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Gamarel KE, Durst A, Zelaya DG, van den Berg JJ, Souza T, Johnson MO, Wu E, Monti PM, Kahler CW. ReACH2Gether: Iterative Development of a Couples-Based Intervention to Reduce Alcohol use Among Sexual Minority Men Living with HIV and Their Partners. AIDS Behav 2024; 28:1244-1256. [PMID: 37548795 PMCID: PMC11017934 DOI: 10.1007/s10461-023-04148-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2023] [Indexed: 08/08/2023]
Abstract
Unhealthy alcohol use, which encompasses heavy episodic drinking to alcohol use disorder, has been identified as a modifiable barrier to optimal HIV care continuum outcomes. Despite the demonstrated efficacy of couples-based interventions for addressing unhealthy alcohol use, there are no existing couples-based alcohol interventions designed specifically for people living with HIV. This study presents the development and refinement of a three-session couples-based motivational intervention (ReACH2Gether) to address unhealthy alcohol use among a sample of 17 sexual minority men living with HIV and their partners living in the United States. To increase potential population reach, the intervention was delivered entirely remotely. Throughout an original and a modified version, results indicated that the ReACH2Gether intervention was acceptable and there were no reports of intimate partner violence or adverse events. Session engagement and retention were high. In pre-post-test analyses, the ReACH2Gether intervention showed trends in reducing Alcohol Use Disorder Identification Test scores and increasing relationship-promoting dynamics, such as positive support behaviors and goal congruence around alcohol use. Results support the need for continued work to evaluate the ReACH2Gether intervention.
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Affiliation(s)
- Kristi E Gamarel
- Deparment of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - Ayla Durst
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - David G Zelaya
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jacob J van den Berg
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Timothy Souza
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Mallory O Johnson
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Elwin Wu
- Social Intervention Group, Columbia University School of Social Work, New York, NY, USA
| | - Peter M Monti
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Bush R, Staiger PK, McNeill IM, Brown R, Orellana L, Lubman D, McNair R. Evaluation of an SMS Based Alcohol Intervention for Same Sex Attracted Women: A Randomized Controlled Trial to Examine Feasibility, Acceptability, and Efficacy. Subst Use Misuse 2024; 59:1157-1166. [PMID: 38407160 DOI: 10.1080/10826084.2024.2321257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
PURPOSE The purpose of this randomized controlled trial (Trial registration ID: redacted) was to examine the feasibility, acceptability, and efficacy of the Step One program, an SMS-based alcohol intervention for same-sex attracted women (SSAW). METHODS Ninety-seven SSAW who scored ≥8 on the Alcohol Use Disorders Identification Test (AUDIT) were randomly allocated to receive the Step One program (n = 47; mean age = 36.79) or a weekly message containing a link to a website with health information and support services for LGBT individuals (n = 50; mean age = 34.08). Participants completed questionnaires on alcohol use, wellbeing, and help-seeking at baseline (T1), intervention completion (T2; 4 wk after baseline) and 12 wk post-intervention (T3). In addition, participants in the intervention condition completed feasibility and accessibility measures at T2, and a subsample (n = 10) was interviewed about acceptability at T3. RESULTS Across conditions, participants significantly reduced their alcohol intake and improved their wellbeing and help-seeking over time. However, there were no significant differences between the intervention and control condition. Furthermore, frequency of help-seeking was low; only four intervention group participants and three control group participants began accessing support between T1 and T3. Overall, our findings indicate the intervention would benefit from revision prior to implementation. CONCLUSIONS Our approach was consistent with best practice in the development of an ecologically valid intervention; however, this intervention, in its current form, lacks the complexity desired by its users to optimally facilitate alcohol reduction among SSAW. Keywords: Alcohol intervention; Intervention mapping framework; Randomized controlled trial (RCT); Same-sex attracted women; Short-message service (SMS).
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Affiliation(s)
- Rachel Bush
- School of Psychology, Deakin University, Geelong, Australia
| | | | - Ilona M McNeill
- School of Psychology, Deakin University, Geelong, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Rhonda Brown
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | | | - Dan Lubman
- Turning Point, Monash University, Eastern Health, Richmond, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, Carlton, Australia
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Brem MJ, Shorey RC, Ramsey SE, Stuart GL. Randomized Clinical Trial of a Brief Alcohol Intervention as an Adjunct to Batterer Intervention for Women Arrested for Domestic Violence. Interv Psicosoc 2023; 32:79-88. [PMID: 37383647 PMCID: PMC10294462 DOI: 10.5093/pi2023a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/10/2023] [Indexed: 06/30/2023]
Abstract
Despite a rise in women being arrested for domestic violence and court-ordered to batterer intervention, batterer interventions remain limited in their ability to address women's treatment needs. Alcohol use is an important intervention target: one-third of women in batterer interventions have an alcohol-related diagnosis, half engage in at-risk drinking, and alcohol use contributes to intimate partner violence (IPV) and batterer intervention dropout. Research has not evaluated whether adding an alcohol intervention to batterer intervention improves women's alcohol use and IPV outcomes. We randomized 209 women (79.9% white) in Rhode Island to receive the state-mandated batterer intervention program alone or the batterer intervention program plus a brief alcohol intervention. Alcohol use (percentage of days abstinent from alcohol [PDAA], number of drinks per drinking day [DPDD], percentage of heavy drinking days [PHDD], percentage of days abstinent from alcohol and drugs [PDAAD]), and IPV perpetration and victimization frequency (psychological, physical, and sexual IPV, injury) data were collected at baseline and 3-, 6-, and 12-month follow-up. Multilevel modeling revealed that, relative to the batterer intervention alone, women who received the brief alcohol intervention reported a higher PDAA and PDAAD, fewer DPDD, and a lower PHDD across all follow-up assessments. Women who received the brief alcohol intervention perpetrated less physical IPV and experienced less injury than did women who only received the batterer intervention. For physical IPV, these differences became more pronounced over time. No other group differences or group x time interactions emerged. Adding an alcohol intervention may improve batterer intervention outcomes for women arrested for domestic violence.
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Affiliation(s)
- Meagan J. Brem
- Virginia Polytechnic Institute and State UniversityBacksburgUSAVirginia Polytechnic Institute and State University, Backsburg, USA;
| | - Ryan C. Shorey
- University of Wisconsin-MilwaukeeUSAUniversity of Wisconsin-Milwaukee, USA
| | - Susan E. Ramsey
- Alpert Medical School of Brown UniversityRhode Island HospitalProvidenceUSAAlpert Medical School of Brown University and Rhode Island Hospital, Providence, USA;
| | - Gregory L. Stuart
- University of Tennessee-KnoxvilleUSAUniversity of Tennessee-Knoxville, USA
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Abstract
Older adults continue to drink as they age. Aging changes alcohol kinetics just as with any other drug. Older adults have increased sensitivity to acute alcohol intake that accounts for the increased risk of falls, traffic accidents, and other injury. The Annual Medicare Wellness Exam is an excellent opportunity to introduce screening for unsafe drinking along with accumulated risks and deficits of aging. Older adults have responded well to brief interventions for unhealthy drinking. In the presence of alcohol use disorder or serious comorbidity including psychiatric illness, referral to specialized multidisciplinary care can be lifesaving.
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Kuhns LM, Karnik N, Hotton A, Muldoon A, Donenberg G, Keglovitz K, McNulty M, Schneider J, Summersett-Williams F, Garofalo R. A randomized controlled efficacy trial of an electronic screening and brief intervention for alcohol misuse in adolescents and young adults vulnerable to HIV infection: step up, test up study protocol. BMC Public Health 2020; 20:30. [PMID: 31914971 PMCID: PMC6950936 DOI: 10.1186/s12889-020-8154-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young people account for more than a quarter of new HIV infections in the US, with the majority of cases among young men who have sex with men; young transgender women are also vulnerable to infection. Substance use, particularly alcohol misuse, is a driver of sexual transmission and a potential barrier to engagement in the HIV prevention and care continuum, however vulnerable youth are difficult to reach for substance use services due, in part, to complex social and structural factors and limited access to health care. The Community Prevention Services Task Force recommends electronic screening and brief intervention as an evidence-based intervention for the prevention of excessive alcohol consumption; however, no prior studies have extended this model to community-based populations of youth that are susceptible to HIV infection. This paper describes the study protocol for an electronic screening and brief intervention to reduce alcohol misuse among adolescents and young adults vulnerable to HIV infection in community-based settings. METHODS This study, Step Up, Test Up, is a randomized controlled trial of an electronic alcohol screening and brief intervention among youth, ages 16-25, who are vulnerable to HIV infection. Individuals who present for HIV testing at one of three community-based locations are recruited for study participation. Eligibility includes those aged 16-25 years, HIV-negative or unknown HIV status, male or trans female with a history of sex with men, and English-speaking. Participants who screen at moderate to high risk for alcohol misuse on the Alcohol Use Disorders Identification Test (AUDIT) are randomized (1:1) to either an electronic brief intervention to reduce alcohol misuse or a time-and attention-matched control. The primary outcome is change in the frequency/quantity of recent alcohol use at 1, 3, 6 and 12-month follow-up. DISCUSSION Testing of evidence-based interventions to reduce alcohol misuse among youth vulnerable to HIV infection are needed. This study will provide evidence to determine feasibility and efficacy of a brief electronically-delivered intervention to reduce alcohol misuse for this population. TRIAL REGISTRATION ClinicalTrials.gov number, NCT02703116, registered March 9, 2016.
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Affiliation(s)
- Lisa M Kuhns
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611, USA. .,Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Niranjan Karnik
- Department of Psychiatry & Behavioral Sciences, Rush Medical College, Rush University, Chicago, IL, USA
| | - Anna Hotton
- Chicago Center for HIV Elimination, University of Chicago Medicine, Chicago, IL, USA
| | - Abigail Muldoon
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611, USA
| | - Geri Donenberg
- Department of Medicine, University of Illinois at Chicago, Center for Dissemination and Implementation Science, Chicago, IL, USA
| | | | - Moira McNulty
- Chicago Center for HIV Elimination, University of Chicago Medicine, Chicago, IL, USA
| | - John Schneider
- Chicago Center for HIV Elimination, University of Chicago Medicine, Chicago, IL, USA.,Howard Brown Health, Chicago, IL, USA
| | - Faith Summersett-Williams
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611, USA.,Department of Psychiatry, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Robert Garofalo
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611, USA.,Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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6
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Kahler CW, Surace A, Durst A, Pantalone DW, Mastroleo NR, Miguez MJ, Bueno D, Liu T, Monti PM, Mayer KH. Telehealth interventions to reduce alcohol use in men with HIV who have sex with men: Protocol for a factorial randomized controlled trial. Contemp Clin Trials Commun 2019; 16:100475. [PMID: 31701045 PMCID: PMC6831665 DOI: 10.1016/j.conctc.2019.100475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Heavy alcohol use is prevalent among men who have sex with men (MSM) living with HIV and is associated with reduced antiretroviral therapy adherence, reduced HIV viral suppression, and reduced survival. We recently found that compared to HIV treatment as usual, three sessions of in-person motivational interviewing (MI) substantially reduced drinking in MSM with HIV. In an effort to enhance the effectiveness and efficiency of this intervention, the present study will test whether MI is more effective than brief intervention when delivered by videoconferencing, whether interactive text messaging (ITM) can enhance the effects of alcohol intervention, and whether extended duration of intervention is more effective than brief duration. METHODS Using a 2 × 2 × 2 factorial design, we will randomly assign 224 heavy-drinking MSM with HIV to: MI or brief intervention (BI); ITM or no ITM; Standard or Extended intervention (EI). All participants will receive intervention immediately after baseline assessment via videoconferencing and at 1-month post baseline via telephone. Participants randomized to EI will receive additional intervention sessions at 3, 6, and 9 months. Participants randomized to ITM will receive daily interactive texts about alcohol use for 1 month, with those randomized to EI receiving weekly interactive texts through 9 months. Alcohol and HIV-related outcomes will be assessed at 6 and 12 months post baseline. CONCLUSION By testing the combinations of interventions that can most effectively reduce alcohol use among MSM with HIV, this study will set the stage for wider-scale implementation of an optimized intervention combination.
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Affiliation(s)
- Christopher W. Kahler
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Anthony Surace
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Ayla Durst
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - David W. Pantalone
- The Fenway Institute, Fenway Health Boston, MA, USA
- University of Massachusetts - Boston, Boston, MA, USA
| | - Nadine R. Mastroleo
- College of Community and Public Affairs, Binghamton University (SUNY), Binghamton, NY, USA
| | | | - Diego Bueno
- Florida International University, Miami, FL, USA
| | - Tao Liu
- Center for Statistical Sciences and Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | - Peter M. Monti
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health Boston, MA, USA
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
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7
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Seddon JL, Wadd S, Wells E, Elliott L, Madoc-Jones I, Breslin J. Drink wise, age well; reducing alcohol related harm among people over 50: a study protocol. BMC Public Health 2019; 19:240. [PMID: 30819125 PMCID: PMC6394010 DOI: 10.1186/s12889-019-6525-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/08/2019] [Indexed: 11/20/2022] Open
Abstract
Background Evidence suggests that the use of alcohol among older adults (defined as those aged 50+) has increased in recent years, with people aged 55–64 now more likely to exceed the recommended weekly guidelines than any other age group. Methods/ design This is a quasi-experimental study with a before-after design. A postal questionnaire will be sent to 76,000 people aged 50 and over registered with a general practice in five different ‘demonstration’ (intervention) and control areas in the UK. Multiple interventions will then be delivered in demonstration areas across the UK. At the end of the programme, a postal questionnaire will be sent to the same individuals who completed it pre-programme to establish if there has been a reduction in alcohol use, at-risk drinking and alcohol related problems. Qualitative interviews with clients and staff will explore how the interventions were experienced; how they may work to bring about change and to identify areas for practice improvements. Discussion This study protocol describes a multi-level, multi-intervention prevention-to-treatment programme which aims to reduce alcohol-related harm in people aged 50 and over.
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Affiliation(s)
- J L Seddon
- Substance Misuse and Ageing Research Team, Tilda Goldberg Centre for Social Work and Social Care, University of Bedfordshire, Park Square, Luton, Bedfordshire, LU1 3NJ, UK.
| | - S Wadd
- Substance Misuse and Ageing Research Team, Tilda Goldberg Centre for Social Work and Social Care, University of Bedfordshire, Park Square, Luton, Bedfordshire, LU1 3NJ, UK
| | - E Wells
- Drink Wise, Age Well Programme, Furnival House, 48 Furnival Gate, Sheffield, S1 4QP, UK
| | - L Elliott
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK
| | | | - J Breslin
- Drink Wise, Age Well Programme, 34 Argyll Arcade, Buchanan Street, Glasgow, G2 8BD, UK
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Lau-Barraco C, Linden-Carmichael AN, Stamates AL, Preonas PD, Braitman AL. The Influence of a Brief Alcohol Intervention on Alcohol Use Trajectories in Nonstudent Emerging Adult Drinkers. Subst Use Misuse 2019; 54:2025-2032. [PMID: 31215832 PMCID: PMC6764863 DOI: 10.1080/10826084.2019.1626434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: This study sought to inform research with noncollege-attending emerging adults, an at-risk, and understudied population, by identifying patterns of response following a brief alcohol intervention. This study was a reanalysis of data from a randomized controlled intervention trial testing a brief, personalized feedback alcohol intervention targeting nonstudent emerging adult drinkers. Objectives: The study aims were to (1) model intervention response by identifying subgroups characterized by changes in heavy drinking (i.e. peak use, number of binges during a typical week, proportion of binge days, peak estimated blood alcohol concentration [eBAC]) following the alcohol intervention, and (2) distinguish subgroups on factors related to intervention response (i.e. perceived norms regarding how much peers drink, alcohol use severity, mental health symptoms, and readiness to change). Methods: Participants were 81 (64.2% men) nonstudent heavy drinkers between ages 18-25 years (average age = 22.04) recruited from the community. Results: Findings revealed two latent subgroups that exhibited differential response to the intervention (i.e. intervention "responders" and "nonresponders"). Further, responders reported higher pre-intervention descriptive normative perceptions and alcohol use severity. Conclusions/Importance: The current investigation contributed to knowledge regarding for whom brief alcohol interventions work in the short term within nonstudent emerging adults and could inform future research to facilitate behavior change in those unresponsive to intervention efforts.
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Affiliation(s)
- Cathy Lau-Barraco
- Department of Psychology, Old Dominion University , Norfolk , VA , USA.,Virginia Consortium Program in Clinical Psychology , Norfolk , VA , USA
| | - Ashley N Linden-Carmichael
- Department of Biobehavioral Health and the Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University , University Park , PA , USA
| | - Amy L Stamates
- Department of Psychology, Old Dominion University , Norfolk , VA , USA
| | - Peter D Preonas
- Virginia Consortium Program in Clinical Psychology , Norfolk , VA , USA
| | - Abby L Braitman
- Department of Psychology, Old Dominion University , Norfolk , VA , USA.,Virginia Consortium Program in Clinical Psychology , Norfolk , VA , USA
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Li L, Uyei J, Nucifora KA, Kessler J, Stevens ER, Bryant K, Braithwaite RS. Using value of information methods to determine the optimal sample size for effectiveness trials of alcohol interventions for HIV-infected patients in East Africa. BMC Health Serv Res 2018; 18:590. [PMID: 30064428 PMCID: PMC6069863 DOI: 10.1186/s12913-018-3356-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 07/04/2018] [Indexed: 01/08/2023] Open
Abstract
Background Unhealthy alcohol consumption exacerbates the HIV epidemic in East Africa. Potential benefits of new trials that test the effectiveness of alcohol interventions could not be evaluated by traditional sampling methods. Given the competition for health care resources in East Africa, this study aims to determine the optimal sample size given the opportunity cost of potentially re-allocating trial funds towards cost-effective alcohol treatments. Methods We used value of information methods to determine the optimal sample size by maximizing the expected net benefit of sampling for a hypothetical 2-arm intervention vs. control randomized trial, across ranges of policymaker’s willingness-to-pay for the health benefit of an intervention. Probability distributions describing the relative likelihood of alternative trial results were imputed based on prior studies. In the base case, policymaker’s willingness-to-pay was based on a simultaneously resource-constrained priority (routine HIV virological testing). Sensitivity analysis was performed for various willingness-to-pay thresholds and intervention durations. Results A new effectiveness trial accounting for the benefit of more precise decision-making on alcohol intervention implementation would benefit East Africa $67,000 with the optimal sample size of 100 persons per arm under the base case willingness-to-pay threshold and intervention duration of 20 years. At both a conservative willingness-to-pay of 1 x GDP/capita and a high willingness-to-pay of 3 x GDP/capita for an additional health gain added by an alcohol intervention, a new trial was not recommended due to limited decision uncertainty. When intervention duration was 10 or 5 years, there was no return on investment across suggested willingness-to-pay thresholds. Conclusions Value of information methods could be used as an alternative approach to assist the efficient design of alcohol trials. If reducing unhealthy alcohol use is a long-term goal for HIV programs in East Africa, additional new trials with optimal sample sizes ranging from 100 to 250 persons per arm could save the opportunity cost of implementing less cost-effective alcohol strategies in HIV prevention. Otherwise, conducting a new trial is not recommended.
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Affiliation(s)
- Lingfeng Li
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6, New York, NY, 10016, USA
| | - Jennifer Uyei
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6, New York, NY, 10016, USA
| | - Kimberly A Nucifora
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6, New York, NY, 10016, USA.
| | - Jason Kessler
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6, New York, NY, 10016, USA
| | - Elizabeth R Stevens
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6, New York, NY, 10016, USA
| | - Kendall Bryant
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - R Scott Braithwaite
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6, New York, NY, 10016, USA
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10
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Hummer JF, Davison GC. Examining the Role of Source Credibility and Reference Group Proximity on Personalized Normative Feedback Interventions for College Student Alcohol Use: A Randomized Laboratory Experiment. Subst Use Misuse 2016; 51:1701-15. [PMID: 27487077 DOI: 10.1080/10826084.2016.1197258] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Personalized normative feedback (PNF) interventions are designed to reduce misperceived drinking norms by delivering feedback regarding the actual drinking behavior of college students, thereby leading to subsequent reductions in one's own drinking. OBJECTIVE We examined the roles of data source credibility and reference group proximity in the effectiveness of a laboratory-based PNF intervention to reduce perceived drinking norms and thereby decrease intentions to drink. METHOD Following completion of an online preintervention survey and using a 2 (highly credible data source/low credible data source) × 2 (proximal reference group/distal reference group) between-subjects factorial design, 104 college student drinkers were randomly assigned to condition. Participants then completed a postintervention questionnaire to assess for changes in various aspects of drinking. RESULTS Highly credible feedback was associated with greater reductions in perceived weekly drinking by American college students compared to feedback with low credibility. Similarly, more proximal than distal reference group feedback led to greater reductions in perceived weekly drinking by a same-gender/same-class year students at one's university. No condition effects emerged for intended drinks per week. CONCLUSIONS PNF interventions may benefit from considering data source credibility and reference group proximity to reduce misperceptions of college student drinking, depending on the goals and resources of practitioners implementing such programs. Even the use of such a distal reference group as American college students can indeed lead to a reduction of normative perceptions provided there is an emphasis on the credibility of the data source.
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Affiliation(s)
- Justin F Hummer
- a Laboratory for Cognitive Studies in Clinical Psychology , University of Southern California , Los Angeles , California , USA
| | - Gerald C Davison
- a Laboratory for Cognitive Studies in Clinical Psychology , University of Southern California , Los Angeles , California , USA
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11
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Grossbard JR, Mastroleo NR, Geisner IM, Atkins D, Ray AE, Kilmer JR, Mallett K, Larimer ME, Turrisi R. Drinking norms, readiness to change, and gender as moderators of a combined alcohol intervention for first-year college students. Addict Behav 2016; 52:75-82. [PMID: 26363307 PMCID: PMC6486950 DOI: 10.1016/j.addbeh.2015.07.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 06/11/2015] [Accepted: 07/27/2015] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Alcohol interventions targeting college students and their parents have been shown to be efficacious. Little research has examined moderators of intervention efficacy to help tailor interventions for subgroups of students. METHOD This study is a secondary data analysis of readiness to change, drinking norms, and gender as moderators of an efficacious peer- and parent-based intervention (Turrisi et al., 2009). Students (n=680) were randomized to the combined peer and parent intervention (n=342) or assessment-only control (n=338). RESULTS The combined intervention reduced peak blood alcohol content (BAC) compared to control. Gender and norms did not moderate the relationship between the intervention and drinking. Significant interactions were found between gender, precontemplation, and intervention. Students in the combined condition with higher precontemplation had lower weekly drinking compared to those with lower precontemplation. This pattern was also found among men for peak BAC and alcohol-related consequences but not among women, indicating a three-way interaction. CONCLUSION Interventions may need to consider readiness to change and gender to optimize effectiveness.
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Affiliation(s)
- Joel R Grossbard
- Veterans Affairs/University of Washington, Department of Health Services, 1100 Olive Way, Suite 1400, Seattle, WA 98108, United States.
| | - Nadine R Mastroleo
- Brown University, Center for Alcohol and Addiction Studies, Box G-S121-5, Providence RI 02912, United States
| | - Irene Markman Geisner
- University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States
| | - David Atkins
- University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States
| | - Anne E Ray
- Rutgers, The State University of New Jersey, Center of Alcohol Studies, 607 Allison Road, Piscataway, NJ 08854, United States
| | - Jason R Kilmer
- University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States
| | - Kimberly Mallett
- The Pennsylvania State University, Biobehavioral Health and Prevention Center, 210 Biobehavioral Health Building, University Park, PA 16802, United States
| | - Mary E Larimer
- University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States
| | - Rob Turrisi
- The Pennsylvania State University, Biobehavioral Health and Prevention Center, 210 Biobehavioral Health Building, University Park, PA 16802, United States
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Dulin PL, Gonzalez VM, Campbell K. Results of a pilot test of a self-administered smartphone-based treatment system for alcohol use disorders: usability and early outcomes. Subst Abus 2015; 35:168-75. [PMID: 24821354 DOI: 10.1080/08897077.2013.821437] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND This paper provides results from a pilot study focused on assessing early-stage effectiveness and usability of a smartphone-based intervention system that provides a stand-alone, self-administered intervention option, the Location-Based Monitoring and Intervention for Alcohol Use Disorders (LBMI-A). The LBMI-A provided numerous features for intervening with ongoing drinking, craving, connection with supportive others, managing life problems, high-risk location alerting, and activity scheduling. METHODS Twenty-eight participants, ranging in age from 22 to 45, who met criteria for an alcohol use disorder used an LBMI-A-enabled smartphone for 6 weeks. RESULTS Participants indicated the LBMI-A intervention modules were helpful in highlighting alcohol use patterns. Tools related to managing alcohol craving, monitoring consumption, and identifying triggers to drink were rated by participants as particularly helpful. Participants also demonstrated significant reductions in hazardous alcohol use while using the system (56% of days spent hazardously drinking at baseline vs. 25% while using the LBMI-A) and drinks per day diminished by 52%. CONCLUSIONS Implications for system improvement as well as suggestions for designing ecological momentary assessment and intervention systems for substance use disorders are discussed.
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Affiliation(s)
- Patrick L Dulin
- a Department of Psychology, University of Alaska, Anchorage , Anchorage , Alaska , USA
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