Alcohol Abuse Clinical Trial
Official title:
Mentored Research on Improving Alcohol Brief Interventions in Medical Settings
The NIAAA estimates that 16% (40 million) of adults in the US are drinking at unsafe levels. More than 50% of alcohol health consequences occur in risky, non-dependent drinkers. Increasing the efficacy and efficiency of brief interventions in medical setting could significantly reduce the public health impacts of risky drinking. There is intense interest in conducting motivational interviewing (MI) informed brief interventions for risky alcohol use in medical settings, but little empirical information is available regarding which MI behavioral and interpersonal style components drive effectiveness. The field would benefit greatly from empirically-based Stage 1 treatment development and modeling studies to delineate the degree to which adding motivational interviewing components to brief intervention improves outcome.
The NIAAA estimates that 16% (40 million) of adults in the US are drinking at unsafe levels,
placing them at risk for a variety of physical, mental health, and social consequences. More
than 50% of alcohol health consequences occur in risky, non-dependent drinkers. Increasing
the efficacy and efficiency of brief interventions in medical setting could significantly
reduce the public health impacts of risky drinking. Despite overall positive findings for
brief interventions, there are high levels of variability in effects, with meta-analyses
reporting significant unexplained heterogeneity in outcomes that is likely accounted for by
differences in intervention components and strategies. There is intense interest in
conducting motivational interviewing (MI) informed brief interventions for risky alcohol use
in medical settings, but little empirical information is available regarding which MI
behavioral and interpersonal style components drive effectiveness.
Following promising efficacy trials from counseling applications, MI was translated into
brief (5-15 minute) interactions and subjected to randomized controlled trial methodology.
Lack of mixed-methods, Stage 1 treatment development is evidenced by our inability to provide
consistent delineation of key intervention components and mechanisms of action. Variability
in these factors is likely responsible for the wide variability in effects observed in
meta-analyses of brief interventions. Many MI skills and behaviors require significant
training and supervision and increased patient-provider interaction time. The field would
benefit greatly from empirically-based Stage 1 treatment development and modeling studies to
delineate the degree to which adding motivational interviewing components to brief
intervention improves outcome.
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