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Simpson T, Sistad R, Brooks JT, Newberger NG, Livingston NA. Seeking care where they can: A systematic review of global trends in online alcohol treatment utilization among non-veteran and veteran women. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100116. [PMID: 36844155 PMCID: PMC9948922 DOI: 10.1016/j.dadr.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/21/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
Background Findings from a person-level meta-analysis of online alcohol intervention trials suggest that women disproportionately seek out such interventions (Riper et al., 2018). Although women may be a "hidden population" that is particularly drawn to online alcohol interventions, trial design features may explain women's apparent over-representation in these trials. Methods This systematic review examined associations between gender-tailored recruitment/inclusion criteria and proportions of women enrolled in online alcohol intervention trials, evaluated whether community samples have greater proportions of women than clinical samples, and compared country-specific average proportions of women in trials to country-specific proportions of women with Alcohol Use Disorder (AUD). Results Forty-four trials met inclusion/exclusion criteria, 34 community samples and 10 drawn from clinical settings; 4 studies included U.S. veterans and were examined separately. The average proportion of community-recruited women across the studies was 51.20% and the average proportion of clinically-recruited women was 35.81%, a difference that was statistically significant. Across the countries with relevant trials, the expected proportion of those with AUD who are women is 27.1% (World Population Review, 2022). Only 2 studies used targeted recruitment for women so no between-group tests were conducted. There was not a statistically significant difference in the proportion of women across trials that did and did not use gender-tailored alcohol inclusion criteria. Conclusions Results from this systematic review suggest that study design factors do not account for the marked over-representation of women in online alcohol interventions, indicating that women are indeed a "hidden population" whose needs should be understood and accommodated.
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Affiliation(s)
- Tracy Simpson
- Center of Excellence in Substance Addiction Treatment & Education, VA Puget Sound Healthcare System, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Rebecca Sistad
- VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Jack T. Brooks
- VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Noam G. Newberger
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Nicholas A. Livingston
- VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
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Baumann S, Staudt A, Freyer-Adam J, Zeiser M, Bischof G, Meyer C, John U. Three-year trajectories of alcohol use among at-risk and among low-risk drinkers in a general population sample of adults: A latent class growth analysis of a brief intervention trial. Front Public Health 2022; 10:1027837. [PMID: 36466482 PMCID: PMC9714030 DOI: 10.3389/fpubh.2022.1027837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Few studies have assessed trajectories of alcohol use in the general population, and even fewer studies have assessed the impact of brief intervention on the trajectories. Especially for low-risk drinkers, it is unclear what trajectories occur, whether they benefit from intervention, and if so, when and how long. The aims were first, to identify alcohol use trajectories among at-risk and among low-risk drinkers, second, to explore potential effects of brief alcohol intervention and, third, to identify predictors of trajectories. Methods Adults aged 18-64 years were screened for alcohol use at a municipal registration office. Those with alcohol use in the past 12 months (N = 1646; participation rate: 67%) were randomized to assessment plus computer-generated individualized feedback letters or assessment only. Outcome was drinks/week assessed at months 3, 6, 12, and 36. Alcohol risk group (at-risk/low-risk) was determined using the Alcohol Use Disorders Identification Test-Consumption. Latent class growth models were estimated to identify alcohol use trajectories among each alcohol risk group. Sex, age, school education, employment status, self-reported health, and smoking status were tested as predictors. Results For at-risk drinkers, a light-stable class (46%), a medium-stable class (46%), and a high-decreasing class (8%) emerged. The light-stable class tended to benefit from intervention after 3 years (Incidence Rate Ratio, IRR=1.96; 95% Confidence Interval, CI: 1.14-3.37). Male sex, higher age, more years of school, and current smoking decreased the probability of belonging to the light-stable class (p-values<0.05). For low-risk drinkers, a very light-slightly increasing class (72%) and a light-increasing class (28%) emerged. The very light-slightly increasing class tended to benefit from intervention after 6 months (IRR=1.60; 95% CI: 1.12-2.28). Male sex and more years of school increased the probability of belonging to the light-increasing class (p-value < 0.05). Conclusion Most at-risk drinkers did not change, whereas the majority of low-risk drinkers increased alcohol use. There may be effects of alcohol feedback, with greater long-term benefits among persons with low drinking amounts. Our findings may help to identify refinements in the development of individualized interventions to reduce alcohol use.
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Affiliation(s)
- Sophie Baumann
- Department of Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andreas Staudt
- Department of Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jennis Freyer-Adam
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Maria Zeiser
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany
| | - Gallus Bischof
- Department of Psychiatry and Psychotherapy, University Lübeck, Lübeck, Germany
| | - Christian Meyer
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ulrich John
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Boumans J, van de Mheen D, Crutzen R, Dupont H, Bovens R, Rozema A. Understanding How and Why Alcohol Interventions Prevent and Reduce Problematic Alcohol Consumption among Older Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063188. [PMID: 35328875 PMCID: PMC8953167 DOI: 10.3390/ijerph19063188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/05/2022] [Accepted: 03/06/2022] [Indexed: 11/16/2022]
Abstract
Problematic alcohol use has been increasing in older adults (55+) in recent decades. Many of the effective interventions that are available to prevent or reduce the negative effects of alcohol consumption are aimed at adults in general. It is unclear whether these interventions also work for older adults. The objective of this review was to understand how (i.e., which elements), in which context, and why (which mechanisms) interventions are successful in preventing or reducing (problematic) alcohol consumption among older adults. A systematic review of articles published between 2000 and 2022 was performed using PubMed, PsycINFO, Web of Science and CHINAHL. Realist evaluation was used to analyze the data. We found 61 studies on interventions aimed at preventing or reducing problematic alcohol use. Most of the interventions were not specifically designed for older adults but also included older adults. The findings of the current study highlight three major effective elements of interventions: (1) providing information on the consequences of alcohol consumption; (2) being in contact with others and communicating with them about (alcohol) problems; and (3) personalized feedback about drinking behavior. Two of these elements were also used in the interventions especially designed for older adults. Being in contact with others and communicating with them about (alcohol) problems is an important element to pay attention to for developers of alcohol interventions for older adults because loneliness is a problem for this age group and there is a relationship between the use of alcohol and loneliness.
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Affiliation(s)
- Jogé Boumans
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands; (D.v.d.M.); (R.B.); (A.R.)
- Correspondence:
| | - Dike van de Mheen
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands; (D.v.d.M.); (R.B.); (A.R.)
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands; (R.C.); (H.D.)
| | - Hans Dupont
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands; (R.C.); (H.D.)
| | - Rob Bovens
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands; (D.v.d.M.); (R.B.); (A.R.)
| | - Andrea Rozema
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands; (D.v.d.M.); (R.B.); (A.R.)
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Montanaro EA, Magnan R. A latent profile analysis using the theory of planned behavior to predict alcohol use. Psychol Health 2021; 37:799-810. [PMID: 33775196 DOI: 10.1080/08870446.2021.1903462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The current study sought to identify subgroups of adult drinkers who differ in their level of association between alcohol-related Theory of Planned Behavior (TPB) constructs (attitudes, perceived norms, self-efficacy, and intentions), and explore if distinct subgroup profiles relate to alcohol use two weeks later. DESIGN Participants (N = 121) were recruited to participate in a two-week study about daily experiences with exercise and alcohol (Mage = 30.93; SDage = 9.88; 59.2% female; 71.1% Caucasian). MAIN OUTCOME MEASURES Alcohol attitudes, subjective norms, alcohol refusal self-efficacy, and intentions were used to create class membership. Behavioral outcomes included (1) drinking frequency, (2) drinking quantity, and (3) drinking to get drunk. RESULTS Two classes of drinkers were determined - Class 1 was categorized by moderate scores on all constructs, whereas Class 2 was categorized by moderate scores on attitudes and high scores on norms, alcohol refusal self-efficacy, and intentions. Class designation was associated with frequency, but not quantity of use. CONCLUSION The current study suggests that a minority of individuals who score moderately across all constructs should receive intervention efforts that focus on just those included in the TPB, while the vast majority may require additional constructs to be addressed.
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Affiliation(s)
- Erika A Montanaro
- Department of Psychological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Renee Magnan
- Department of Psychology, Washington State University, Vancouver, WA, USA
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Jonas B, Tensil MD, Leuschner F, Strüber E, Tossmann P. Predictors of treatment response in a web-based intervention for cannabis users. Internet Interv 2019; 18:100261. [PMID: 31890614 PMCID: PMC6926274 DOI: 10.1016/j.invent.2019.100261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/08/2019] [Accepted: 07/23/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Trials demonstrate the effectiveness of web-based interventions for cannabis-related disorders. For further development of these interventions, it is of vital interest to identify user characteristics which predict treatment response. METHODS Data from a randomized factorial trial on a web-based intervention for cannabis-users (n = 534) was reanalyzed. As potential predictors for later treatment response, 31 variables from the following categories were tested: socio-demographics, substance use and cognitive processing. The association of predictors and treatment outcome was analyzed using unbiased recursive partitioning and represented as classification tree. Predictive performance of the tree was assessed by comparing its cross-validated results to models derived with all-subsets logistic regression and random forest. RESULTS Goal commitment (p < .001), the extent of self-reflection (p < .001), the preferred effect of cannabis (p = .005) and initial cannabis use (p = .015) significantly differentiate between successful and non-successful participants in all three analysis methods. The predictive accuracy of all three models is comparable and modest. CONCLUSIONS Participants who commit to quit using cannabis, who at least have moderate levels of self-reflection and who prefer mild intoxicating effects were most likely to respond to treatment. To predict treatment response on an individual level, the classification tree should only be used as one of several sources of information.Trial registration: http://www.isrctn.com/ISRCTN99818059.
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Affiliation(s)
- Benjamin Jonas
- Delphi - Gesellschaft, Berlin, Germany,Corresponding author at: Delphi-Gesellschaft für Forschung, Beratung und Projektentwicklung mbH, Kaiserdamm 8, 14057 Berlin, Germany.
| | | | | | - Evelin Strüber
- Federal Centre for Health Education (BZgA), Cologne, Germany
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Bedendo A, Ferri CP, de Souza AAL, Andrade ALM, Noto AR. Pragmatic randomized controlled trial of a web-based intervention for alcohol use among Brazilian college students: Motivation as a moderating effect. Drug Alcohol Depend 2019; 199:92-100. [PMID: 31029880 DOI: 10.1016/j.drugalcdep.2019.02.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/08/2019] [Accepted: 02/09/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Web-based personalized normative feedback (PNF) interventions are less effective than their laboratory versions. Participant motivation may account for this reduced effect, but there is only a limited amount of research into the influence of motivation on PNF effectiveness. We evaluated the effectiveness of a web-based PNF in reducing alcohol use and consequences among college students with different motivation levels. METHODS Pragmatic randomized controlled trial among Brazilian college drinkers aged 18-30 years (N = 4460). Participants were randomized to a Control or PNF group and followed-up after one (T1), three (T2) and six (T3) months. Outcomes were: AUDIT score (primary outcome), the number of consequences, and the typical number of drinks. Motivation for receiving the intervention was assessed with a visual analog scale (range: 0-10). Generalized mixed models assessed intervention effects via two paradigms: observed cases and attrition models. RESULTS PNF reduced the number of typical drinks at T1 (OR = 0.71, p = 0.002), T2 (OR = 0.60, p < 0.001) and T3 (OR = 0.68, p = 0.016), compared to the control. Motivated students (score ≥3) receiving PNF also reduced the number of typical drinks at T1 (OR = 0.60, p < 0.001), T2 (OR = 0.55, p < 0.001) and T3 (OR = 0.56, p = 0.001), compared to the control. However, the attrition models were more robust at T1 and T2. In contrast, low-motivated students receiving the PNF increased AUDIT score at T3 (b = 1.49, p < 0.001). CONCLUSIONS The intervention reduced alcohol use, and motivation for receiving the intervention moderated the intervention effects. Motivated students reduced their typical alcohol use, whereas low-motivated students increased their AUDIT score.
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Affiliation(s)
- André Bedendo
- Department of Psychobiology, Research Center on Health and Substance Use (NEPSIS), Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1º Andar, Vila Clementino, Sao Paulo, CEP: 04023062, SP, Brazil; Department of Health Sciences, Faculty of Sciences, University of York, Seebohm Rowntree Bldg., Heslington, York, YO10 5DD United Kingdom.
| | - Cleusa Pinheiro Ferri
- Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1º Andar, Vila Clementino, Sao Paulo, SP, Brazil
| | - Altay Alves Lino de Souza
- Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1º Andar, Vila Clementino, Sao Paulo, SP, Brazil
| | - André Luiz Monezi Andrade
- Centro de Ciências da Vida (CCV), Pontifícia Universidade Católica de Campinas (PUC-Campinas), Av. John Boyd Dunlop, Jardim Ipaussurama, Campinas, SP, Brazil
| | - Ana Regina Noto
- Department of Psychobiology, Research Center on Health and Substance Use (NEPSIS), Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1º Andar, Vila Clementino, Sao Paulo, CEP: 04023062, SP, Brazil
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Brites RMR, Abreu AMM, Portela LF. REDUCTION OF THE ALCOHOL CONSUMPTION AMONG WORKERS USING A BRIEF INTERVENTION. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-2018-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze the effect of a brief intervention on the reduction of the alcohol consumption pattern among workers from the worker health perspective. Methods: a quasi-experimental study with a single sample of 36 workers, applying the positive (>8) Alcohol Use Disorders Identification Test and sample selection and using data from the Worker Health Booklet in combination with the mentioned test. Participants had three weekly sessions of brief intervention with motivational interviewing and were reevaluated after three months. Data were analyzed quantitatively. The Wilcoxon test was applied to data on the reduction of the consumption pattern, and a significance p<0.05 was adopted. Results: risky consumption prevailed (61.1%), followed by probable dependence (27.8%) and hazardous consumption (11.1%). The score obtained in the test after three months of the brief intervention was lower than the initial result, with Z=-4.709 and p<0.000. Regarding sociodemographic and occupational characteristics, all the participants showed a significant reduction. Concerning Alcohol Use Disorders Identification Test questions, there was a reduction, especially in the frequency (Z=-3.880 and p<0.000) and binge drinking (Z=-4.144 and p<0.000). Conclusion: the effect of brief intervention associated with motivational interviewing reduced the alcohol consumption pattern among workers at a public university.
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Staudt A, Freyer-Adam J, Meyer C, John U, Baumann S. Short-term stability of different drinking patterns over the course of four weeks among adults. A latent transition analysis. Drug Alcohol Depend 2018; 191:181-186. [PMID: 30125760 DOI: 10.1016/j.drugalcdep.2018.06.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The purpose of the present study was to identify drinking patterns and determine their intraindividual stability over the course of four weeks among a sample of adults from the general population. METHODS The sample comprised 288 adults who reported drinking alcohol at least once per month (49% female; mean age = 33.1 years, SD = 12.8 years). Participants were recruited in the waiting area of a local registration office in northeastern Germany. Data were collected four times over four consecutive weeks by interview (once in the registration office and thrice by telephone). To assess alcohol consumption in the past seven days, timeline follow-back questions were administered each time. For data analysis, latent profile and latent transition analyses were applied. Indicators for latent classes were total number of drinks per seven days, number of drinking days, and number of days with heavy episodic drinking. RESULTS Three classes of seven-day drinking patterns were identified at baseline: (a) light drinkers (77%), (b) moderate drinkers (18%), and (c) heavy drinkers (5%). Approximately one-fifth (21%) of baseline light drinkers and 94% of baseline moderate drinkers changed their drinking pattern at least once during the four weeks. The majority (81%) of baseline moderate drinkers also reported light drinking in at least one of the three subsequent weeks. CONCLUSIONS Our findings suggest intraindividual changes in drinking patterns even during a short period of time. Instability of drinking patterns may potentially impair the assessment of light to moderate alcohol consumption when a quantity-frequency approach is applied.
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Affiliation(s)
- Andreas Staudt
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, D-17475 Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, Fleischmannstr. 42-44, D-17475 Greifswald, Germany.
| | - Jennis Freyer-Adam
- German Centre for Cardiovascular Research, Partner Site Greifswald, Fleischmannstr. 42-44, D-17475 Greifswald, Germany; Institute for Medical Psychology, University Medicine Greifswald, Walther-Rathenau-Str. 48, D-17475 Greifswald, Germany.
| | - Christian Meyer
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, D-17475 Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, Fleischmannstr. 42-44, D-17475 Greifswald, Germany.
| | - Ulrich John
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, D-17475 Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, Fleischmannstr. 42-44, D-17475 Greifswald, Germany.
| | - Sophie Baumann
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, D-17475 Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, Fleischmannstr. 42-44, D-17475 Greifswald, Germany; Institute and Policlinic for Occupational and Social Medicine, Medical Faculty, TU Dresden, Fetscherstr. 74, D-01307 Dresden, Germany.
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