No abstract

Context Excessive drinking is responsible for 1 in 10 deaths among working-age adults in the U.S. annually. Alcohol screening and brief intervention (ASBI) is an effective, but underutilized, intervention for reducing excessive drinking among adults. Electronic screening and brief intervention (e-SBI) uses electronic devices to deliver key elements of ASBI, and has the potential to expand population reach. Evidence acquisition Using Community Guide methods, a systematic review of the scientific literature on the effectiveness of e-SBI for reducing excessive alcohol consumption and related harms was conducted. The search covered studies published from 1967 to October 2011. A total of 31 studies with 36 study arms met quality criteria, and were included in the review. Analyses were conducted in 2012. Evidence synthesis Twenty-four studies (28 study arms) provided results for excessive drinkers only and seven studies (eight study arms) reported results for all drinkers. Nearly all studies found that e-SBI reduced excessive alcohol consumption and related harms: nine study arms reported a median 23.9% reduction in binge drinking intensity (maximum drinks/binge episode) and nine study arms reported a median 16.5% reduction in binge drinking frequency. Reductions in drinking measures were sustained for up to 12 months. Conclusion According to Community Guide rules of evidence, e-SBI is an effective method for reducing excessive alcohol consumption and related harms among intervention participants. Implementation of e-SBI could complement population-level strategies previously recommended by the Community Preventive Services Task Force for reducing excessive drinking (e.g., increasing alcohol taxes and regulating alcohol outlet density).

Context The objective of this systematic review was to determine the costs, benefits, and overall economic value of communication campaigns that included mass media and distribution of specified health-related products at reduced price or free of charge. Evidence Acquisition Economic evaluation studies from a literature search from January 1980–December 2009 were screened and abstracted following systematic economic review methods developed by The Community Guide. Data were analyzed in 2011. Evidence Synthesis The economic evidence was grouped and assessed by type of product distributed and health risk addressed. A total of 15 evaluation studies were included in the economic review, involving campaigns promoting the use of child car seats or booster seats, pedometers, condoms, recreational safety helmets, and nicotine replacement therapy (NRT). Conclusion Economic merits of the intervention could not be determined for health communication campaigns associated with use of recreational helmets, child car seats, and pedometers, primarily because available economic information and analyses were incomplete. There is some evidence that campaigns with free condom distribution to promote safer sex practices were cost-effective among high-risk populations and the cost per quit achieved in campaigns promoting tobacco cessation with NRT products may translate to a cost per quality-adjusted life year (QALY) less than $50,000. Many interventions were publicly funded trials or programs, and the failure to properly evaluate their economic cost and benefit is a serious gap in the science and practice of public health.