The effect of brief interventions on alcohol consumption among heavy drinkers in a general hospital setting. Counselling problem drinkers in medical wards: a controlled study. Influence of counselor characteristics and behaviors on the efficacy of a brief motivational intervention for heavy drinking in young men--a randomized controlled trial. A brief motivational interview in a pediatric emergency department, plus 10-day telephone follow-up, increases attempts to quit drinking among youth and young adults who screen positive for problematic drinking. Internet-Based Brief Personalized Feedback Intervention in a Non-Treatment-Seeking Population of Adult Heavy Drinkers: A Randomized Controlled Trial Alcohol screening and brief interventions for offenders in the probation setting (SIPS Trial): a pragmatic multicentre cluster randomized controlled trial. A Randomized Trial of Motivational Interviewing and Feedback with Heavy Drinking College Students Randomized trial comparing computer-delivered and face-to-face personalized feedback interventions for high-risk drinking among college students. The Effectiveness of Alcohol Screening and Brief Intervention in Emergency Departments: A Multicentre Pragmatic Cluster Randomized Controlled Trial Controlled evaluation of a general practice-based brief intervention for excessive drinking. Randomised controlled trial of a brief alcohol intervention in a general hospital setting Is brief motivational intervention effective in reducing alcohol use among young men voluntarily receiving it? A randomized controlled trial. Evaluation of a controlled drinking minimal intervention for problem drinkers in general practice (the DRAMS scheme). A randomized clinical trial comparing the efficacy of two active conditions of a brief intervention for heavy college drinkers. Brief intervention for male heavy drinkers in routine general practice: a three-year randomized controlled study. Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial Alcohol screening and brief intervention in a college student health center: a randomized controlled trial. Relative efficacy of a brief motivational intervention for college student drinkers. Brief alcohol intervention and alcohol assessment do not influence alcohol use in injured patients treated in the emergency department: a randomized controlled clinical trial. Treatment of problem alcohol use in women of childbearing age: results of a brief intervention trial. Brief motivational enhancement intervention to prevent or reduce postpartum alcohol use: a single-blinded, randomized controlled effectiveness trial. Dismantling motivational interviewing and feedback for college drinkers: a randomized clinical trial. Screening and brief intervention for high-risk college student drinkers: results from a 2-year follow-up assessment. Ethnic differences in drinking outcomes following a brief alcohol intervention in the trauma care setting. RCT of effectiveness of motivational enhancement therapy delivered by nurses for hazardous drinkers in primary care units in Thailand. Brief Physician Advice For High-Risk Drinking Among Young Adults One-year follow-up results of the STARS for Families alcohol prevention program. Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Screening, brief intervention, and referral to treatment (SBIRT): 12-month outcomes of a randomized controlled clinical trial in a Polish emergency department. Brief alcohol intervention for general hospital inpatients: a randomized controlled trial. Brief intervention in a primary care setting for hazardous drinkers. Brief alcohol intervention for college drinkers: how brief is? Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices. Evaluating a brief alcohol intervention with fraternities. Screening and brief intervention targeting risky drinkers in Danish general practice--a pragmatic controlled trial. Intervention of heavy drinking--a prospective and controlled study of 438 consecutive injured male patients. Intervention in alcohol abuse among macrocytic patients in general practice. Challenges applying alcohol brief intervention in diverse practice settings: populations, outcomes, and costs. The clinical effectiveness and cost-effectiveness of brief intervention for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial (SHEAR). Brief intervention for heavy-drinking college students: 4-year follow-up and natural history. Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers. The effect of general practitioners' advice to heavy drinking men. Alcohol screening, brief intervention, and referral in the emergency department: an implementation study. Brief physician advice for heavy drinking college students: a randomized controlled trial in college health clinics. A randomized controlled trial of a brief intervention after alcohol-related facial injury. Brief motivational interventions for heavy college drinkers: A randomized controlled trial. Brief intervention for female heavy drinkers in routine general practice: a 3-year randomized, controlled study. Effectiveness of brief intervention on non-dependent alcohol drinkers (EBIAL): a Spanish multi-centre study. A randomized trial of a brief primary-care-based intervention for reducing at-risk drinking practices. Randomized controlled trial of a brief intervention for unhealthy alcohol use in hospitalized Taiwanese men. Efficacy of physician-delivered brief counseling intervention for binge drinkers. Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk. Efficacy of brief motivational intervention in reducing binge drinking in young men: A randomized controlled trial.
AIMS ( i ) To evaluate the effect of receiving one of two brief interventions in reducing alcohol consumption among general hospital patients compared with usual care . ( ii ) To assess whether a brief intervention of self-efficacy enhancement was superior to a self-help booklet in reducing alcohol consumption . DESIGN A three-arm cluster r and omized controlled trial . SETTING Seven general medical , six general surgical , one dermatology and two otolaryngology wards of a large teaching hospital covering a large urban and rural area . PARTICIPANTS A total of 215 of 789 in- patients aged 18 - 75 years , who screened positive for alcohol consumption in excess of national recommended limits according to a 7-day retrospective drinking diary . INTERVENTIONS Participants were allocated to receive one of three interventions : ( i ) face-to-face self-efficacy enhancement ; ( ii ) a self-help booklet ; or ( iii ) usual care . MEASUREMENTS The primary outcome measure was change in reported alcohol consumption at 6-month follow-up as measured by a 7-day retrospective drinking diary . Secondary outcomes were change in : number of alcohol drinking days in last week ; the maximum units of alcohol consumed on any one day in last week ; and Drinking Refusal Self-efficacy Expectancy Question naire score . FINDINGS Compared to the usual care group the self-efficacy enhancement group ( -10.1 units 95 % CI -16.1 to -4.1 ) and the self-help booklet group ( -10.0 units 95 % CI -16.0 to -3.9 ) had greater reductions in self-reported weekly alcohol consumption . There was no evidence that self-efficacy enhancement was superior to the self-help booklet ( P = 0.96 ) . CONCLUSIONS Brief interventions delivered in hospital offer simple means of helping heavy drinkers to reduce their alcohol consumption Seven hundred and thirty one men admitted to medical wards were interviewed to identify problem drinkers who had not received previous treatment for alcoholism and who had some social support . One hundred and sixty one met the diagnostic criteria ; 156 agreed to a follow up interview and were allocated to one of two groups . One group received a session of counselling about their drinking habits from a nurse while the other received only routine medical care . Both groups reported a reduction in alcohol consumption when interviewed 12 months later , but the counselled group had a significantly better outcome than the control group . It is concluded that systematic screening for alcohol consumption and related problems should become a routine part of medical assessment and that advice on drinking habits is effective if given before irreversible physical or psychosocial problems have developed BACKGROUND Brief motivational intervention ( BMI ) has shown promising results to reduce alcohol use in young adults . Knowledge on mechanisms that predict BMI efficacy could potentially improve treatment effect sizes through data that optimize clinical training and implementation . Particularly , little attention has been given to counselor influence on treatment mechanisms . METHODS We investigated the influence of counselors on  BMI efficacy in reducing alcohol use among non-treatment-seeking young men ( age 20 ) screened as hazardous drinkers . Participants were r and omly allocated to ( i ) a group receiving a single BMI from 1 of 18 counselors selected to maximize differences in several of their characteristics ( gender , professional status , clinical experience , and motivational interviewing [ MI ] experience ) or ( ii ) a control group receiving assessment only .  Drinking at 3-month follow-up was first compared between the BMI and control groups to assess efficacy . Then , the influence of counselors ' characteristics ( i.e. , gender , professional status , clinical experience , MI experience , BMI attitudes , and expectancies ) and within-session behaviors ( i.e. , measured by the Motivational Interviewing Skill Code ) on outcome was tested in regression analyses . RESULTS There was a significant ( p = 0.02 ) decrease in alcohol use among the BMI group compared to the control group . Counselors that were male , more experienced , that had more favorable BMI attitudes and expectancies , higher MI skills , but surprisingly less MI-consistent behaviors , had significantly better outcomes than the control group while their counterparts did not . CONCLUSIONS The current study demonstrated  BMI efficacy on alcohol use reduction within a sample of non-treatment-seeking young adult males . Moreover , BMI effect was related to interindividual differences among counselors , and results therefore provide recommendations for BMI training and implementation with similar population OBJECTIVES Adolescents in their late teens and early 20s have the highest alcohol consumption in the United States ; binge drinking peaks at age 21 - 25 years . Underage drinking is associated with many negative consequences , including academic problems and risk of intentional and unintentional injuries . This study tested the effectiveness of pediatric emergency department ( PED ) screening and brief intervention to reduce alcohol consumption and associated risks . METHODS A three-group r and omized assignment trial was structured to test differences between intervention ( I ) and st and ard assessed control ( AC ) groups in alcohol consumption and alcohol-related behaviors from baseline to 12 months and to compare the AC group with a minimally assessed control ( MAC ) group to adjust for the effect of assessment reactivity on control group behavior . Patients aged 14 - 21 years were eligible if they screened positive on the Alcohol Use Disorders Identification Test ( AUDIT ) or for binge drinking or high-risk behaviors . The MAC group received a re source h and out , written advice about alcohol-related risks , and a 12-month follow-up appointment . Patients in the AC group were assessed using st and ardized instruments in addition to the MAC protocol . The I group received a peer-conducted motivational intervention , referral to community re sources and treatment if indicated , and a 10-day booster in addition to assessment . Measurements included 30-day self-report of alcohol consumption and alcohol-related behaviors , screens for depression and posttraumatic stress disorder , and self-report of attempts to quit , cut back , or change conditions of use , all repeated at follow-up . Motor vehicle records and medical records were also analyzed for changes from baseline to 1-year follow-up . RESULTS Among 7,807 PED patients screened , 1,202 were eligible ; 853 enrolled ( I , n = 283 ; AC , n = 284 ; MAC , n = 286 ) , with a 12-month follow-up rate of 72 % . At 12 months , more than half of enrollees in Reaching Adolescents for Prevention ( RAP ) attempted to cut back on drinking , and over a third tried to quit . A significantly larger proportion of the I group made efforts to quit drinking and to be careful about situations when drinking compared to AC enrollees , and there was a numerically but not significantly greater likelihood ( p = 0.065 ) among the I group for efforts to cut back on drinking . At 3 months , the likelihood of the I group making attempts to cut back was almost triple that of ACs . For efforts to quit , it was double , and for trying to be careful about situations when drinking , there was a 72 % increase in the odds ratio ( OR ) for the I group . Three-month results for attempts were sustained at 12 months for quit attempts and efforts to be careful . Consumption declined in both groups from baseline to 3 months to 12 months , but there were no significant between-group differences in alcohol-related consequences at 12 months or in alcohol-related risk behaviors . We found a pattern suggestive of assessment reactivity in only one variable at 12 months : the attempt to cut back ( 73.3 % for the I group vs. 64.9 % among the AC group and 54.8 % among the MAC group ) . CONCLUSIONS Brief motivational intervention result ed in significant efforts to change behavior ( quit drinking and be careful about situations while drinking ) but did not alter between-group consumption or consequences Background Internet-based interventions for heavy drinkers show promising results , but existing research is characterized by few studies in nonstudent adult population s and few comparisons with appropriate control groups . Objective To test whether a fully automated Internet-based brief personalized feedback intervention and a fully automated Internet-based personalized brief advice intervention in a non-treatment-seeking population of heavy drinkers would result in a reduced alcohol intake . Methods We conducted a 3-arm parallel r and omized controlled trial in a general population -based sample of heavy drinkers . The 54,157 participants ( median age of 58 years ) were screened for heavy drinking . Of the 3418 participants who had a weekly alcohol consumption above 14 drinks for women and 21 drinks for men , 1380 ( 619 women ) consented to take part in the trial and were r and omly assigned to an Internet-based brief personalized feedback intervention group ( normative feedback , n = 476 ) , an Internet-based personalized brief advice intervention group ( n = 450 ) , or a nonintervention control group ( n = 454 ) . Follow-up after 6 and 12 months included 871 and 1064 participants , respectively , of all groups combined . The outcome measure was self-reported weekly alcohol consumption . We analyzed the data according to the intention-to-treat principle . To examine changes over time and to account for the multiple time measurements , we used a multilevel linear mixed model . To take attrition into account , we used multiple imputation to address missing data . Results The intervention effect of the Internet-based brief personalized feedback intervention , determined as the mean additional difference in changes in alcohol consumption in the Internet-based brief personalized feedback intervention compared with the control group , was –1.8 drinks/week after 6 months and –1.4 drinks/week after 12 months ; these effects were nonsignificant ( 95 % confidence interval –4.0 to 0.3 at 6 months , –3.4 to 0.6 at 12 months ) . The intervention effect of the Internet-based personalized brief advice intervention was –0.5 drinks/week after 6 months and –1.2 drinks/week after 12 months ; these effects were nonsignificant ( 95 % confidence interval –2.7 to 1.6 at 6 months , –3.3 to 0.9 at 12 months ) . Conclusions In this r and omized controlled trial we found no evidence that an Internet-based brief personalized feedback intervention was effective in reducing drinking in an adult population of heavy drinkers . Trial registration Clinical Trials.gov NCT00751985 ; http:// clinical trials.gov/ct2/show/NCT00751985 ( Archived by WebCite at http://www.webcitation.org/68WCRLyaP AIM To evaluate the effectiveness of different brief intervention strategies at reducing  hazardous or harmful drinking in the probation setting . Offender managers were r and omized to three interventions , each of which built on the previous one : feedback on screening outcome and a client information leaflet control group , 5 min of structured brief advice and 20 min of brief lifestyle counselling . METHODS A pragmatic multicentre factorial cluster r and omized controlled trial . The primary outcome was self-reported hazardous or harmful drinking status measured by Alcohol Use Disorders Identification Test ( AUDIT ) at 6 months ( negative status was a score of < 8) . Secondary outcomes were AUDIT status at 12 months , experience of alcohol-related problems , health utility , service utilization , readiness to change and reduction in conviction rates . RESULTS Follow-up rates were 68 % at 6 months and 60 % at 12 months . At both time points , there was no significant advantage of more intensive interventions compared with the control group in terms of AUDIT status . Those in the brief advice and brief lifestyle counselling intervention groups were statistically significantly less likely to reoffend ( 36 and 38 % , respectively ) than those in the client information leaflet group ( 50 % ) in the year following intervention . CONCLUSION Brief advice or brief lifestyle counselling provided no additional benefit in reducing hazardous or harmful drinking compared with feedback on screening outcome and a client information leaflet . The impact of more intensive brief intervention on reoffending warrants further research Motivational interviewing ( MI ) is a brief intervention that has been shown to reduce heavy drinking among college students . Because all college studies of MI to date have included a personalized feedback report , it remains unclear which of the components is necessary to produce behavior change . This study evaluated the separate and collective effects of MI and feedback among 122 “ binge ” drinking college students . Participants were r and omized to : 1 ) MI with feedback , 2 ) MI without feedback , 3 ) Mailed feedback only , 4 ) MI with mailed feedback , or 5 ) Assessment only control . At an eight-week follow-up , all groups reduced their consumption , peak BAC , consequences , and dependence symptoms . For females , there were reductions in consequences and dependence symptoms in groups that received feedback , as compared to groups that did not receive feedback . For females , there was an effect of the feedback on consequences and dependence symptoms , but was no overall effect of MI on any outcome measure This study evaluated the efficacy of two brief personalized feedback interventions ( PFIs ) using identical feedback and motivational interviewing strategies aim ed at reducing alcohol consumption and alcohol-related problems to two control conditions among a sample of high-risk drinking college students . Students ( N = 152 ) were r and omly assigned to a computer-delivered PFI with a video interviewer , a face-to-face PFI with a live interviewer , a comprehensive assessment condition , or a minimal assessment -only condition . At 10 weeks posttreatment , the face-to-face PFI significantly reduced weekly drinking quantity and peak and typical blood alcohol concentration compared with the comprehensive assessment and minimal assessment -only conditions ( d values ranged from 0.32 to 0.61 ) . No significant between-group differences were evidence d for the computer-delivered PFI condition , although effect sizes were comparable to other college drinking studies using computer-delivered interventions ( d values ranged from 0.20 to 0.27 ) . Results provide further support for the use of a face-to-face PFI to help reduce  college students ' alcohol consumption and suggest that a video interviewer in the context of a computer-delivered PFI is likely a helpful but not necessarily a complete substitute for a live interviewer Background Alcohol misuse is common in people attending emergency departments ( EDs ) and there is some evidence of efficacy of alcohol screening and brief interventions ( SBI ) . This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in Engl and : the SIPS ED trial . Methods and Findings Pragmatic multicentre cluster r and omized controlled trial of SBI for hazardous and harmful drinkers presenting to ED . Nine EDs were r and omized to three conditions : a patient information leaflet ( PIL ) , 5 minutes of brief advice ( BA ) , and referral to an alcohol health worker who provided 20 minutes of brief lifestyle counseling ( BLC ) . The primary outcome measure was the Alcohol Use Disorders Identification Test ( AUDIT ) status at 6 months . Of 5899 patients aged 18 or more presenting to EDs , 3737 ( 63·3 % ) were eligible to participate and 1497 ( 40·1 % ) screened positive for hazardous or harmful drinking , of whom 1204 ( 80·4 % ) gave consent to participate in the trial . Follow up rates were 72 % ( n = 863 ) at six , and 67 % ( n = 810 ) at 12 months . There was no evidence of any differences between intervention conditions for AUDIT status or any other outcome measures at months 6 or 12 in an intention to treat analysis . At month 6 , compared to the PIL group , the odds ratio of being AUDIT negative for brief advice was 1·103 ( 95 % CI 0·328 to 3·715 ) . The odds ratio comparing BLC to PIL was 1·247 ( 95 % CI 0·315 to 4·939 ) . A per protocol analysis confirmed these findings . Conclusions SBI is difficult to implement in typical EDs . The results do not support widespread implementation of alcohol SBI in ED beyond screening followed by simple clinical feedback and alcohol information , which is likely to be easier and less expensive to implement than more complex interventions . Trial Registration Current Controlled Trials IS RCT N In a controlled evaluation of general practitioner (GP)-based brief intervention , 378 excessive drinkers identified opportunistically by screening in 40 group practice s in metropolitan Sydney were assigned to groups receiving : ( i ) a five-session intervention by the GP ( the Alcoholscreen Program ) ; ( ii ) a single session of 5 minutes ' advice by the GP plus a self-help manual ( minimal intervention ) ; ( iii ) an alcohol-related assessment but no intervention ; ( iv ) neither intervention nor assessment . Among all patients allocated to receive it , the Alcoholscreen Program did not result in a significantly greater reduction in consumption at follow-up than control conditions but patients offered Alcoholscreen reported a significantly greater reduction in alcohol-related problems in the period to 6 months follow-up . A greater proportion of patients who returned for the second Alcoholscreen visit were drinking below recommended levels at follow-up than in the remainder of the sample . There was no evidence that minimal intervention or alcohol-related assessment were effective in reducing alcohol consumption or problems . Implication s for further research into GP-based brief interventions are discussed Background The evidence suggests that brief alcohol-focused interventions , directed at hazardous and harmful drinkers in non-specialist setting s such as primary care are effective in reducing alcohol consumption . However , there is a need for further research in the hospital setting . This is a r and omised controlled trial to investigate the effectiveness of a 10-minute brief intervention amongst ' at risk ’ drinkers admitted to general hospital wards . Unlike some previous trials , this trial is r and omised , used blinded assessors , includes an intention-to-treat analysis , included female subjects and excluded people with alcohol dependence . Methods A total of 250 ' at risk ’ drinkers admitted to King ’s College Hospital were identified using the Alcohol Use Disorders Identification Test ( AUDIT ) . Some 154 subjects entered the study and were r and omly allocated to the control and intervention groups . Subjects in the control group received no advice about their drinking whilst subjects in the intervention group received 10 minutes of simple advice on reducing alcohol consumption . Recruitment took place between 1995 and 1997 . The primary outcome was the AUDIT question naire at 12 months . Secondary outcomes were a previous week ’s Drinks Diary , question naires ( General Health Question naire , Alcohol Problems Question naire and the Severity of Alcohol Dependence Question naire ) and laboratory blood tests ( gamma glutamyl transferase , mean cell volume and haemoglobin ) . Results At 3-month and 12-month follow-up , all participants were included in the intention-to-treat analysis . At both time points there was no evidence of an intervention effect that could be attributed to the brief intervention . Both the intervention and control groups had an improved AUDIT score and reduced levels of alcohol consumption as measured by a subjective Drinks Diary at 3 months which was maintained at 12 months . Conclusions This study has added further evidence on brief interventions in the hospital setting . In contrast to the recent Cochrane review by McQueen et al. , the results of this study do not support the effectiveness of a brief alcohol intervention in general hospital wards . However our study was underpowered and there were flaws in the statistical analyses , and these limitations temper the strength of our conclusions BACKGROUND Heavy drinking is one of the leading causes of morbidity and mortality in young men .  Brief motivational intervention ( BMI ) has shown promising results for young people , but has never been tested in young men in the community who volunteered to receive an intervention . METHODS We evaluated the effectiveness of  BMI  in reducing alcohol use  among heavy episodic users and in maintaining low-risk drinking among nonheavy episodic users . Participants were French-speaking young men attending the m and atory Swiss army conscription process . They were offered the opportunity to receive a 20-minute BMI , and those interested were r and omized into an intervention group ( BMI immediately ) or into a control group ( BMI after the 6-month follow-up assessment , in a waiting list design ) . Analyses were conducted separately for heavy and nonheavy episodic users ( separated using baseline heavy episodic use frequency ) as the hypotheses tested were different between both groups ( primary vs. secondary prevention intervention ) . RESULTS From a pool of 6,085 young men invited to receive BMI , 727 ( 11.9 % ) showed up and 572 were included in the study ( after exclusions related to organizational aspects of the conscription process ) . Among nonheavy episodic users , there was a protective effect of BMI on weekly alcohol use ( p < 0.05 ) . Among heavy episodic users , there were no significant effects of BMI . CONCLUSIONS About 12 % of young men were interested in addressing their drinking within the BMI framework , suggesting that there is some need for easily accessible alcohol intervention . The present intervention did have a preventive effect among low-risk young drinkers in helping them maintain their patterns of alcohol use . An explanation for the lack of effectiveness among heavy episodic users might be that those individuals interested in BMI had patterns of more severe alcohol use , thereby making change more difficult Sixteen general practitioners participated in a controlled trial of the Scottish Health Education Group 's  DRAMS ( drinking reasonably and moderately with self-control ) scheme . The scheme was evaluated by r and omly assigning 104 heavy or problem drinkers to three groups - a group participating in the DRAMS scheme  ( n = 34 ) , a group given simple advice only ( n = 32 ) and a non-intervention control group ( n = 38 ) . Six month follow-up information was obtained for 91 subjects ( 87.5 % of initial sample ) . There were no significant differences between the groups in reduction in alcohol consumption , but patients in the DRAMS group showed a significantly greater reduction in a logarithmic measure of serum gamma-glutamyl-transpeptidase than patients in the group receiving advice only . Only 14 patients in the DRAMS group completed the full DRAMS procedure . For the sample as a whole , there was a significant reduction in alcohol consumption , a significant improvement on a measure of physical health and well-being , and significant reductions in the logarithmic measure of serum gamma-glutamyl transpeptidase and in mean corpuscular volume . The implication s of these findings for future research into controlled drinking minimal interventions in general practice are discussed Brief interventions for college heavy drinkers have shown promise in reducing drinking and alcohol-related negative consequences . However , intervention duration , content , method of delivery , and follow-up length vary across studies . It therefore remains unclear whether intervention length significantly influences the interventions ' efficacy . The present study is a r and omized clinical trial systematic ally evaluating the efficacy of two brief interventions aim ed at reducing alcohol use and alcohol-related negative consequences among college student drinkers . Treatment mediators were also evaluated . Participants ( N=278 ) were , on average , 20.1 years old ( SD=2.4 ) , mostly Caucasian ( 87 % ) and female ( 71 % ) . They were r and omly assigned to a 10-minute brief intervention , a 50-minute brief intervention , or an attention-control group . Both active interventions were provided by clinical graduate students trained in Brief Alcohol Screening and Intervention for College Students ( BASICS ) . As hypothesized , participants in both active conditions significantly reduced their alcohol consumption , as compared to the control group participants F(2,264)=9.84 , p=.00 , η(2)=.07 . There were no significant differences in alcohol-related negative consequences F(2,264)=3.08 , p=.06 , η(2)=.02 . The hypothesized mediators , alcohol drinking norms and coping behavioral strategies , explained significant variance in intervention efficacy , but neither self-efficacy nor alcohol expectancies were significant mediators . Given the preliminary nature of our investigation , more research is warranted to determine parameters of the critical mechanisms of change within brief alcohol interventions with college student drinkers The aim of this research was to evaluate the effectiveness of long-term brief intervention in routine general practice . In five primary care out-patient clinics in a Finnish town , 296 male early-phase heavy drinkers consulting a general practitioner ( GP ) for various reasons were identified . Control group C ( n = 88 ) was informed of the risks of drinking after the screening and were advised at the subsequent feedback about 2 weeks later to reduce their drinking . Groups A ( n = 109 ) and B ( n = 99 ) were offered in addition seven and three brief intervention sessions , respectively . All GPs took part , whether or not they indicated a special interest . The main outcome measures were differences between beginning and end-point at 3 years in self-reported alcohol consumption , mean corpuscular volume ( MCV ) , and serum carbohydrate-deficient transferrin , aspartate aminotransferase , alanine aminotransferase and gamma-glutamyltransferase . There were no statistically significant differences between study groups A , B and C in mean changes in outcome measures . Within all the groups , MCV decreased . Depending on the outcome measure used and the study group analysed , clinical ly significant reduction of drinking was found in 25 - 53 % of the subjects . In routine general practice , giving additional sessions of brief intervention may not be as effective as in special research conditions . Factors reducing the effectiveness of brief intervention programmes should be investigated , so that primary health care staff can be better supported in their efforts Objective To evaluate the effectiveness of different brief intervention strategies at reducing  hazardous or harmful drinking in primary care . The hypothesis was that more intensive intervention would result in a greater reduction in hazardous or harmful drinking . Design Pragmatic cluster r and omised controlled trial . Setting Primary care practice s in the north east and south east of Engl and and in London . Participants 3562 patients aged 18 or more routinely presenting in primary care , of whom 2991 ( 84.0 % ) were eligible to enter the trial : 900 ( 30.1 % ) screened positive for hazardous or harmful drinking and 756 ( 84.0 % ) received a brief  intervention .  The sample was predominantly male ( 62 % ) and white ( 92 % ) , and 34 % were current smokers . Interventions Practice s were r and omised to three interventions , each of which built on the previous one : a patient information leaflet control group , five minutes of structured brief advice , and 20 minutes of brief lifestyle counselling . Delivery of the patient leaflet and brief advice occurred directly after screening and brief lifestyle counselling in a subsequent consultation . Main outcome measures The primary outcome was patients ’ self reported hazardous or harmful drinking status as measured by the alcohol use disorders identification test ( AUDIT ) at six months . A negative AUDIT result ( score < 8) indicated non-hazardous or non-harmful drinking . Secondary outcomes were a negative AUDIT result at 12 months , experience of alcohol related problems ( alcohol problems question naire ) , health utility ( EQ-5D ) , service utilisation , and patients ’ motivation to change drinking behaviour ( readiness to change ) as measured by a modified readiness ruler . Results Patient follow-up rates were 83 % at six months ( n=644 ) and 79 % at 12 months ( n=617 ) . At both time points an intention to treat analysis found no significant differences in AUDIT negative status between the three interventions . Compared with the patient information leaflet group , the odds ratio of having a negative AUDIT result for brief advice was 0.85 ( 95 % confidence interval 0.52 to 1.39 ) and for brief lifestyle counselling was 0.78 ( 0.48 to 1.25 ) . A per protocol analysis confirmed these findings . Conclusions All patients received simple feedback on their screening outcome . Beyond this input , however , evidence that brief advice or brief lifestyle counselling provided important additional benefit in reducing hazardous or harmful drinking compared with the patient information leaflet was lacking . Trial registration Current Controlled Trials IS RCT N06145674 OBJECTIVE This study tested the effectiveness of brief primary care provider interventions delivered in a college student health center to a sample of college students who screened positive for high-risk drinking . METHOD Between November 2005 and August 2006 , 8,753 students who presented as new patients to the health service at a large public university were screened for high-risk drinking , and 2,484 students ( 28 % ) screened positive on the 5/4 gender-specific high-risk drinking question ( i.e. , five or more drinks per occasion for men and four or more for women ) . Students who screened positive for high-risk drinking and consented to participate ( N= 363 ; 52 % female ) were r and omly assigned either to a control group ( n = 182 ) or to an experimental group ( n = 181 ) . Participants in the experimental group received two brief intervention sessions that were founded in motivational interviewing techniques and delivered by four specially trained providers within the student health center . Data on alcohol use and related harms were obtained from a Web-based Healthy Lifestyle Question naire , 30-day Timeline Followback alcohol-use diaries , the Rutgers Alcohol Problem Index ( RAPI ) , and eight items from the Drinker Inventory of Consequences-2L . RESULTS Repeated measures analysis showed that , compared with the control group ( C ) , the intervention group ( I ) had significant reductions in typical estimated blood alcohol concentration ( BAC ) ( C = .071 vs I = .057 at 3 months ; C = .073 vs I = .057 at 6 months ) , peak BAC ( C = . 142 vs I = .112 at 3 months ; C = .145 vs I = .108 at 6 months ) , peak number of drinks per sitting ( C = 8.03 vs I = 6.87 at 3 months ; C = 7.98 vs I = 6.52 at 6 months ) , average number of drinks per week ( C = 9.47 vs I = 7.33 at 3 months ; C = 8.90 vs I = 6.16 at 6 months ) , number of drunk episodes in a typical week ( C = 1.24 vs I = 0.85 at 3 months ; C = 1.10 vs I = 0.71 at 6 months ) , number of times taken foolish risks ( C = 2.24 vs I = 1.12 at 3 months ) , and RAPI sum scores ( C = 6.55 vs I = 4.96 at 6 months ; C = 6.17 vs I = 4.58 at 9 months ) . CONCLUSIONS Brief interventions delivered by primary care providers in a student health center to high-risk-drinking students may result in significantly decreased alcohol consumption , high-risk drinking , and alcohol-related harms The authors evaluated the efficacy of Brief Alcohol Screening and Intervention for College Students ( BASICS - L. A. Dimeff , J. S. Baer , D. R. Kivlahan , & G. A. Marlatt , 1999 ) , a single session of drinking-related feedback intended to reduce heavy drinking and related harm .  College student drinkers ( N = 99 ) were assigned to BASICS , an educational intervention , or an assessment -only control group . At 3 months postintervention . there were no overall significant group differences , but heavier drinking BASICS participants showed greater reductions in weekly alcohol consumption and binge drinking than did heavier drinking control and education participants . At 9 months , heavier drinking BASICS participants again showed the largest effect sizes . BASICS participants evaluated the intervention more favorably than did education participants . This study suggests that BASICS may be more efficacious than educational interventions for heavier drinking college students AIMS To evaluate the effectiveness of brief alcohol intervention ( BAI ) in reducing alcohol use among hazardous drinkers treated in the emergency department ( ED ) after an injury ; in addition it tests whether assessment of alcohol use without BAI is sufficient to reduce hazardous drinking . DESIGN R and omized controlled clinical trial with 12-month follow-up conducted between January 2003 and June 2005 . SETTING Urban academic emergency department ( ED ) of the Lausanne University Hospital , Lausanne , Switzerl and . PARTICIPANTS A total of 5136 consecutive patients attending ED after an injury completed a seven-item general and a three-item alcohol screen and 1472 ( 28.7 % ) were positive for hazardous drinking according to the National Institute on Alcohol Abuse and Addiction definition ; of these 987 ( 67.1 % ) were r and omized into a BAI group ( n = 310 ) or a control group with screening and assessment ( n = 342 ) or a control group with screening only ( n = 335 ) and then a total of 770 patients ( 78.0 % ) completed the 12-month follow-up procedures . INTERVENTION A single 10 - 15-minute session of st and ardized BAI conducted by a trained research assistant . MEASUREMENTS Percentage of participants who have changed to low-risk drinking at follow-up . FINDINGS Data obtained at 12 months indicated that similar proportions were low-risk drinkers in BAI versus control groups with and without assessment ( 35.6 % , 34.0 % , 37.0 % , respectively , P = 0.71 ) . Data also indicated similar reductions in drinking frequency , quantity , binge drinking frequency and Alcohol Use Disorders Identification Test ( AUDIT ) scores across groups . All groups reported similar numbers of days hospitalized and numbers of medical consults in the last 12 months . A model including age groups , gender , AUDIT and injury severity scores indicated that BAI had no influence on the main alcohol use outcome . CONCLUSIONS This study provides the evidence that a 10 - 15-minute BAI does not decrease alcohol use and health re source utilization in hazardous drinkers treated in the ED , and demonstrates that commonly found decreases in hazardous alcohol use in control groups can not be attributed to the baseline alcohol assessment BACKGROUND Studies suggest that 14 % of women age 18 to 40 drink alcohol above recommended limits . Of special concern is the increasing use of alcohol by women during pregnancy . This article reports 48 month follow-up data from a sub analysis of a trial for early alcohol treatment ( Project TrEAT ) focused on women of childbearing age . METHODS Project TrEAT was conducted in the offices of 64 primary care , community-based physicians from 10 Wisconsin counties . Of 5979 female patients ages 18 to 40 who were screened for problem drinking , 205 were r and omized into an experimental group ( n = 103 ) or control group ( n = 102 ) . The intervention consisted of two 15 min , physician-delivered counseling visits that included advice , education , and contracting by using a scripted workbook . A total of 174 subjects ( 85 % ) completed the 48 month follow-up procedures . RESULTS No significant differences were found between the experimental and control groups at baseline for alcohol use , age , socioeconomic status , smoking , depression or anxiety , conduct disorder , lifetime drug use , or health care utilization . The trial found a significant treatment effect in reducing both 7 day alcohol use ( p = 0.0039 ) and binge drinking episodes ( p = 0.0021 ) over the 48 month follow-up period . Women in the experimental group who became pregnant during the follow-up period had the most dramatic decreases in alcohol use . A logistic regression model based on a 20 % or greater reduction in drinking found an odds ratio of 1.93 ( confidence interval 1.07 - 3.46 ) in the sample exposed to physician intervention . Age , smoking , depression , conduct disorder , antisocial personality disorder , and illicit drug use did not reduce drinking significantly . No significant differences were found in health care utilization and health status between groups . CONCLUSIONS This trial provides the first direct evidence that brief intervention is associated with sustained reductions in alcohol consumption by women of childbearing age . The results have enormous implication s for the U.S. health care system AIMS The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use . DESIGN This study is a single-blinded , r and omized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10 - 30 minutes each and occurring at study enrollment , 4 and 8 weeks after enrollment , 32 weeks of gestation , and 6 weeks postpartum . SETTING The setting is in a large , urban , obstetrics clinic . PARTICIPANTS Participants were women who were ≥ 18 years old , < 20 weeks of gestation , and consumed alcohol during pregnancy . Of 3438 women screened , 330 eligible women were assigned to usual care ( n = 165 ) or intervention ( n=165 ) . Due to missing data , we analyzed 125 in the intervention group and 126 in the usual care group . MEASUREMENTS The measurements were the proportion of women with any alcohol use and the number of drinks per day , reported via follow-up telephone interviews at 4 and 8 weeks after enrollment , 32 weeks of gestation , and 6 weeks , 6 months , and 12 months postpartum . FINDINGS In r and om effects models adjusted for confounders , the intervention group was less likely to use any alcohol ( odds ratio 0.50 ; 95 % confidence interval [ CI ] , 0.23 - 1.09 ; P=0.08 ) and consumed fewer drinks per day ( coefficient -0.11 ; 95 % CI -0.23 - 0.01 ; P=0.07 ) than , the usual care group in the postpartum period but these differences were non-significant . Missing data during the prenatal period prevented us from modeling prenatal alcohol use . CONCLUSIONS Brief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period Motivational interviewing ( MI ) is a counseling style that has been shown to reduce heavy drinking among college students . To date , all studies of MI among college students have used a format that includes a feedback profile delivered in an MI style . This study was a dismantling trial of MI and feedback among heavy-drinking college students . After an initial screen , 279 heavy-drinking students were r and omized to ( a ) Web feedback only , ( b ) a single MI session without feedback , ( c ) a single MI session with feedback , or ( d ) assessment only . At 6 months , MI with feedback  significantly reduced drinking , as compared with assessment only ( effect size = .54 ) , MI without feedback ( effect size = .63 ) , and feedback alone ( effect size = .48 ) . Neither MI alone nor feedback alone differed from  assessment  only . Neither sex , race or ethnicity , nor baseline severity of drinking moderated the effect of the intervention . Norm perceptions mediated the effect of the intervention on drinking . MI with feedback appears to be a robust intervention for reducing drinking and may be mediated by changes in normative perceptions This r and omized controlled trial evaluated the efficacy of a brief intervention design ed to reduce the harmful consequences of heavy drinking among high-risk college students . Students screened for risk while in their senior year of high school ( 188 women and 160 men ) were r and omly assigned to receive an individualized motivational brief intervention in their freshman year of college or to a no-treatment control condition . A normative group selected from the entire screening pool provided a natural history comparison . Follow-up assessment s over a 2-year period showed significant reductions in both drinking rates and harmful consequences , favoring students receiving the intervention . Although high-risk students continued to experience more alcohol problems than the natural history comparison group over the 2-year period , most showed a decline in problems over time , suggesting a developmental maturational effect 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 r and omized 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 ( chi(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 evidence d 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 AIMS To determine the effectiveness of Motivational Enhancement Therapy ( MET ) for hazardous drinkers in Primary Care Unit ( PCU ) setting s in rural Thail and . METHODS A r and omized controlled trial was conducted in eight PCUs in Ubonratchatanee and Chachoengsao provinces in Thail and . Hazardous drinkers were identified using the World Health Organization-recommended Alcohol Use Disorder Identification Test . Of 117 eligible participants ( 91 % male ) , 59 were r and omized to the  intervention  group to receive MET in three individual appointments with a trained nurse and 58 to an assessment -only control group . Outcome evaluations were carried out after 6 weeks , 3 months and 6 months . RESULTS Follow-up data were available on 84 , 94 and 91 % of subjects , respectively , at the three intervals . Self-reported drinks per drinking day , frequency of hazardous drinking assessed either on a daily or weekly basis , and of binge drinking sessions were reduced in the intervention group more than in the control group ( P < 0.05 ) after both 3 and 6 months . The groups did not generally differ at 6 weeks . However , although self-reported consumption in both groups fell from baseline to 6-month follow-up , serum gamma-glutamyl transferase increased in both groups , which raises doubts about the validity of this marker in this sample and /or the validity of the self-reported data in this study . CONCLUSION MET delivered by nurses in PCUs in Thail and appears to be an effective intervention for male hazardous drinkers . Uncertainties about the validity of self-reported data jeopardize the safety of this conclusion BACKGROUND High-risk alcohol use in persons 18 to 30 years of age is a critical public health problem . It is the number 1 cause of death in this population . This article reports the results of a sub analysis of young adults ( aged 18 to 30 years ) who participated in Project TrEAT ( Trial of Early Alcohol Treatment ) conducted in the offices of 64 primary care physicians located in 10 counties in southern Wisconsin . METHODS Project TrEAT was a r and omized clinical trial design ed to test the efficacy of a brief intervention protocol to reduce alcohol use , improve health status , and decrease health care utilization . A total of 226 young adults were r and omly assigned to either a usual care or brief intervention group . RESULTS There were no significant differences between the 2 groups at baseline on a number of potential confounders . During the 4-year follow-up period , there were significant reductions in number of persons drinking more than 3 drinks per day , average 7-day alcohol use , number of persons drinking 6 or more drinks per occasion , and number of binge drinking episodes in the previous 30 days ( P < .01 to P < .001 ) . There were also significant differences ( P < .05 ) in emergency department visits ( 103 vs 177 ) , motor vehicle crashes ( 9 vs 20 ) , total motor vehicle events ( 114 vs 149 ) , and arrests for controlled substance or liquor violation ( 0 vs 8) . CONCLUSION In this 4-year sub analysis of young adults who participated in Project TrEAT , we found long-term reductions in high-risk drinking behaviors and consequences . The findings of this study support more widespread implementation of brief interventions in primary care setting This study examined the 1-year follow-up effects of the STARS ( Start Taking Alcohol Risks Seriously ) for Families program , a 2-year preventive intervention based on a stage of acquisition model , and consisting of nurse consultations and parent material s. A r and omized controlled trial was conducted , with participants receiving either the intervention or a minimal intervention control .  Participants included a cohort of 650 sixth- grade students from two urban middle schools-one magnet ( bused ) and one neighborhood . Trained project staff administered question naires to students following a st and ardized protocol in the schools . For the magnet school sample , significantly fewer intervention students ( 5 % ) were planning to drink in the next 6 months than control students ( 18 % ) , chi2 = 11.53 , 1 d.f . , P = 0.001 . Magnet school intervention students also had less intentions to drink in the future , greater motivation to avoid drinking and less total alcohol risk than control students , Ps < 0.05 . For the neighborhood school , intervention students ( m = 7.90 , SD = 1.87 ) had less total alcohol risk than control students ( m = 8.42 , SD = 1.83 ) , F(1,205 ) = 4.09 , P = 0.04 . These findings suggest that a brief , stage and risk/protective factor tailored program holds promise for reducing risk for alcohol use among urban school youth 1 year after intervention , and has the unique advantage of greater ' transportability ' over classroom-based prevention programs OBJECTIVE Alcoholism is the leading risk factor for injury . The authors hypothesized that providing brief alcohol interventions as a routine component of trauma care would significantly reduce alcohol consumption and would decrease the rate of trauma recidivism . METHODS This study was a r and omized , prospect i ve controlled trial in a level 1 trauma center . Patients were screened using a blood alcohol concentration , gamma glutamyl transpeptidase level , and short Michigan Alcoholism Screening Test ( SMAST ) . Those with positive results were r and omized to a brief intervention or control group .  Reinjury was detected by a computerized search of emergency department and statewide hospital discharge records , and 6- and 12-month interviews were conducted to assess alcohol use . RESULTS A total of 2524 patients were screened ; 1153 screened positive ( 46 % ) . Three hundred sixty-six were r and omized to the intervention group , and 396 to controls . At 12 months , the intervention group decreased alcohol consumption by 21.8+/-3.7 drinks per week ; in the control group , the decrease was 6.7+/-5.8 ( p = 0.03 ) . The reduction was most apparent in patients with mild to moderate alcohol problems ( SMAST score 3 to 8) ; they had 21.6+/-4.2 fewer drinks per week , compared to an increase of 2.3+/-8.3 drinks per week in controls ( p < 0.01 ) . There was a 47 % reduction in injuries requiring either emergency department or trauma center admission ( hazard ratio 0.53 , 95 % confidence interval 0.26 to 1.07 , p = 0.07 ) and a 48 % reduction in injuries requiring hospital admission ( 3 years follow-up ) . CONCLUSION Alcohol interventions are associated with a reduction in alcohol intake and a reduced risk of trauma recidivism . Given the prevalence of alcohol problems in trauma centers , screening , intervention , and counseling for alcohol problems should be routine BACKGROUND A r and omized controlled trial of screening , brief intervention , and referral to treatment ( SBIRT ) among at-risk ( based on average number of drinks per week and drinks per drinking day ) and dependent drinkers was conducted in an emergency department ( ED ) among 446 patients 18 and older in Sosnowiec , Pol and . METHODS Patients were recruited over a 23-week period ( 4:00 pm to 12:00 midnight ) and r and omized to 1 of 3 conditions : screened-only ( n = 147 ) , assessed ( n = 152 ) , and intervention ( n = 147 ) . Patients in the assessed and intervention conditions were blindly reassessed via a telephone interview at 3 months , and all 3 groups were assessed at 12 months ( screened-only = 92 , assessed = 99 , and intervention = 87 ) . RESULTS No difference was found across the 3 conditions in at-risk drinking at 12 months , as the primary outcome variable , or in decrease in the number of drinks per drinking day , with all 3 groups showing a significant reduction in both . Significant declines between baseline and 12 months in secondary outcomes of the RAPS4 , number of drinking days per week , and the maximum number of drinks on an occasion were seen only for the intervention condition , and in negative consequences for both the assessment and intervention conditions . CONCLUSIONS Data suggest that improvements in drinking outcomes found in the assessment condition were not because of assessment reactivity , with both the screened and intervention conditions demonstrating greater ( although nonsignificant ) improvement than the assessed condition . Only those in the intervention condition showed significant improvement in all outcome variables from baseline to 12-month follow-up . Although group by time interaction effects were not found to be significant , these findings suggest that declines in drinking measures for those receiving a brief intervention can be maintained at long-term follow-up AIM To test the effectiveness of a brief alcohol intervention among non-dependent general hospital in patients with alcohol problems , delivered by either a specialized liaison service or hospital physicians . METHOD All in patients of 29 wards from four general hospitals of one region in Germany were screened for alcohol problems ( n=14,332 ) . Of those screening positive , 595 patients were included in a r and omized controlled group design using a time-frame . Patients with alcohol dependence were not considered in this study . Patients received Motivational Interviewing based counselling either by a specialized liaison service , by hospital physicians trained under routine conditions or received hospital treatment as usual without additional counselling . One year later , alcohol consumption , motivation and well-being were assessed . Sample survey analyses and generalized estimating equations were conducted . RESULTS At baseline , the three groups differed regarding motivation , with higher motivation among the controls . At follow-up , the groups did not differ regarding alcohol consumption , alcohol-related problems and well-being . All groups decreased their alcohol consumption significantly . Regarding motivation , longitudinal analyses revealed significant interaction effects of time and intervention ( p<0.05 ) , indicating a stronger increase of readiness to change drinking and a less profound drop of readiness to seek help among those who received intervention compared to the controls . CONCLUSION The intervention was not effective in reducing alcohol consumption or in increasing well-being 12 months after hospitalization . It had a positive effect on readiness to change drinking and on readiness to seek formal help for alcohol problems . The intervention groups compensated their lag of motivation INTRODUCTION The study was design ed to test a brief intervention for reducing alcohol consumption among moderate to heavy ( hazardous ) drinkers in a busy HMO primary care setting . METHODS In a r and omized controlled trial , hazardous drinkers ( n = 516 ) were identified by the AUDIT screening question naire . Intervention included brief clinician advice ( 30 seconds ) , a 15-minute motivational session by counselors , and printed material s. RESULTS At six-month follow-up , intervention subjects reported fewer total st and ard drinks in the past three months ( 176 versus 216 , P = .04 , one-tailed ) and fewer drinking days per week ( 2.8 versus 3.3 , P = .02 ) than controls , but similar drinks per drinking day ( 3.3 versus 3.5 ; P = .13 ) . At 12 months , intervention subjects again reported fewer drinking days per week ( 2.7 versus 3.1 ; P = .04 ) than controls , but similar numbers of st and ard drinks ( 157 versus 179 ; P = .13 ) and drinks per drinking day ( 3.6 versus 3.3 ; P = .20 ) . Intervention subjects were somewhat more likely than controls to report drinking within daily recommended limits ( < or = 3 for men , < or = 2 for women ) at both six months ( 79 % versus 71 % ; P = .06 ) and 12 months ( 80 % versus 73 % ; P = .07 ) , but did not differ significantly from controls on other drinking outcomes ( percent abstinent , frequency of drinking > or = 6 drinks per drinking occasion , estimated peak blood alcohol concentration ) , or use of medical care in the year following intervention . CONCLUSIONS A one-time , brief motivational intervention using minimal clinician time supplemented by trained counselors result ed in a modest reduction in frequency of alcohol consumption in a busy primary care population . Future research should focus on strengthening and maintaining intervention effects OBJECTIVE Brief interventions for college student drinkers have been shown to be effective in reducing the amount of alcohol consumed as well as the number of alcohol-related problems . However , the duration of brief interventions varies substantially across studies . METHOD In the present study 114 undergraduate students who drank alcohol heavily were r and omly assigned to a 10-minute brief intervention , a 50-minute brief intervention , or assessment -only control . The content of the active interventions was based on the same concept , and both interventions incorporated motivational interviewing components . Participants were assessed at baseline and 4-week post intervention on quantity of alcohol use , alcohol-related problems , and protective behavioral strategies . RESULTS As hypothesized , there was a significant difference between participants in the 10-minute intervention and control condition regarding their alcohol consumption at 4-week follow up . However , there was no significant difference between the 50-minute intervention and the control condition on alcohol consumption . There were also no significant differences between active intervention conditions , and neither intervention showed advantages for reducing problems or increasing protective behaviors relative to the control condition . CONCLUSIONS Results suggest a very brief intervention can impact short-term alcohol use outcomes , with potentially no advantage of longer interventions for this population OBJECTIVE Project TrEAT ( Trial for Early Alcohol Treatment ) was design ed to test the efficacy of brief physician advice in reducing alcohol use and health care utilization  in problem drinkers . DESIGN R and omized controlled clinical trial with 12-month follow-up . SETTING A total of 17 community-based primary care practice s ( 64 physicians ) located in 10 Wisconsin counties . PARTICIPANTS Of the 17695 patients screened for problem drinking , 482 men and 292 women met inclusion criteria and were r and omized into a control ( n=382 ) or an experimental ( n=392 ) group . A total of 723 subjects ( 93 % ) participated in the 12-month follow-up procedures . INTERVENTION The intervention consisted of two 10- to 15-minute counseling visits delivered by physicians using a scripted workbook that included advice , education , and contracting information . MAIN OUTCOME MEASURES Alcohol use measures , emergency department visits , and hospital days . RESULTS There were no significant differences between groups at baseline on alcohol use , age , socioeconomic status , smoking status , rates of depression or anxiety , frequency of conduct disorders , lifetime drug use , or health care utilization . At the time of the 12-month follow-up , there were significant reductions in 7-day alcohol use ( mean number of drinks in previous 7 days decreased from 19.1 at baseline to 11.5 at 12 months for the experimental group vs 18.9 at baseline to 15.5 at 12 months for controls ; t=4.33 ; P<.001 ) , episodes of binge drinking ( mean number of binge drinking episodes during previous 30 days decreased from 5.7 at baseline to 3.1 at 12 months for the experimental group vs 5.3 at baseline to 4.2 at 12 months for controls ; t=2.81 ; P<.001 ) , and frequency of excessive drinking ( percentage drinking excessively in previous 7 days decreased from 47.5 % at baseline to 17.8 % at 12 months for the experimental group vs 48.1 % at baseline to 32.5 % at 12 months for controls ; t=4.53 ; P<.001 ) . The chi2 test of independence revealed a significant relationship between group status and length of hospitalization over the study period for men ( P<.01 ) . CONCLUSIONS This study provides the first direct evidence that physician intervention with problem drinkers decreases alcohol use and health re source utilization in the US health care system OBJECTIVE The current study tested the efficacy of a brief intervention design ed to reduce drinking and drinking-related consequences among first-year fraternity members . METHOD Twelve fraternities were r and omly assigned to receive either a motivational enhancement intervention with individual and housewide feedback components ( n = 6 houses ) or a treatment-as-usual control condition ( n = 6 houses ) . Individual feedback was delivered either by peer interviewers or professional research staff . Participants were assessed during their pledge ( first ) year of house membership and during a follow-up period 1 year later . RESULTS Of the participants who completed follow-up ( N = 120 ) , fraternity members who received the brief intervention reported significant reductions in alcohol use ( total average consumption ) and typical peak blood alcohol concentrations when compared with fraternity members in the control condition . No differences in drinking-related consequences were observed . Fraternity members who received their individualized feedback from peer interviewers and professional members of the research staff reported similar outcomes . CONCLUSIONS Results provide support for the efficacy of a brief motivational enhancement intervention in reducing drinking within this high-risk population . The cost-effective use of peer interviewers appears to be a promising strategy for delivering individualized prevention programming in college population AIMS Recommendations for routine alcohol screening and brief counselling intervention in primary health care rest on results from intervention efficacy studies . By conducting a pragmatic controlled trial ( PCT ) , we aim ed at evaluating the effectiveness of the  WHO recommendations for screening and brief intervention ( SBI ) in general practice . METHODS A r and omized PCT ( brief counselling intervention vs no intervention ) involving 39 Danish general practitioners ( GPs ) . Systematic screening of 6897 adults led to inclusion of 906 risky drinkers , and research follow-up on 537 of these after 12 - 14 months . Outcome measures focused on patients ' acceptance of screening and intervention and their self-reported alcohol consumption . RESULTS Patient acceptance of screening and intervention -10.3 % ( N = 794 ) of the target population ( N = 7 , 691 ) explicitly refused screening . All intervention group subjects ( N = 442 ) were exposed to an instant brief counselling session while only 17.9 % of them ( 79/442 ) attended a follow-up consultation that was offered by their GP . Consumption Changes At one-year follow-up , average weekly consumption had increased by 0.7 drinks in both comparison groups . As secondary findings , we observed an indiscriminate absolute risk reduction ( ARR = 0.08 ( 95 % CI : -0.02 ; 0.18 ) ) in male binge drinking , but adverse intervention effects for women on the secondary outcomes ( binge drinking ARR = -0.30 ( 95 % CI : -0.47 ; -0.09 ) ) . CONCLUSIONS The results of brief interventions in everyday general practice performed on the basis of systematic question naire screening may fall short of theoretical expectations . When applied to non-selected groups in everyday general practice SBI may have little effect and engender diverse outcome . Women may be more susceptible to defensive reactions than men We studied 120 injured male patients of working age who were heavy drinkers or alcoholics , obtaining seven points or more in the Michigan Alcoholism Screening Test ( MAST ) . They were r and omly allocated either to an intervention group ( IG ) or to a control group ( CG ) . In addition to the MAST interview , the consumption of alcohol during the previous week prior to hospital admission was calculated and laboratory measures ( serum GGT , ASAT and ALAT ) were obtained . Counselling of the patients in the IG was carried out by a trained assistant nurse and a physician . Forty-nine patients in IG and 40 patients in CG were re-examined after 6 months . In the IG 45 % and in the CG 20 % of the patients were improved ( Chi square test , P less than 0.05 ) . Improvement criteria were a decrease in alcohol consumption by at least one-third and decrease of S-GGT by at least 20 % during the follow-up period . In respect to the laboratory measures the groups were identical at the beginning of the study and after 6 months ' follow-up . Our results are encouraging and suggest that the assessment of heavy drinking should be a routine in the treatment of alcohol-related injuries and that education and counselling must be intensive to be effective The study examined the effectiveness of routine intervention in alcohol abuse by a general practitioner , with help of a laboratory test . Patients diagnosed as abusers because of high erythrocyte mean cell volume value ( MCV ) and having no other cause for it were r and omly allocated to two groups : 1 ) an  intervention group  , comprising 92 patients ( 69 men and 23 women ) , who were invited for follow-up at three-monthly intervals for a year ; 2 ) a  control ( mini-intervention ) group , 86 patients ( 71 men and 15 women ) , who were followed-up only after 12 months . Follow-up attendance was poor , particularly in the intervention group . In general , MCV-values were unchanged in the groups at the end of the study , though there was a clear trend for the female controls to have lower values ( 101.9 fl at the start , 98.5 fl at the end , p = 0.06 ) . Altogether 11 % ( 4/38 ) of the women and 7 % ( 10/140 ) of the men had clearly reduced their alcohol consumption after one year , and this was also seen in their MCV-values .  Mini-intervention , especially in women with an abnormal laboratory value , seems to be , with the help of MCV , at least as effective a way of counselling nonalcoholic abusers as a more systematic intervention This article summarizes the proceedings of a symposium at the 2005 Research Society on Alcoholism , Santa Barbara , California . The purpose of the symposium was to address challenges that arise in translating evidence for efficacy of alcohol brief intervention ( BI ) into diverse clinical setting s and population s by review ing the literature and describing 4 research studies . Dr. Saitz review ed the limitations in evidence for efficacy of BIs and then described results of a r and omized clinical trial of brief motivational intervention for medical in patients drinking risky amounts . Dr. Svikis presented alternative methods for identifying pregnant women in prenatal care at risk for alcohol and drug problems ( including nicotine and caffeine ) and BIs to reduce or eliminate use . Dr. D'Onofrio discussed results of a r and omized trial of the brief negotiated interview in emergency department patients . Dr. Kraemer presented results of a decision analytic and computer-simulation model regarding the cost-effectiveness of alcohol screening  and intervention in primary care setting s. Finally , Dr. Perl discussed the salient issues and suggested future directions for work in the area of alcohol BI BACKGROUND Excessive use of alcohol is associated with poor sexual health , but the clinical effectiveness and cost-effectiveness of brief alcohol intervention in this setting has not been investigated . OBJECTIVE To examine the effects and cost-effectiveness of brief intervention for excessive alcohol consumption among people who attend sexual health clinics . DESIGN A two-arm , parallel-group , single-blind , pragmatic , r and omised controlled trial . Participants were r and omised via an independent and remote telephone r and omisation service using permuted blocks , stratified by clinic . SETTING Study participants were recruited from three sexual health clinics in central and west London . PARTICIPANTS For inclusion , potential participants had to be aged ≥ 19 years , drink excessive alcohol according to the Modified-Single Alcohol Screening Question , and be willing to provide written informed consent . We excluded those who were unable to communicate in English sufficiently well to complete the baseline assessment and those who could not provide contact details for the follow-up assessment . INTERVENTIONS Brief advice was delivered by the treating clinician and comprised feedback on the possible health consequences of excessive drinking , a discussion of whether the participant 's clinic attendance was linked to current alcohol use , written information on alcohol and health and an offer of an appointment with an alcohol health worker ( AHW ) . Appointments with AHWs took place either in person or by telephone , lasted up to 30 minutes , and used the ' FRAMES ' ( Feedback about the adverse effects of alcohol , an emphasis on personal Responsibility for changing drinking behaviour , Advice about alcohol consumption , a Menu of options for further help and advice , an Empathic stance towards the patient and an emphasis on Self-efficacy ) approach . Those in the control arm of the trial were offered a copy of a leaflet providing general information on health and lifestyle . MAIN OUTCOME MEASURES Outcomes were assessed 6 months after r and omisation . The primary outcome was mean weekly alcohol consumption during the previous 90 days . The main secondary outcome was unprotected sex during this period . RESULTS Eight hundred and two people were recruited to the study of whom 592 ( 74 % ) were followed up 6 months later . Among 402 participants who were r and omised to brief intervention , 397 ( 99 % ) received brief advice from the treating clinician and 81 ( 20 % ) also received input from an AHW . The adjusted mean difference in alcohol consumption after 6 months was -2.33 units per week [ 95 % confidence interval ( CI ) -4.69 to 0.03 units per week , p = 0.053 ] for those in the active arm compared with the control arm . Unprotected sex was reported by 154 ( 53 % ) of those who received brief intervention and by 178 ( 59 % ) of controls ( adjusted odds ratio 0.89 , 95 % CI 0.63 to 1.25 , p = 0.496 ) . Participants r and omised to brief intervention reported drinking a mean of 10.4 units of alcohol per drinking day compared with 9.3 units among control participants ( difference 1.10 , 95 % CI 0.29 to 1.96 , p = 0.009 ) . We found no statistically significant differences in other outcomes .  Brief intervention ( brief advice and input from an AHW ) cost on average £ 12.60 per person to deliver and did not appear to provide a cost-effective use of re sources . CONCLUSIONS Introduction of universal screening and brief intervention for excessive alcohol use among people who attend sexual health clinics does not result in clinical ly important reductions in alcohol consumption or provide a cost-effective use of re sources . While people attending sexual health clinics may want to achieve better sexual health , attempts to reduce alcohol consumption may not be seen by them as a necessary means of trying to achieve this aim . TRIAL REGISTRATION This trial is registered as IS RCT N 99963322 . FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol . 18 , No. 30 . See the NIHR Journals Library website for further project information OBJECTIVES This study examined long-term response to an individual preventive intervention for high-risk college drinkers relative to the natural history of college drinking . METHODS A single-session , individualized preventive intervention was evaluated within a r and omized controlled trial with college freshmen who reported drinking heavily while in high school . An additional group r and omly selected from the entire screening pool provided a normative comparison . Participant self-report was assessed annually for 4 years . RESULTS High-risk controls showed secular trends for reduced drinking quantity and negative consequences without changes in drinking frequency . Those receiving the brief preventive intervention reported significant additional reductions , particularly with respect to negative consequences . Categorical individual change analyses show that remission is normative , and they suggest that participants receiving the brief intervention are more likely to improve and less likely to worsen regarding negative drinking consequences . CONCLUSIONS Brief individual preventive interventions for high-risk college drinkers can achieve long-term benefits even in the context of maturational trends OBJECTIVE Brief interventions for hazardous and low-dependent drinkers in the primary care setting have considerable empirical support . The purpose of this study was to ( 1 ) evaluate the effects of brief advice ( BA ) and motivational enhancement ( ME ) interventions on alcohol consumption . In addition , a hindsight matching design was used to ( 2 ) study the moderator effects of patient readiness to change ( alcohol use ) on alcohol consumption . METHOD The subjects ( N = 301 , 70 % men ) were patients 21 years of age or older who presented for treatment at one of 12 primary care clinics . After screening for eligibility and providing consent to participate in the study , the patients completed a baseline assessment and were r and omly assigned to the BA , ME or st and ard care ( SC ) interventions condition . Follow-up assessment s were completed at 1- , 3- , 6- , 9- and 12-months postbaseline assessment . RESULTS Evaluation of the first hypothesis ( n = 232 for these analyses ) showed that all participants tended to reduce their alcohol use considerably between the baseline and 12-month assessment s. In addition , evaluation of the second hypothesis showed a moderator effect of readiness to change in predicting the number of drinks at 12 months , such that the BA intervention seemed more effective for patients relatively low in readiness to change compared to those higher in readiness . Readiness to change did not seem to be related to changes in drinking of participants in the SC or ME conditions . CONCLUSIONS The results confirm that , among primary care patients , substantial changes in alcohol consumption are possible . They further suggest that matching studies of patient readiness to change their alcohol use , as well as other variables , are warranted The objective of the study was to determine the effectiveness of  advice from general practitioners to heavy drinking men ( consuming 350 - 1050 grams of alcohol per week ) to reduce their alcohol consumption .  One hundred and fifty-four men recruited from eight general practice s were allocated r and omly to treatment and control groups . Men in the treatment group received advice from their own general practitioner . At one year follow-up , when analyzed according to intention to treat , the treatment group had reduced their consumption by an excess of 65 grams of alcohol per week when compared with the control group ( p less than 0.05 ) . General practitioners should be recommended to screen for alcohol consumption amongst their patients and to give advice to those found to be at risk because of their drinking INTRODUCTION Alcohol is the single greatest contributor to injury in the United States . Numerous studies have reported that a st and ardized screening , brief intervention , and referral to treatment ( SBIRT ) intervention can effectively minimize future alcohol consumption , reduce injury recurrence , and decrease the number of repeat ED visits . To date , SBIRT studies have been conducted in setting s in which physicians or research assistants carried out SBIRT . Little is known about ED nurses carrying out SBIRT . The purpose of this study was to examine ED nurse training needs and identify both barriers to , and enablers of , SBIRT implementation in the emergency department . METHODS Two coordinators from each of the 5 ED sites selected for the study attended a 1-day SBIRT educational session . Site coordinators then trained their staff nurses to conduct SBIRT . Site coordinators were surveyed at the midpoint and end of the 6-month implementation study period . Patient data from each facility was collected . RESULTS Ten site coordinators were trained and held subsequent training sessions with nursing staff in their respective emergency departments . All sites encountered barriers to implementation , but 2 of 5 sites were able to implement the SBIRT process fully by the end of the evaluation period . A total of 3265 patients were screened for alcohol use problems . Of those screened , 678 ( 21 % ) were classified as hazardous drinkers . Overall , 56 % of the positive-screened patients received 3 to 5 minutes of a brief intervention . After the brief intervention , between 9 % and 82 % of patients were referred for further care . DISCUSSION The SBIRT process can be conducted successfully by emergency nurses . However , substantial operational barriers to widespread routine implementation exist . These barriers need to be addressed before emergency nurses incorporate SBIRT as routine part of ED care OBJECTIVE The aim of this study was to test the efficacy of brief physician advice in reducing alcohol use and related harm in college students . METHOD The College Health Intervention Projects ( CHIPs ) is a r and omized , controlled clinical trial with 12-month follow-up conducted in five college health clinics in Wisconsin ; Washington state ; and Vancouver , Canada . Of the 12,900 students screened for high-risk drinking , 484 men and 502 women met inclusion criteria and were r and omized into a  control  ( n = 493 ) or intervention ( n = 493 ) group . Ninety-six percent of students participated in the follow-up procedures . The intervention consisted of two 15-minute counseling visits and two follow-up phone calls , and used motivational interviewing , contracting , diary cards , and take-home exercises . RESULTS No significant differences were found between groups at baseline on alcohol use , age , socioeconomic or smoking status , rates of depression , or measures of alcohol-related harm . At 12 months , the experimental subjects reduced their 28-day drinking totals by 27.2 % , and the control group reduced their totals by 21 % . A mixed effects repeated measures model found a statistical difference in favor of the brief-intervention group ( beta = 4.7 , SE = 2.0 , p = .018 ) in 28-day drinking totals . The total Rutgers Alcohol Problem Index score was also significantly different during the 12-month follow-up period ( beta = 0.8 , SE = 0.4 , p = .033 ) . There was no difference on the other outcome measures of interest , such as frequency of excessive heavy drinking , health care utilization , injuries , drunk driving , depression , or tobacco use . CONCLUSIONS The study supports re source allocation and implementation of alcohol screening and brief physician advice in primary care-based college health clinics AIM To evaluate the effectiveness of a brief motivational intervention on alcohol consumption and misuse in young males with alcohol-related face injury . DESIGN R and omized controlled trial . SETTING Oral and maxillofacial surgery out-patient clinic in an urban teaching hospital . PARTICIPANTS One hundred and fifty-one participants were r and omized to motivational intervention and control conditions . INTERVENTIONS Control was treatment as usual . The intervention was treatment as usual plus a one-session brief motivational intervention administered by a nurse . MEASUREMENTS Three sets of measurements were taken at baseline , 3-month and 1-year follow-up . Collateral measurements were also taken at 1-year follow-up . Primary outcome measures were total alcohol consumption , typical weeks consumption and days abstinent in preceding 3 months . Other outcome measures included the Alcohol Use Disorders Identification Test , a short form of the Alcohol Problems Question naire , and a measure of satisfaction with social relationships . RESULTS There was a significant decrease in 84-day total alcohol consumption across the year ( P < 0.006 ) and further , a significant effect for the motivational intervention was demonstrated ( P < 0.029 ) . This pattern was repeated for days abstinent and alcohol consumption in a typical week as well as alcohol-related problems . There was a significantly greater reduction in the percentage of hazardous drinkers in the motivational intervention group ( from 60 % to 27 % , P < 0.009 ) compared to the control group ( from 54 % to 51 % , NS ) . CONCLUSION A proportion of young men change their alcohol consumption following alcohol-related injury . A nurse-led psychological intervention adds significantly to the proportion and magnitude of response In this r and omized controlled trial , the authors evaluated brief motivational interventions ( BMI s ) for at-risk college drinkers . Heavy drinking students ( N = 509 ; 65 % women , 35 % men ) were r and omized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback ( TLFB ) interview ( present versus absent ) and intervention type ( basic BMI , BMI enhanced with a decisional balance module , or none ) . Assessment s completed at baseline , 1 , 6 , and 12 months measured typical and risky drinking as well as drinking-related problems . Relative to controls , the TLFB interview  reduced consumption but not problems at 1 month . The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month , whereas the enhanced BMI did not . Risk reduction achieved by brief interventions maintained throughout the follow-up year 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 , clinical ly 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 OBJECTIVE The project was design ed to compare the effectiveness of brief intervention ( BI ) versus simple advice ( SA ) in the secondary prevention of hazardous alcohol consumption  . METHODS A r and omized controlled trial with a 12-month follow-up was conducted . A total of 74 community-based primary care practice s ( 328 physicians ) located in 13 Spanish autonomous regions were recruited initially . Out of 546 men screened , only 229 were r and omized into BI ( n = 104 ) and SA ( n = 125 ) ; 44.6 % of practice s finalized the study . The interventions on the BI group consisted of a 15-minute counselling visit carried out by physicians which included : ( i ) alcohol quantification , ( ii ) information on safe limits , ( iii ) advice , ( iv ) drinking limits agreement , ( v ) self-informative booklet with drinking diary record and ( vi ) unscheduled reinforcement visits . The SA group spent 5 minutes which included ( i ) , ( ii ) and ( iii ) . RESULTS There were no significant differences between both groups at baseline on alcohol use , age , socioeconomic status and CAGE score . After the 12-month follow-up there was a significant decrease in frequency of excessive drinkers ( 67 % of BI group reached targeted consumption , versus 44 % of SA ; P < 0.001 ) as well as weekly alcohol intake reduction ( BI reached 52 versus 32 % in SA ; P < 0.001 ) . A trend to improve outcome with the number of reinforcement visits was found with BI . The only predictor of success was the initial alcohol consumption level . CONCLUSIONS Brief intervention is more effective than simple advice to reduce alcohol intake on adult men who attend primary care services in Spain This r and omized trial evaluated an intervention for reducing at-risk drinking practice s in a sample of 307 patients . Eligible drinking patterns included chronic drinking ( > or = 2 drinks per day in the past month ) , binge drinking ( > or = 5 drinks per occasion at least twice in the past month ) , and drinking and driving ( driving after > 2 drinks in the past month ) . Members of the intervention group received a message from their physician during their regularly scheduled visit , a self-help manual , written personalized feedback , and up to 3 telephone counseling calls .  Dropout was significantly higher in the intervention than control group AIMS To evaluate the effectiveness of a brief intervention in hospitalized Taiwanese men to reduce unhealthy alcohol consumption . DESIGN R and omized controlled trial . SETTING Medical/surgical wards of a medical centre in Taipei , Taiwan . PARTICIPANTS Of 3669 consecutive adult male in- patients , 616 were identified as unhealthy alcohol users ( > 14 drinks/week ) and assigned r and omly to either usual care ( n = 308 ) or a brief intervention ( n = 308 ) . MEASUREMENTS Primary outcomes were changes in alcohol consumption at 4 , 9 and 12 months , including self-reported weekly alcohol consumption , drinking days and heavy drinking episodes assessed by 7-day time-line follow-back . Secondary outcomes were ( i ) self-reported alcohol problems , ( ii ) health-care utilization ( hospital days and emergency department visits ) , ( iii ) self-reported seeking of speciality treatment for alcohol problems and ( iv ) 3-month Quick Drinking Screen . FINDINGS Based on intention-to-treat analyses , the intervention group consumed significantly less alcohol than the control group among both unhealthy drinkers and the subgroup of alcohol-dependent participants over 12 months , on both 7-day and 3-month assessment s. Adjunctive analyses of only those who completed all assessment s found that total drinks consumed did not remain significant . Significantly more participants with alcohol use disorders in the intervention than in the control group ( 8.3 % , 19 of 230 versus 2.1 % , four of 189 ) consulted specialists by 12 months ( P = 0.01 ) . However , alcohol-related problems and health-care utilization did not differ significantly in the two groups during follow-up . CONCLUSIONS Data from Taiwan confirm that brief in-hospital intervention can result in a reduction in alcohol intake by men who drink heavily or are diagnosed with an alcohol use disorder BACKGROUND Binge drinking is a common pattern of alcohol use in the US . However , no studies have evaluated the effectiveness of brief interventions targeting only binge drinkers . METHODS R and omized controlled clinical trial with a 12-month follow-up period conducted from March 1 , 2003 to March 1 , 2006 in Spain . Of a screened population of 15,325 patients seeking routine medical care from their primary care providers , patients who met inclusion criteria were r and omized into an experimental group ( n=371 ) or a control group ( n=381 ) . The primary outcome measures were the frequency of binge drinking episodes and weekly alcohol intake . RESULTS There were no significant differences at baseline between groups in alcohol use and demographic variables . At the end of the 12-month follow-up period , there were significant reductions in binge-drinking status ( 52.2 % vs 67.2 % , P < .001 ) , number of episodes of binge drinking ( 1.14 vs 1.56 , P < .001 ) , number of drinks weekly ( 19.2 vs 22.4 , P < .001 ) , and frequency of excessive alcohol intake in 7 days ( 47.9 % vs 66.6 % , P > .001 ) . CONCLUSIONS This study provided evidence that screening and brief counseling delivered by a primary care physician as part of regular health care significantly reduced binge drinking episodes in binge drinkers Alcohol exposed pregnancy ( AEP ) is a leading cause of preventable birth defects . While r and omized controlled trials ( RCTs ) have shown that multi-session motivational interviewing-based interventions reduce AEP risk , a one-session intervention could facilitate broader implementation . The purpose s of this study were to : ( 1 ) test a one-session motivational AEP prevention intervention for community women and ( 2 ) compare outcomes to previous RCTs . Participants at risk for AEP ( N=217 ) were r and omized to motivational interviewing+ assessment feedback ( EARLY ) , informational video , or informational brochure conditions . Outcomes were drinks per drinking day ( DDD ) , ineffective contraception rate , and AEP risk at 3 and 6 months . All interventions were associated with decreased DDD , ineffective contraception rate , and AEP risk .  Participants who received EARLY had larger absolute risk reductions in ineffective contraception and AEP risk , but not DDD . Effect sizes were compared to previous RCTs . The one-session EARLY intervention had less powerful effects than multi-session AEP prevention interventions among community women , but may provide a new option in a continuum of preventive care BACKGROUND Brief motivational intervention ( BMI ) is one of the few effective strategies targeting alcohol consumption , but has not been tested in young men in the community . We evaluated the efficacy of  BMI  in reducing alcohol use and related problems among binge drinkers and in maintaining low-risk drinking among non-bingers . METHODS A r and om sample of a census of men included during army conscription ( which is m and atory for 20-year-old males in Switzerl and ) was r and omized to receive a single face-to-face BMI session ( N=199 ) or no intervention ( N=219 ) . A six-month follow-up rate was obtained for 88.7 % of the subjects . RESULTS Among binge drinkers , there was 20 % less drinking in the BMI group versus the control group ( incidence rate ratio=0.80 , confidence interval 0.66 - 0.98 , p=0.03 ) ; the BMI group showed a weekly reduction of 1.5 drinks compared to an increase of 0.8 drinks weekly in the control group . Among subjects who experienced one or more alcohol-related consequences over the last 12 months , there was 19 % less drinking in the BMI group compared to the control group ( incidence rate ratio=0.81 , confidence interval 0.67 - 0.97 , p=0.04 ) . Among non-bingers , BMI did not contribute to the maintenance of low-risk drinking . CONCLUSION BMI reduced the alcohol use of binge drinkers , particularly among those who experienced certain alcohol-related adverse consequences . No preventive effect of BMI was observed among non-bingers . BMI is a plausible secondary preventive option for young binge drinkers
Background While the efficacy and effectiveness of  brief interventions for alcohol ( ABI ) have been demonstrated in primary care , there is weaker evidence in other setting s and review s do not consider differences in content .
We conducted a systematic review to measure the effect of  ABIs  on alcohol consumption  and how it differs by the setting , practitioner group and content of intervention .