Motivational interview improves treatment entry in homeless veterans. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial A brief intervention for at-risk drinking in an employee assistance program. A pilot study of an interactive web site in the workplace for reducing alcohol consumption. Efficiency of brief interventions on alcohol-related risks in occupational medicine Controlled trial of worksite health education through face-to-face counseling vs. e-mail on drinking behavior modification. Alcohol consumption and workplace absenteeism: the moderating effect of social support. Effectiveness of a brief intervention using mental simulations in reducing alcohol consumption in corporate employees Short-term effects of a brief motivational intervention to reduce alcohol and drug risk among homeless adolescents. Community-based alcohol counselling: a randomized clinical trial. Enhancing the effectiveness of traditional interventions with drinking drivers by adding brief individual intervention components. Brief motivational intervention with homeless adolescents: evaluating effects on substance use and service utilization. Problem drinking and the workplace: an individualized approach to prevention. Preventing high-risk drinking in youth in the workplace: a web-based normative feedback program. A randomized controlled trial of different methods of alcohol screening and brief intervention in routine probation settings: 12-month outcomes Brief motivational interviewing for DWI recidivists who abuse alcohol and are not participating in DWI intervention: a randomized controlled trial. Screening and brief intervention for risky alcohol consumption in the workplace: results of a 1-year randomized controlled study.
Motivational Interviewing ( MI ) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs . Some questions have been raised as to the effectiveness of MI in severely distressed population s. This study aims to assess the effectiveness of MI in a population of homeless , unemployed , and substance dependent veterans who are being wait-listed for entry into a residential treatment program . Seventy-five veterans placed on a wait-list were r and omized to receive a single MI or st and ard ( Std ) intake interview . Outcomes assessed were entry , and length of stay ( LOS ) . Secondary outcomes assessed included program completion and rates of graduation . Readiness to change and self-efficacy were assessed before and after the interview . Significantly more participants entered the program in the MI group ( 95 % ) than in the Std group ( 71 % ) . Although those in the MI group remained in the program longer , and had higher program completion and graduation rates , these differences were not statistically significant . No significant between-group or within-group differences were found in readiness or self-efficacy . This study demonstrates that a single , easily administered intervention can increase program entry . Also based on the study findings , further research into the question of whether MI can increase program retention , in a severely distressed population , is warranted Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more 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 The current pilot study examined the preliminary efficacy of a brief intervention ( BI ) for at-risk drinking in an employee assistance program . METHOD Clients ( N = 107 ) entering the employee assistance program ( EAP ) for mental health services were screened and met criteria for at-risk drinking . EAP therapists were r and omly assigned to deliver either the BI plus EAP services as usual ( SAU ) or SAU only . Participants in the final analyses consisted of 44 BI + SAU ( 30 women , 14 men ) and 30 SAU ( 21 women , 9 men ) EAP clients who completed a 3-month follow-up . RESULTS Results suggested that participants in the BI + SAU group had significant reductions in peak blood alcohol concentration , peak quantity , and alcohol-related consequences compared with the SAU group . Men in the BI + SAU group had greater reductions in alcohol-related problems compared with men in the SAU group . Groups did not differ by number of total EAP sessions attended or rates of presenting problem resolution . CONCLUSIONS Results provide preliminary evidence to support the integration of alcohol screening and BI as a low-cost method of intervening with clients with at-risk drinking in the context of co-occurring presenting problems An interactive web-site-based intervention for reducing alcohol consumption was pilot tested . Participants were 145 employees of a work site in the Silicon Valley region of California , categorized as low or moderate risk for alcohol problems . All participants were given access to a web site that provided feedback on their levels of stress and use of coping strategies . Participants r and omized to the full individualized feedback condition also received individualized feedback about their risk for alcohol-related problems . Some evidence was found for greater alcohol reduction among participants who received full individualized feedback , although due to difficulties in recruiting participants , the sample size was inadequate for evaluating treatment effects on drinking . The results provide preliminary support for using an interactive web site to provide individualized feedback for persons at risk for alcohol problems . However , the low participation rate ( 2.7 % ) suggests that such an intervention must address the challenges of recruiting employees through their work site Aim . To evaluate the effectiveness of brief interventions ( BIs ) in reducing alcohol use among hazardous drinkers consulting their occupational doctors . Material s and methods . Design : R and omized controlled trial with 12-month follow-up , conducted between November 2004 and September 2006 . Setting : Fifteen French regional occupational medicine centers with 147 doctors and 157 assistants who were trained in BI and screening with the AUDIT question naire . Participants : We invited 33,488 individuals to fill out AUDIT . These patients were eligible if their scores were 6–12 for women and 7–12 for men , indicating hazardous drinking without dependence ( found in 7.1 % of respondents ) . Intervention : After r and omization , BIs ( informative advice using motivational approach , with 10-minute average duration ) were performed by the occupational doctors . The control group received information booklets from the doctors ’ assistants . Measurements : Situations were evaluated 12 months after inclusion . Outcome measures : AUDIT scores , self-reported alcohol consumption ( SRAC ) and biological assays . The main criteria were the differences observed between groups for SRAC , the AUDIT score at follow-up , and any reduction in score between inclusion and final assessment . Success of intervention , which was defined as an AUDIT score below the hazardous drinking threshold at follow-up , was considered to analyze the variables associated with the efficiency of intervention . Results . The analyzed sample included 787 persons , among whom 435 were met again 12 months later . In the BI group , we found a lower AUDIT score ( p = 0.01 ) , a higher reduction in reported consumptions ( –60 g/week versus −44g/week , p = 0.04 ) and in AUDIT scores ( p = 0.009 ) . In the control group , 44.8 % reduced their AUDIT scores below hazardous drinking thresholds , as compared to 51.6 % in the BI group ( p = 0.15 ) . Success was associated with a significant reduction in biological and clinical indices . Conclusions . Though the high attrition rate led to careful conclusions , BIs seem to be efficient in occupational medicine , in comparison with written information , which also seems to influence drinking behavior This study examined the effectiveness of a traditional face-to-face health education and e-mail health education on alcohol usage among male workers in comparison with a control group . Male workers at a manufacturing plant ( N=36 ) who had abnormal serum gamma-GTP were stratified by age and job types , then r and omized into three groups : face-to-face education , e-mail education , and the control . The subjects were assessed on their knowledge about and attitude towards drinking , reported alcohol consumption , and serum gamma-GTP before the start of education and 2 months later after comparison of the education . Paired t-test and repeated ANOVA were conducted to test the significance of changes pre and post the intervention and across groups . In the face-to-face group , knowledge ( p=0.001 ) , attitude ( p=0.026 ) , alcohol consumption ( p=0.003 ) and serum gamma-GTP showed significant improvement . In the e-mail group , only alcohol consumption showed marginal improvement ( p=0.077 ) . In the control group , no variables remarkably changed . These results indicate that the face-to-face health education was more effective than the e-mail program . We discuss why the face-to-face approach was superior to the e-mail approach in this study by referring to self-monitoring , goal setting processes and timely feedback . We concluded that further studies are warranted to identify the effect of health education using e-mails and other network tools in consideration of the above three factors Although it is commonly assumed that alcohol consumption has a significant impact on employee absenteeism , the nature of the alcohol-absence relationship remains poorly understood . Proposing that alcohol impairment likely serves as a key mechanism linking drinking and work absence , we posit that this relationship is likely governed less by the amount of alcohol consumed and more by the way it is consumed . Using a prospect i ve study design and a r and om sample of urban transit workers , we found that the frequency of heavy episodic drinking over the previous month is positively associated with the number of days of absence recorded in the subsequent 12-month period , whereas modal consumption ( a metric capturing the typical amount of alcohol consumed in a given period of time ) is not . In addition , consistent with both volitional treatments of absenteeism and social exchange theory , perceived coworker support was found to attenuate , and supervisory support to amplify , the link between the frequency of heavy episodic drinking and absenteeism A theory-based intervention aim ed at reducing corporate employees ' alcohol consumption in excess of guideline limits is presented . The intervention adopted an outcome mental simulation technique and was administered to a sample of corporate employees from three companies . A single-arm r and omized-controlled design was adopted . All participants completed baseline psychological measures and self-reported number of alcohol units consumed and binge-drinking occasions . Participants allocated to the intervention condition were presented with a mental simulation exercise . One month later , participants completed follow-up measures of the psychological variables and alcohol consumption . Results revealed a significant effect of the mental simulation intervention on number of units of alcohol consumed at follow-up . There was no effect of the intervention on frequency of binge-drinking occasions . There was no evidence for the mediation of the effect of mental simulations on alcohol consumption by the perceived behavioural control and motivation variables . Results support the efficacy of the mental simulation intervention in reducing alcohol consumption but not in reducing binge drinking or alcohol consumption in excess of guideline limits , among corporate employees . Results are discussed with respect to the importance of the mental simulation intervention to inform practice and the proposed processes by which mental simulations affect alcohol consumption The short-term results of a r and omized trial testing a brief feedback and motivational intervention for substance use among homeless adolescents are presented . Homeless adolescents ages 14 - 19 ( N = 285 ) recruited from drop-in centers at agencies and from street intercept were r and omly assigned to either a brief motivational enhancement ( ME ) group or 1 of 2 control groups . The 1-session motivational intervention presented personal feedback about patterns of risks related to alcohol or substance use in a style consistent with motivational interviewing . Follow-up interviews were conducted at 1 and 3 months postintervention . Youths who received the motivational intervention reported reduced illicit drug use other than marijuana at 1-month follow-up compared with youths in the control groups . Treatment effects were not found with respect to alcohol or marijuana . Post hoc analyses within the ME group suggested that those who were rated as more engaged and more likely to benefit showed greater drug use reduction than did those rated as less engaged . Limitations of the study are discussed as are implication s for development of future substance use interventions for this high-risk group AIMS To examine the effectiveness of a brief intervention ( BI ) and cognitive behaviour therapy ( CBT ) for alcohol abuse . DESIGN A r and omized trial with clients r and omized within counsellors . SETTING Community-based drug and alcohol counselling in Australia . PARTICIPANTS Of all new clients attending counselling . 869 ( 82 % ) completed a computerized assessment at their first consultation . Four hundred and twenty-one ( 48 % ) were defined as eligible , of whom 295 ( 70 % ) consented and were allocated r and omly to an intervention . Of these , 13 3 ( 45 % ) were followed-up at 6 months post-test . INTERVENTIONS BI comprised the elements identified by the acronym FRAMES : feedback , responsibility , advice , menu , empathy , self-efficacy . Face-to-face counselling time was not to exceed 90 minutes . CBT comprised six consecutive weekly sessions : introduction : cravings and urges ; managing crises ; saying ' no ' and solving problems : emergencies and lapses : and maintenance . Total face-to-face counselling time was 270 minutes ( six 45-minute sessions ) . MEASUREMENTS Treatment outcomes are measured in terms of counsellor compliance , client satisfaction , weekly and binge consumption , alcohol-related problems , the AUDIT question naire and cost-effectiveness . FINDINGS When analysed on an intention-to-treat basis and for those followed-up . treatment outcomes between BI and CBT were not statistically significantly different at pre- or post-test , whether considered as continuous or categorical variables . BI was statistically significantly more cost-effective than CBT and there was no difference between them in clients ' reported levels of satisfaction . CONCLUSION For low-dependence alcohol abuse in community setting s , BI may be the treatment of choice OBJECTIVE The purpose of the research was to determine whether the effectiveness of a traditional DUI ( Driving Under the Influence ) group intervention program could be enhanced by the addition of two brief individual intervention sessions and a follow-up . The differential effectiveness of the individual intervention component was examined for four offender subgroups ( young minorities , problem drinkers , women and depressed offenders ) that had been previously identified as at high risk or vulnerable . METHOD Adjudicated first DUI offenders ( N = 4,074 ) , of whom 776 ( 19 % ) were female , were r and omly assigned to a st and ard first-offender program or an enhanced st and ard program that included two short individual sessions and a brief follow-up session . The setting was a m and ated first-offender program in 10 Mississippi locations . RESULTS Depressed offenders who were assigned to the enhanced program were 35 % less likely to recidivate than those assigned to the st and ard program . The effectiveness of the two programs did not differ significantly for offenders who self-reported low depression . No significant interaction effects were found between program type and age , minority status or gender . After depressed mood was controlled for , problem-drinker status was not related to program effectiveness ; however , problem drinkers had higher depression rates . CONCLUSIONS Results suggest that the combination of a st and ard first-offender program with brief individual counseling can be effective for DUI offenders who report depressed mood and who are at high risk for recidivism . A five-item screen for sad/depressed mood from a widely used DUI risk assessment instrument identified offenders who benefited from the enhanced intervention A brief motivational intervention with 117 homeless adolescents was evaluated using a r and omized design and 3-month follow-up . The intervention was design ed to raise youths ' concerns about their substance use , support harm reduction , and encourage greater service utilization at a collaborating agency . The study was design ed to strengthen initial promising results of an earlier study ( P. L. Peterson , J. S. Baer , E. A. Wells , J. A. Ginzler , & S. B. Garrett , 2006 ) . Several modifications in the clinical protocol were included to enhance engagement with the intervention . Analyses revealed no significant benefits for intervention participants when homeless youths ' substance use rates were compared with those of control participants . Service utilization during the intervention period increased for those receiving the intervention but returned to baseline levels at follow-up . Participants reported overall reductions in substance use over time . Differences between sampling methods for the current and previous study are discussed , as are the limitations of brief interventions with this population . Future research needs to eluci date mechanisms of change and service engagement for highly vulnerable youth The present study evaluated the efficacy of a brief , individualized , alcohol abuse prevention program design ed to reduce problem drinking within the workplace environment . One hundred fifty-five r and omly selected employees of a medium-sized company in the food and retail services sector participated in a 6-month controlled worksite prevention trial . Female problem drinkers who received the intervention were more likely than those in the no-treatment control group to reduce alcohol-related negative consequences at follow-up . In addition , there was a significant multivariate treatment effect , suggesting that participants who received the intervention were significantly more likely to reduce drinking frequency at follow-up . Evaluation of attrition rates and reports of participant satisfaction suggest that the intervention was effective in engaging participants at all levels of alcohol consumption This study evaluated the efficacy of an alcohol web-based personalized feedback program delivered in the workplace to young adults . Participants ( N = 124 ) were r and omly assigned to one of three conditions : web-based feedback ( WI ) , web-based feedback plus a 15-minute motivational interviewing session ( MI ) , or a control group . Results indicated that participants in the intervention group ( WI and MI conditions combined ) reported significantly lower levels of drinking than those in the control group at a 30-day follow-up . This was particularly true for participants classified as high-risk drinkers at the baseline assessment . Similar results were found when comparing the WI condition to the control group . No differences were found between the WI and MI conditions , indicating that the addition of a 15-minute motivational interviewing session did not increase the efficacy of the web-based feedback program . Findings support the use of web-based feedback as a st and -alone alcohol prevention program for young adults in the workplace A large number of r and omized controlled trials in health setting s have consistently reported positive effects of BI to reduce risky alcohol use . However , although alcohol misuse is common amongst offenders , there is limited evidence of alcohol BI in the criminal justice system . The Screening and Intervention Program for Sensible Drinking ( SIPS ) Criminal Justice System trial ( SIPS-CJS ) , a prospect i ve pragmatic cluster r and omized control trial , was the first large multicenter trial of alcohol screening and BI in the CJS carried out in Engl and . Offender managers ( n = 227 ) from 20 probation offices were r and omized to one of three conditions : patient intervention leaflet only [ PIL ] , brief advice [ BA ] , or brief lifestyle counseling [ BLC ] ) and to one of two screening tools ( the Modified Single Alcohol Screening Question [ M-SASQ ] or the Fast Alcohol Screening Test [ FAST ] ) . The primary hypothesis was that BLC delivered by an alcohol health worker would be more effective than BA or PIL delivered by CJS staff . Outcomes were assessed at six and 12 months . The mean age of participants was 31 , and the mean Alcohol Use Disorders Identification Test ( AUDIT ) score at baseline was 16.1 . The majority of the sample were male ( 85 % ) , white ( 76 % ) , and current smokers ( 79 % ) . Sixty-seven percent of participants were available for follow-up at six months post-intervention , and 59 % were available at 12 months . No significant differences were found in follow-up rates between the intervention groups . At 12-month follow-up , ratings were high in all groups in terms of general satisfaction , communication , and interpersonal manner . At 12 months , the proportion of participants positive for AUDIT overall had been reduced by 15.6 % . This reflected a decrease of 18.6 % in the PIL group , 14.4 % in the BA group , and 13.7 % in the BLC group . An adjusted logistic regression model found no significant effects of intervention group , screening approach , or baseline AUDIT score BACKGROUND Driving while impaired ( DWI ) recidivists with unresolved alcohol use problems pose an ongoing risk for traffic safety . Following conviction , many do not participate in m and ated alcohol evaluation and intervention programs , or continue to drink problematically after being relicensed . This study investigated if , in DWI recidivists with alcohol problems and not currently involved in DWI intervention , Brief Motivational Interviewing ( BMI ) produced greater reductions in risky drinking at 6- and 12-month follow-up compared to an information-advice control condition . Additional analyses explored whether BMI was associated with greater readiness to change , subsequent substance abuse treatment service utilization , and satisfaction compared to the control condition . METHODS Male and female recidivists with drinking problems and not currently engaged in DWI intervention were recruited , evaluated , and then r and omly assigned to receive 1 of 2 manualized interventions : 30-minute BMI session or information-advice . Participants , interviewers , research ers , and statisticians were blind to assignment . Outcomes were changed in : percent of risky drinking days ( i.e. , > or =3 st and ard drinks/d for males ; > or = 2 for females ) in the previous 6 months derived from the Timeline Followback , biomarkers of alcohol abuse ( GGT , AST , ALT , MCV ) by blood assay , and alcohol abuse-related behaviors using the MMPI-Mac scale . Data from the Readiness to Change Question naire , a substance abuse service utilization question naire , and the Client Satisfaction Scale were also collected . RESULTS Analyses revealed significant declines in risky drinking with both interventions . BMI ( n = 92 ) result ed in a 25 % reduction in risky drinking days at 12-month follow-up , which compared to the control intervention ( n = 92 ) represented a significant decline from 6-month levels . Exposure to BMI also produced significantly greater improvement at 6-month follow-up in a biomarker of alcohol abuse and a behavioral measure related to recidivism risk . Exploration of readiness to change , substance abuse service utilization , and satisfaction with intervention indicated a perception of BMI being more useful in coping with problems . CONCLUSIONS Brief MI approaches warrant further implementation and effectiveness research as an opportunistic DWI intervention strategy to reduce risks associated with alcohol use outside of clinical and DWI relicensing setting AIMS To assess the effectiveness of brief alcohol intervention on  hazardous and harmful drinking  in the 12-month period after a voluntary alcohol screening . METHODS At a large transport company , employees presenting to the occupational health services for a routine health and lifestyle check-up were offered to undertake an alcohol screening by means of self-report ( the Alcohol Use Disorders Identification Test-AUDIT ) and a biomarker ( carbohydrate-deficient transferrin in serum-CDT ) . Those screening positive for the AUDIT and /or CDT were r and omized to a brief or comprehensive intervention group or to a control group . An identical follow-up session was performed 12 months later . RESULTS Of 990 employees ( 68 % men ) that volunteered for the alcohol screening , 194 ( 20 % ) tested positive for the  AUDIT and /or CDT .  Among the 158 ( 81 % ) subjects who also attended the follow-up session , the frequency of positive screening results at baseline/follow-up were 51%/23 % for the AUDIT ( P < 0.0001 ) and 58%/34 % ( P < 0.0001 ) for CDT . However , there were no significant differences between the brief and comprehensive intervention groups or between the intervention groups and the control group . CONCLUSION The results suggested that alcohol screening and brief intervention performed in connection with routine health and lifestyle examinations in the workplace may be effective in reducing alcohol consumption . Given the lack of difference in outcome between the intervention groups and the control group , alcohol screening may in itself cause reduction in drinking . In addition , at least some of the positive effect may be explained by regression towards the mean
BACKGROUND The robust evidence base for the effectiveness of alcohol screening and brief interventions ( ASBIs ) in primary health care ( PHC ) suggests that a widespread expansion of ASBI in non-medical setting s could be beneficial .
Social service and criminal justice setting s work frequently with persons with alcohol use disorders , and workplace setting s can be an appropriate setting for the implementation of alcohol prevention programs , as a considerable part of their social interactions takes place in this context .