of heavy drinking (HED) per month and weekly alcohol consumption (WAC) in grams. Trials among risky drinkers who were not receiving co-interventions were included in the review (n = 3481, mean age 29 years, 41% female). Data were extracted from reports and authors were contacted for additional data.ResultsTen trials were included and all analyses were based on random-effects models. Primary analyses, including seven trials (n = 2528) for HED and five trials (n = 2236) for WAC, found that the interventions may reduce self-reported HED [-0.33 episodes per month; 95% confidence interval (CI) = -0.79, 0.12] and WAC (-18.62 g per week; 95% CI = -39.61, 2.38), although both estimates included the null. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality of evidence was judged to be low for both HED and WAC, primarily due to risk of attrition and performance bias, heterogeneity and influence of pilot trials on estimates.ConclusionsText messaging alcohol interventions may reduce alcohol consumption compared with no or basic health information; however, there are doubts about the overall quality of the evidence.
| S-EPMC8247265 | biostudies-literature
Project description:BackgroundHarmful use of alcohol continues to be a leading contributor to premature deaths globally. Not only does harmful drinking have consequences for the individuals consuming at increased levels, but it may also result in a range of negative consequences for their family members and friends. Interventions delivered via mobile phones (mobile health [mHealth] interventions) could potentially support risky drinkers seeking help to reduce their alcohol consumption.ObjectiveThis protocol describes a randomized controlled trial that aims to validly estimate the effect of a novel mHealth intervention targeting risky drinkers in the general population of Sweden. Nested within the trial are 3 substudies that focus on methodological and user satisfaction research questions.MethodsA 2-arm parallel group randomized controlled trial will be employed to estimate the effect of the novel intervention. Participants will be recruited through Web advertisements and social media. The inclusion criteria are as follows: 18 years or older, ownership of a mobile phone, and being classified as a risky drinker according to Swedish guidelines. Participants allocated to the intervention group will receive a novel mHealth intervention. The intervention consists of weekly screening, personalized feedback on current consumption, functions allowing for planning of future consumption, as well as a series of messages delivered throughout the week. Participants allocated to the control group will receive a short message regarding negative consequences of alcohol consumption and a hyperlink that offers more information. Following 2 and 4 months after randomization, both groups will be asked to complete follow-up questionnaires (2-month interval being primary). Primary outcomes are weekly alcohol consumption and heavy episodic drinking. Participants in the control group will be given access to the novel intervention after completing the 4-month follow-up. The trial includes 3 substudies: We will explore whether the mode of presenting information before participants giving informed consent affects participation rates and recall of trial parameters, investigate if the content of the short message received by the control group affects study outcomes and requests for more information, and explore user satisfaction with the intervention and reactions of the control group.ResultsParticipant recruitment is planned to begin in April 2019 and to last for a maximum of 24 months. The first dataset will be available approximately 2 months after the final participant has been recruited, and the final dataset will be available approximately 2 months later. No participants had been recruited at the time of submitting this protocol.ConclusionsIf found effective, the intervention has the potential to reduce negative consequences of alcohol consumption for individuals. The technology has been designed to have potential for extensive reach among those who may benefit.Trial registrationISRCTN Registry ISRCTN48317451; http://www.isrctn.com/ISRCTN48317451 (Archived by WebCite at http://www.webcitation.org/779tKLsu3).International registered report identifier (irrid)PRR1-10.2196/13119.
| S-EPMC6495288 | biostudies-literature
Project description:Alcohol consumption is often assessed over weeks to months, but few attempts have been made to characterize alcohol consumption rates at the level of an individual drinking session. Here, we aimed to compare the rate of alcohol consumption in social drinkers at high risk for alcohol use disorder (AUD) and heavy drinkers. One hundred and sixty social drinkers and 48 heavy drinkers participated in an alcohol self-administration study. Social drinkers were classified as low risk or high risk for AUD based on sex, impulsivity, and family history of alcoholism. Participants received a priming dose of intravenous alcohol to assess alcohol-induced craving and completed a 125-minute intravenous alcohol self-administration session to assess rate of achieving a binge-level exposure (blood alcohol concentration greater than or equal to 80 mg%). There were no differences between rates of binging in high-risk and heavy drinkers (hazard ratio = 0.87; 95% CI, 0.48-1.56). Heavy drinkers reported higher levels of craving than high-risk and low-risk drinkers at baseline. However, following a priming dose of alcohol, there were no longer differences in craving between high-risk and heavy drinkers. These results indicate that high-risk social drinkers demonstrate binging behavior that is similar to heavy drinkers, which may be driven by alcohol-induced craving. Prospective studies are needed to elucidate whether these patterns of craving and consumption in high-risk social drinkers are predictive of future AUD.
| S-EPMC6717699 | biostudies-literature
Project description:BACKGROUND::Research suggests that acute alcohol consumption alters recognition of emotional expressions. Extending this work, we investigated the effects of alcohol on recognition of six primary expressions of emotion. METHODS::We conducted two studies using a 2 × 6 experimental design with a between-subjects factor of drink (alcohol, placebo) and a within-subjects factor of emotion (anger, disgust, sadness, surprise, happiness, fear). Study one ( n = 110) was followed by a direct replication study ( n = 192). Participants completed a six alternative forced choice emotion recognition task following consumption of 0.4 g/kg alcohol or placebo. Dependent variables were recognition accuracy (i.e. hits) and false alarms. RESULTS::There was no clear evidence of differences in recognition accuracy between groups ( ps > .58). In study one, there were more false alarms for anger in the alcohol compared to placebo group ( n = 52 and 56, respectively; t(94.6) = 2.26, p = .024, d = .44) and fewer false alarms for happiness ( t(106) = -2.42, p = .017, d = -.47). However, no clear evidence for these effects was found in study two (alcohol group n = 96, placebo group n = 93, ps > .22). When the data were combined we observed weak evidence of an effect of alcohol on false alarms of anger ( t(295) = 2.25, p = .025, d = .26). CONCLUSIONS::These studies find weak support for biased anger perception following acute alcohol consumption in social consumers, which could have implications for alcohol-related aggression. Future research should investigate the robustness of this effect, particularly in individuals high in trait aggression.
| S-EPMC6404104 | biostudies-other
Project description:Almost half of convicted jail inmates have an alcohol use disorder and many are released to environments that put them in contact with network members and cues that make them more likely to relapse on alcohol or drugs. Given the high-risk period immediately following release, the purpose of this study was to examine the efficacy of a brief motivational intervention administered just prior to release to increase substance use treatment entry and attendance, decrease alcohol and drug use, and change social networks for inmates with alcohol use disorders. Forty adult male inmates with AUDs were consented into the study and randomized to a motivational intervention or the control condition (an educational intervention), and then were contacted to do a 1-month follow-up interview (62.5% completed this interview). Results indicated that conducting these interventions was feasible and considered extremely helpful by participants. Although there were no significant group differences, medium to large effect sizes suggest possible benefits from the motivational intervention in decreasing days of alcohol and drug use and increasing abstinence, and reducing the proportion of heavy drug users or users of any kind in the social network. Future studies should replicate these findings in larger sample sizes and over longer follow-up time periods. Results may have implications for the use of brief intervention strategies at jails for inmates with AUDs.
| S-EPMC4955738 | biostudies-literature
Project description:BACKGROUND:The literature shows that computer-delivered interventions with personalized normative feedback can reduce problem drinking for up to 6 months in the West. Meanwhile, no studies have been conducted to examine the effects of such interventions among Japanese problem drinkers. Possible moderators associated with effectiveness of the intervention need to be also explored. OBJECTIVE:The purpose of this study is to conduct a trial and examine the efficacy of a brief intervention with personal normative feedback and psychoeducation on several measures of alcohol consumption among Japanese problem drinkers. Additionally, this study will examine whether the level of alcohol use disorder and beliefs about the physical and psychological outcomes of drinking moderate the effect of the intervention on outcome measures. METHODS:This study will conduct a single-blind, 2-armed randomized controlled trial. Japanese adults with an Alcohol Use Disorder Identification Test score of 8 or higher will be enrolled in the trial. Participants allocated to the intervention group will receive the intervention immediately after the baseline measurements, and participants allocated to the waitlist group will receive the intervention at the end of the trial. Outcome measures include drinking quantity, drinking frequency, and alcohol-related consequences. Follow-up assessment will take place at 1 month, 2 months, and 6 months following the baseline measurement. The authors will not know the group allocation during trial. The authors will plan to collect a sample of 600 participants. Mixed-effect analyses of variance will be used to examine the main effects of condition, the main effects of time, and the interaction effects between condition and time on outcome variables. RESULTS:Enrollment for the trial began on January 6, 2018 and data are expected to be available by August 2018. CONCLUSIONS:This study will contribute to the literature by demonstrating the efficacy of Web-based screenings and brief interventions among Japanese problem drinkers and indicating several possible moderators between the intervention and outcomes. This type of Web-based brief intervention has the possibility of being implemented in Japanese schools and workplaces as a prevention tool. TRIAL REGISTRATION:UMIN Clinical Trials Registry R000034388; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno=R000034388 (Archived by WebCite at http://www.webcitation.org/6xmOoTfTI). REGISTERED REPORT IDENTIFIER:RR1-10.2196/10650.
| S-EPMC6000480 | biostudies-literature
Project description:College students are particularly vulnerable to risky alcohol use, which increases their likelihood of developing an alcohol use disorder in the future. As such, preventing and reducing alcohol use among college students should be a priority for health and social policies. This work was aimed to show that brief group-delivered MI is as effective as brief-group CBT at reducing alcohol use in college students. Eighty-nine college students (69 females; mean age = 21.01, SD = 2.85) with risky alcohol use, as measured by the AUDIT-C, were assigned to two groups, receiving three sessions of either brief group-delivered MI or CBT (bMI/bCBT). Alcohol use was assessed 3 and 6 months after the interventions, and analyzed according to an Intention-to-treat design. Changes in alcohol use at both points (relative to baseline) as well as post-intervention scores of intention to continue treatment and satisfaction with the psychologist were compared across groups, using one-sided Bayesian t-tests. Alcohol use decreased in both groups at the 3- and 6-months measurement points (relative to baseline). However, using bCBT superiority as an alternative hypothesis and the absence of such superiority as a point-null hypothesis, the Bayes factors supported the null at both the 3- and the 6-months follow-up (BF01 = 7.13, and BF01 = 5.22 respectively). Furthermore, the intention to continue treatment was substantially higher in the bMI group (BF10 = 9.77). These results are considerably robust to changes in analyses' priors. This study suggests that bCBT is not more effective than bMI at reducing alcohol use in our college student group (in which females are overrepresented). Additionally, bMI showed higher intention to continue treatment scores. The comparable results of brief and group-delivered CBT and MI interventions in alcohol use reduction allows clinicians to select treatments based on their own skills or preferences without any detriment to efficacy.
| S-EPMC6903743 | biostudies-literature
Project description:Excessive alcohol consumption poses a serious problem for public health. Digital behavior change interventions have the potential to help users reduce their drinking. In accordance with Open Science principles, this paper describes the development of a smartphone app to help individuals who drink excessively to reduce their alcohol consumption. Following the UK Medical Research Council's guidance and the Multiphase Optimization Strategy, development consisted of two phases: (i) selection of intervention components and (ii) design and development work to implement the chosen components into modules to be evaluated further for inclusion in the app. Phase 1 involved a scoping literature review, expert consensus study and content analysis of existing alcohol apps. Findings were integrated within a broad model of behavior change (Capability, Opportunity, Motivation-Behavior). Phase 2 involved a highly iterative process and used the "Person-Based" approach to promote engagement. From Phase 1, five intervention components were selected: (i) Normative Feedback, (ii) Cognitive Bias Re-training, (iii) Self-monitoring and Feedback, (iv) Action Planning, and (v) Identity Change. Phase 2 indicated that each of these components presented different challenges for implementation as app modules; all required multiple iterations and design changes to arrive at versions that would be suitable for inclusion in a subsequent evaluation study. The development of the Drink Less app involved a thorough process of component identification with a scoping literature review, expert consensus, and review of other apps. Translation of the components into app modules required a highly iterative process involving user testing and design modification.
| S-EPMC6417151 | biostudies-literature
Project description:BackgroundBinge drinking (BD) refers to a pattern of alcohol consumption characterized by the consumption of large amounts of alcohol in a short period of time followed by periods of abstinence. This drinking pattern is prevalent worldwide, mainly among young people. Excessive alcohol consumption is the spectrum of consumption patterns that may have or have had health consequences, and includes the concepts of risky alcohol use, harmful alcohol use and alcohol dependence according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), the latter two are currently grouped into alcohol use disorder (AUD) according to the fifth edition of the DSM (DSM-5). Due to the high prevalence of BD among young people, especially university students, as well as the important consequences of its practice, a study was conducted to evaluate excessive alcohol consumption and its relationship with the practice of BD in university students.MethodsA cross-sectional study was conducted among students (aged 18-30 years) enrolled in the academic year 2018-2019 at the Faculty of Nursing at a university in northern Spain. Data collection included sociodemographic information, and alcohol use information, collected using a semi-structured questionnaire. To measure the excessive alcohol consumption, this study used the Alcohol Use Disorders Identification Test (AUDIT).ResultsA total of 142 participants were included, of which 88.03% were women. Up to 38.03% were classified as BD. Up to 14.77% of non-BD participants and 66.67% of BD participants were classified as risky drinkers (AUDIT Total geq 8 in men or geq 6 in women) (p < 0.001). Up to 3.41% of the non-BD and 24.07% of the BD were drinkers with harmful alcohol use and probable alcohol dependence (AUDIT Total geq 13) (p < 0.001). A total of 5.68% of non-BD and 42.59% of BD were AUD drinkers (AUDIT Total geq 9 in males or geq 8 in females) (p < 0.001). In addition, statistically significant differences were found between the BD and non-BD groups in the responses to each of the AUDIT items, as well as in the total score and also in the scores of the three domains of the questionnaire.ConclusionsExcessive alcohol consumption is frequent among university students, especially among those who practice BD.
| S-EPMC9083527 | biostudies-literature
Project description:BACKGROUND:While there is a substantial literature on the efficacy of brief motivational intervention (BMI) for college student drinkers, research has focused less on young adults who do not attend a 4-year college, despite their elevated risk for excessive alcohol use and associated harmful consequences. METHODS:This randomized controlled trial (NCT01546025) compared the efficacy of BMI to a time-matched attention control intervention (relaxation training [REL]) for reducing alcohol consumption and related negative consequences in an underage young adult sample. BMI was tailored to the developmental transition out of high school for young adults who were not immediately planning to enroll in a 4-year college. Non-treatment-seeking underage drinkers who reported past-month heavy drinking (N = 167; ages 17 to 20; 42% female; 59% non-Hispanic White) were randomly assigned to receive a single session of BMI or REL. Outcomes were evaluated 6 weeks and 3 months postintervention via in-person assessments. RESULTS:Generalized estimating equation models provided strong support for the efficacy of BMI for reducing harmful drinking in these young adults. Compared to REL, and after controlling for baseline covariates including gender, those who received BMI subsequently reported significantly fewer average drinks per week, percent drinking days, percent heavy drinking days, lower peak and typical estimated blood alcohol concentration on drinking days, and fewer adverse consequences of drinking (all ps < 0.05). These between-group effects did not weaken over the course of the 3-month follow-up period. CONCLUSIONS:These findings demonstrate an efficacious approach to tailoring BMI for non-college-attending young adults. Future research should replicate and extend these findings over a longer follow-up period.
| S-EPMC6084798 | biostudies-literature