|
| ||
|
|
||
Brief Alcohol Intervention (brief + alcohol_intervention)
Selected AbstractsBRIEF ALCOHOL INTERVENTION: TIME FOR TRANSLATIONAL RESEARCHADDICTION, Issue 6 2010EILEEN KANER No abstract is available for this article. [source] MEETING THE CHALLENGES FOR RESEARCH AND PRACTICE FOR BRIEF ALCOHOL INTERVENTIONADDICTION, Issue 6 2010ANNE MOYER No abstract is available for this article. [source] Implementation of brief alcohol intervention in primary health care: do nurses' and general practitioners' attitudes, skills and knowledge change?DRUG AND ALCOHOL REVIEW, Issue 6 2005MAURI AALTO Abstract Brief alcohol intervention reduces heavy drinking, but its implementation has been challenging. The purpose was to evaluate self-reported changes in attitudes, skills and knowledge regarding brief intervention among nurses and general practitioners (GPs) during an implementation project. A questionnaire survey was used before and after the implementation to all nurses and GPs working at the time in the seven primary health-care centres of the city of Tampere, Finland. Several positive changes indicate an increased amount of knowledge regarding brief intervention among the professionals during the implementation. This was found especially among the nurses. The success in increasing the knowledge can also be seen in a decrease of training needs. Instead, attitudes and skills among the professionals did not seem to develop positively. Increasing motivational skills especially seems to be the future challenge. [source] Brief alcohol intervention,where to from here?ADDICTION, Issue 6 2010Challenges remain for research, practice ABSTRACT Brief intervention (BI) is intended as an early intervention for non-treatment-seeking, non-alcohol-dependent, hazardous and harmful drinkers. This text provides a brief summary of key BI research findings from the last three decades and discusses a number of knowledge gaps that need to be addressed. Five areas are described: patient intervention efficacy and effectiveness; barriers to BI implementation by health professionals; individual-level factors that impact on BI implementation; organization-level factors that impact on BI implementation; and society-level factors that impact on BI implementation. BI research has focused largely upon the individual patient and health professional levels, with the main focus upon primary health care research, and studies are lacking in other settings. However, research must, to a larger degree, take into account the organizational and wider context in which BI occurs, as well as interaction between factors at different levels, in order to advance the understanding of how wider implementation of BI can be achieved in various settings and how different population groups can be reached. It is also important to expand BI research beyond its current parameters to investigate more ambitious long-term educational programmes and new organizational models. More widespread implementation of BI will require many different interventions (efforts, actions, initiatives, etc.) at different interlinked levels, from implementation interventions targeting individual health professionals' knowledge, skills, attitudes and behaviours concerning alcohol issues, BI and behaviour change counselling to efforts at the organizational and societal levels that influence the conditions for delivering BI as part of routine health care. [source] Brief alcohol interventions have expanded in range but how they work is still mysteriousADDICTION, Issue 8 2003Nick Heather No abstract is available for this article. [source] Implementation of brief alcohol intervention in primary health care: do nurses' and general practitioners' attitudes, skills and knowledge change?DRUG AND ALCOHOL REVIEW, Issue 6 2005MAURI AALTO Abstract Brief alcohol intervention reduces heavy drinking, but its implementation has been challenging. The purpose was to evaluate self-reported changes in attitudes, skills and knowledge regarding brief intervention among nurses and general practitioners (GPs) during an implementation project. A questionnaire survey was used before and after the implementation to all nurses and GPs working at the time in the seven primary health-care centres of the city of Tampere, Finland. Several positive changes indicate an increased amount of knowledge regarding brief intervention among the professionals during the implementation. This was found especially among the nurses. The success in increasing the knowledge can also be seen in a decrease of training needs. Instead, attitudes and skills among the professionals did not seem to develop positively. Increasing motivational skills especially seems to be the future challenge. [source] Six-month outcomes associated with a brief alcohol intervention for adult in-patients with psychiatric disordersDRUG AND ALCOHOL REVIEW, Issue 2 2002GARY K. HULSE Abstract The objective of this study was to evaluate the 6-month outcomes of a brief intervention to reduce alcohol consumption by psychiatric in-patients in the general hospital setting and following resolution of psychiatric morbidity. Patients from the psychiatric wards of three general hospitals were screened using the Alcohol Use Disorders Identification Test. Of 144 people approached who matched the study criteria, 120 (83%) people aged 18,64 years (mean 31.7) were recruited. Participants were randomized to either a brief motivational interview or an information package to reduce alcohol consumption. Alcohol consumption was assessed as total weekly consumption and categorized on Australian National Health and Medical Research Council (NH&MRC) criteria. We delivered 62 motivational interviews and 58 information packages. At the 6-month follow-up 83 (69%), participants were reassessed. Both groups had significantly reduced alcohol consumption. However, the motivation group had a significantly greater reduction in weekly consumption than the information group (F = 6.8, (1,65) p < 0.025) after controlling for age, sex, SCL-90-R GSI and alcohol dependence (and baseline alcohol consumption). A greater proportion of the motivation group compared to the information group also ,improved' in their classification on NH&MRC criteria (,2 = 7.3, df 1, p < 0.01). Brief interventions, especially motivational interviews, are effective in reducing alcohol use in persons with psychiatric disorders. They are effective across the mid-range of GSI severity scores for in-patients. Screening and brief interventions can and should be incorporated into the routine assessment and management in psychiatric units. [source] A brief alcohol intervention for hazardously drinking incarcerated womenADDICTION, Issue 3 2010Michael D. Stein ABSTRACT Objective To test the hypothesis that among hazardously drinking incarcerated women who are returning to the community, a brief alcohol intervention will result in less alcohol use at follow-up relative to standard of care. Methods Eligible participants endorsed hazardous alcohol consumption,four or more drinks at a time on at least 3 separate days in the previous 3 months or a score of 8 or above on the Alcohol Use Disorders Identification Test. Participants were randomized to either an assessment-only condition or to two brief motivationally focused sessions, the first delivered during incarceration, the second 1 month later after community re-entry. Participants recalled drinking behaviors at 3 and 6 months after the baseline interview using a 90-day time-line follow-back method. Results The 245 female participants averaged 34 years of age, and were 71% Caucasian. The mean percentage of alcohol use days in the 3 months prior to incarceration was 51.7% and heavy alcohol use days was 43.9%. Intervention effects on abstinent days were statistically significant at 3 months (odds ratio = 1.96, 95% confidence interval 1.17, 3.30); the percentage of days abstinent was 68% for those randomized to intervention and 57% for controls. At 6 months the effect of the intervention was attenuated and no longer statistically significant. Conclusions Among incarcerated women who reported hazardous drinking, a two-session brief alcohol intervention increased abstinent days at 3 months, but this effect decayed by 6 months. Study participants continued to drink heavily after return to the community. More intensive intervention pre-release and after re-entry may benefit hazardously drinking incarcerated women. [source] Ethnic differences in drinking outcomes following a brief alcohol intervention in the trauma care settingADDICTION, Issue 1 2010Craig A. Field ABSTRACT Background Evidence suggests that brief interventions in the trauma care setting reduce drinking, subsequent injury and driving under the influence (DUI) arrest. However, evidence on the effectiveness of these interventions in ethnic minority groups is lacking. The current study evaluates the efficacy of brief intervention among whites, blacks and Hispanics in the United States. Methods We conducted a two-group parallel randomized trial comparing brief motivational intervention (BMI) and treatment as usual with assessment (TAU+) to evaluate treatment differences in drinking patterns by ethnicity. Patients were recruited from a level 1 urban trauma center over a 2-year period. The study included 1493 trauma patients, including 668 whites, 288 blacks and 537 Hispanics. Hierarchical linear modeling was used to evaluate ethnic differences in drinking outcomes including volume per week, maximum amount consumed in 1 day, percentage days abstinent and percentage days heavy drinking at 6- and 12-month follow-up. Analyses controlled for age, gender, employment status, marital status, prior alcohol treatment, type of injury and injury severity. Special emphasis was given to potential ethnic differences by testing the interaction between ethnicity and BMI. Results At 6- and 12-month follow-up, BMI significantly reduced maximum amount consumed in 1 day (P < 0.001; P < 0.001, respectively) and percentage days heavy drinking (P < 0.05; P < 0.05, respectively) among Hispanics. Hispanics in the BMI group also reduced average volume per week at 12-month follow-up (,2 = 6.8, df = 1, P < 0.01). In addition, Hispanics in TAU+ reduced maximum amount consumed at 6- and 12-month follow-up (P < 0.001; P < 0.001) and volume per week at 12-month follow-up (P < 0.001). Whites and blacks in both BMI and TAU+ reduced volume per week and percentage days heavy drinking at 12-month follow-up (P < 0.001; P < 0.01, respectively) and decreased maximum amount at 6- (P < 0.001) and 12-month follow-up (P < 0.001). All three ethnic groups In both BMI and TAU+ reduced volume per week at 6-month follow-up (P < 0.001) and percentage days abstinent at 6- (P < 0.001) and 12-month follow-up (P < 0.001). Conclusions All three ethnic groups evidenced reductions in drinking at 6- and 12-month follow-up independent of treatment assignment. Among Hispanics, BMI reduced alcohol intake significantly as measured by average volume per week, percentage days heavy drinking and maximum amount consumed in 1 day. [source] A long-standing World Health Organization collaborative project on early identification and brief alcohol intervention in primary health care comes to an endADDICTION, Issue 5 2007NICK HEATHER No abstract is available for this article. [source] Use of marketing to disseminate brief alcohol intervention to general practitioners: promoting health care interventions to health promotersJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2000Catherine A. Lock BSc MA Abstract Health research findings are of little benefit to patients or society if they do not reach the audience they are intended to influence. Thus, a dissemination strategy is needed to target new findings at its user group and encourage a process of consideration and adoption or rejection. Social marketing techniques can be utilized to aid successful dissemination of research findings and to speed the process by which new information reaches practice. Principles of social marketing include manipulating the marketing mix of product, price, place and promotion. This paper describes the development of a marketing approach and the outcomes from a trial evaluating the effectiveness and cost-effectiveness of manipulating promotional strategies to disseminate actively a screening and brief alcohol intervention (SBI) programme to general practitioners (GPs). The promotional strategies consisted of postal marketing, telemarketing and personal marketing. The study took place in general practices across the Northern and Yorkshire Regional Health Authority. Of the 614 GPs eligible for the study, one per practice, 321 (52%) took the programme and of those available to use it for 3 months (315), 128 (41%) actively considered doing so, 73 (23%) actually went on to use it. Analysis of the specific impact of the three different promotional strategies revealed that while personal marketing was the most effective overall dissemination and implementation strategy, telemarketing was more cost-effective. The findings of our work show that using a marketing approach is promising for conveying research findings to GPs and in particular a focus on promotional strategies can facilitate high levels of uptake and consideration in this target group. [source] Brief Intervention for Problem Drinkers in a Chinese Population: A Randomized Controlled Trial in a Hospital SettingALCOHOLISM, Issue 1 2009Yun-Fang Tsai Background:, Alcohol is a legal and accessible substance in Taiwan. As excessive alcohol has been linked to health and social problems, it is necessary to develop a brief, rapid, and low-cost tool to help health care providers deal with persons in Taiwan whose alcohol consumption has become hazardous or harmful to their health. Methods:, A randomized controlled clinical trial with 6- and 12-month follow-ups was designed. Eighteen medical/surgical units at a medical center in northern Taiwan were randomly assigned to 2 groups: experimental (n = 9) and control (n = 9). Inpatients on the units were enrolled if they met the following criteria: were older than 18 years, had no severe psychiatric illness, and were not pregnant. The experimental group (n = 138) received the intervention, a 15-minute counseling visit in which nurses screened participants using the Alcohol Use Disorders Identification Test (AUDIT), provided a health promotion booklet for adults, and individually discussed the booklet contents with patients based on their drinking level (AUDIT score). The control group (n = 137) received no treatment. Patterns of alcohol consumption were determined by AUDIT scores at baseline, 6, and 12 months later. Results:, Alcohol use disorders identification test scores decreased significantly in both groups at 6 months after the intervention, but did not differ significantly between the 2 groups. However, 12 months after the brief alcohol intervention, experimental subjects' AUDIT scores were significantly better than those of the control group. Conclusions:, Our brief alcohol intervention provided a 12-month benefit for problem drinkers in Taiwan. [source] Brief Intervention for Female Heavy Drinkers in Routine General Practice: A 3-Year Randomized, Controlled StudyALCOHOLISM, Issue 11 2000Mauri Aalto Background: Today, heavy drinking is a common health hazard among women. The evidence in favor of providing some kind of brief intervention to reduce drinking is quite convincing. However, we do not know if intervention works in a natural environment of routine health care. The purpose of this study was to evaluate the effectiveness of long-lasting, brief alcohol intervention counseling for women in a routine general practice setting. Methods: In five primary care outpatient clinics in a Finnish town, 118 female early-phase heavy drinkers who consulted their general practitioners for various reasons were given brief alcohol intervention counseling. Intervention groups A (n= 40) and B (n= 38) were offered seven and three brief intervention sessions, respectively, over a 3-yr period. The control group C (n= 40) was advised to reduce drinking at baseline. Main outcome measures were self-reported weekly alcohol consumption, carbohydrate-deficient transferrin, mean corpuscular volume (MCV), aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase. Results: Depending on the outcome measure and the study group, clinically meaningful reduction of drinking was found in 27% to 75% of the heavy drinkers. Within all the groups, MCV significantly decreased. However, there were no statistically significant differences between study groups A, B, and C in the mean changes between the beginning and endpoint in the main outcome measures. Conclusions: The present study indicated that minimal advice, as offered to group C, was associated with reduced drinking as much as the brief intervention, as offered to groups A and B, given over a 3-yr period. Furthermore, in the routine setting of the general practice office, the effectiveness of the brief intervention may not be as good as in special research conditions. The factors possibly reducing the effectiveness in a routine setting are unknown. Thus, different methods of implementing brief intervention need to be evaluated to find better ways to support general practice personnel in their efforts to help heavy-drinking female patients to reduce their drinking. [source] The effectiveness of brief alcohol interventions in primary care settings: A systematic reviewDRUG AND ALCOHOL REVIEW, Issue 3 2009EILEEN F. S. KANER Abstract Issues. Numerous studies have reported that brief interventions delivered in primary care are effective in reducing excessive drinking. However, much of this work has been criticised for being clinically unrepresentative. This review aimed to assess the effectiveness of brief interventions in primary care and determine if outcomes differ between efficacy and effectiveness trials. Approach. A pre-specified search strategy was used to search all relevant electronic databases up to 2006. We also hand-searched the reference lists of key articles and reviews. We included randomised controlled trials (RCT) involving patients in primary care who were not seeking alcohol treatment and who received brief intervention. Two authors independently abstracted data and assessed trial quality. Random effects meta-analyses, subgroup and sensitivity analyses and meta-regression were conducted. Key Findings. The primary meta-analysis included 22 RCT and evaluated outcomes in over 5800 patients. At 1 year follow up, patients receiving brief intervention had a significant reduction in alcohol consumption compared with controls [mean difference: ,38 g week,1, 95%CI (confidence interval): ,54 to ,23], although there was substantial heterogeneity between trials (I2 = 57%). Subgroup analysis confirmed the benefit of brief intervention in men but not in women. Extended intervention was associated with a non-significantly increased reduction in alcohol consumption compared with brief intervention. There was no significant difference in effect sizes for efficacy and effectiveness trials. Conclusions. Brief interventions can reduce alcohol consumption in men, with benefit at a year after intervention, but they are unproven in women for whom there is insufficient research data. Longer counselling has little additional effect over brief intervention. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature is relevant to routine primary care. [Kaner EFS, Dickinson HO, Beyer F, Pienaar E, Schlesinger C, Campbell F, Saunders JB, Burnand B, Heather N. The effectiveness of brief alcohol interventions in primary care settings: A systematic review. Drug Alcohol Rev 2009;28:301,323] [source] Moderators and mediators of two brief interventions for alcohol in the emergency departmentADDICTION, Issue 3 2010Nancy P. Barnett ABSTRACT Objective To evaluate moderators and mediators of brief alcohol interventions conducted in the emergency department. Methods Patients (18,24 years; n = 172) in an emergency department received a motivational interview with personalized feedback (MI) or feedback only (FO), with 1- and 3-month booster sessions and 6- and 12-month follow-ups. Gender, alcohol status/severity group [ALC+ only, Alcohol Use Disorders Identification Test (AUDIT+) only, ALC+/AUDIT+], attribution of alcohol in the medical event, aversiveness of the event, perceived seriousness of the event and baseline readiness to change alcohol use were evaluated as moderators of intervention efficacy. Readiness to change also was evaluated as a mediator of intervention efficacy, as were perceived risks/benefits of alcohol use, self-efficacy and alcohol treatment seeking. Results Alcohol status, attribution and readiness moderated intervention effects such that patients who had not been drinking prior to their medical event, those who had low or medium attribution for alcohol in the event and those who had low or medium readiness to change showed lower alcohol use 12 months after receiving MI compared to FO. In the AUDIT+ only group those who received MI showed lower rates of alcohol-related injury at follow-up than those who received FO. Patients who had been drinking prior to their precipitating event did not show different outcomes in the two interventions, regardless of AUDIT status. Gender did not moderate intervention efficacy and no significant mediation was found. Conclusions Findings may help practitioners target patients for whom brief interventions will be most effective. More research is needed to understand how brief interventions transmit their effects. [source] The Role of Ethnic Matching Between Patient and Provider on the Effectiveness of Brief Alcohol Interventions With HispanicsALCOHOLISM, Issue 2 2010Craig Field Background:, Evaluating the effectiveness of treatments such as brief alcohol interventions among Hispanics is essential to effectively addressing their treatment needs. Clinicians of the same ethnicity as the client may be more likely to understand the culture-specific values, norms, and attitudes and, therefore, the intervention may be more effective. Thus, in cases in which Hispanic patients were provided intervention by a Hispanic clinician improved drinking outcomes were expected. Methods:, Patients were recruited from an urban Level I Trauma following screening for an alcohol-related injury or alcohol problems. Five hundred thirty-seven Hispanics were randomly assigned to brief intervention or treatment as usual. Hierarchical linear modeling was used to determine the effects of ethnic match on drinking outcomes including volume per week, maximum amount, and frequency of 5 or more drinks per occasion. Analyses controlled for level of acculturation and immigration status. Results:, For Hispanics who received brief motivational intervention, an ethnic match between patient and provider resulted in a significant reduction in drinking outcomes at 12-month follow-up. In addition, there was a tendency for ethnic match to be most beneficial to foreign-born Hispanics and less acculturated Hispanics. Conclusion:, As hypothesized, an ethnic match between patient and provider significantly enhanced the effectiveness of brief intervention among Hispanics. Ethnic concordance between patient and provider may have impacted the effectiveness of the intervention through several mechanisms including cultural scripts, ethnic-specific perceptions pertaining to substance abuse, and ethnic-specific preferred channels of communication. [source] | ||||||||||