Are brief alcohol interventions targeting alcohol use efficacious in military and veteran populations? A meta-analysis

Doherty, Ailbhe; Mason, C.; Fear, Nicola T.; Rona, Roberto; Greenberg, Neil; Goodwin, Laura

doi:10.1016/j.drugalcdep.2017.05.029

Cited by 30 publications

(28 citation statements)

References 29 publications

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“…Numerous systematic reviews have assessed the effectiveness of screening and brief alcohol intervention approaches and generally conclude they are effective in reducing alcohol consumption [ 6 ••, 12 •]. Some reviews have a narrower focus than others, investigating the impact of a particular type of brief intervention [ 13 •, 14 ], delivery in a specific setting [ 15 – 19 ] or location [ 20 , 21 ], or for a certain population [ 22 – 25 ]. This evidence base has most recently been synthesised in two linked Cochrane systematic reviews: the first was an update of a review of practitioner-delivered brief interventions in primary care settings (including emergency care) [ 26 ••]; the second focused on digital interventions to reduce hazardous and harmful alcohol consumption [ 27 ••].…”

Section: Evidence Of Effectivenessmentioning

confidence: 99%

Brief Interventions in Primary Care: an Evidence Overview of Practitioner and Digital Intervention Programmes

2018

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Purpose of the ReviewExcessive drinking is a major public health problem that adversely affects all parts of the population. Previous systematic reviews and meta-analyses have reported that brief interventions delivered in primary care are effective at reducing alcohol consumption, albeit with small effect sizes that have decreased over time. This review summarises the updated evidence base on practitioner and digitally delivered brief interventions.Recent FindingsUsing Cochrane methodology, 69 primary care brief intervention trials (33,642 participants) and 57 digital intervention trials (34,390 participants) were identified. Meta-analyses showed both approaches significantly reduced consumption compared to controls. Five trials (390 participants) compared practitioner-delivered and digital interventions directly with no evidence of difference in outcomes at follow-up.SummaryBrief interventions have the potential to impact at both individual and population levels. Future research should focus on optimising components and delivery mechanisms, and on alcohol-related harms. Digital interventions may overcome some of the implementation barriers faced by practitioner-delivered interventions.

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Section: Evidence Of Effectivenessmentioning

confidence: 99%

Brief Interventions in Primary Care: an Evidence Overview of Practitioner and Digital Intervention Programmes

2018

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“…There is a body of research that confirms the efficacy of brief interventions in reducing alcohol consumption and alcohol-related harm for those drinking at a hazardous level in the general population [ 18 - 20 ]. However, little is known about their efficacy in the AF context [ 19 ]. Given the shared culture in the military in which alcohol plays a meaningful role, it is important to evaluate the efficacy of brief interventions in this type of population.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Efficacy of a Mobile App (Drinks:Ration) and Personalized Text and Push Messaging to Reduce Alcohol Consumption in a Veteran Population: Protocol for a Randomized Controlled Trial

Leightley¹,

Rona²,

Shearer³

et al. 2020

JMIR Res Protoc

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Background Alcohol misuse is higher in the UK Armed Forces than in the general population. Previous research has shown that interventions delivered via smartphones are efficacious in promoting self-monitoring of alcohol use, have utility in reducing alcohol consumption, and have a broad reach. Objective This single-blinded randomized controlled trial (RCT) aims to assess the efficacy of a 28-day brief alcohol intervention delivered via a smartphone app (Drinks:Ration) in reducing weekly self-reported alcohol consumption between baseline and 3-month follow-up among veterans who drink at a hazardous or harmful level and receive or have received support for mental health symptoms in a clinical setting. Methods In this two-arm, single-blinded RCT, a smartphone app that includes interactive features designed to enhance participants’ motivation and personalized messaging is compared with a smartphone app that provides only government guidance on alcohol consumption. The trial will be conducted in a veteran population that has sought help through Combat Stress, a UK veteran’s mental health charity. Recruitment, consent, and data collection will be carried out automatically through the Drinks:Ration platform. The primary outcome is the change in self-reported weekly alcohol consumption between baseline (day 0) and 3-month follow-up (day 84) as measured using the Time-Line Follow back for Alcohol Consumption. Secondary outcome measures include (1) change in the baseline to 3-month follow-up (day 84) Alcohol Use Disorder Identification Test score and (2) change in the baseline to 3-month follow-up (day 84) World Health Organization Quality of Life-BREF score to assess the quality of adjusted life years. Process evaluation measures include (1) app use and (2) usability ratings as measured by the mHealth App Usability Questionnaire. The primary and secondary outcomes will also be reassessed at the 6-month follow-up (day 168) to assess the longer-term benefits of the intervention, which will be reported as a secondary outcome. Results The study will begin recruitment in October 2020 and is expected to require 12 months to complete. The study results will be published in 2022. Conclusions This study assesses whether a smartphone app is efficacious in reducing self-reported alcohol consumption in a veteran population that has sought help through Combat Stress using personalized messaging and interactive features. This innovative approach, if successful, may provide a means to deliver a low-cost health promotion program that has the potential to reach large groups, in particular those who are geographically dispersed, such as military personnel. Trial Registration ClinicalTrials.gov NCT04494594; https://clinicaltrials.gov/ct2/show/NCT04494594 International Registered Report Identifier (IRRID) PRR1-10.2196/19720

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“…The increased prevalence of drinking and alcohol use disorders in the veteran population (Doherty et al, 2017; Williamson et al., 2018) is concerning because research has revealed that alcohol consumption can influence mental health status (Marti, Choi, DiNitto, & Choi, 2015; Rehm, 2011). In addition, high-volume drinkers and frequent binge drinkers are more likely to report psychological distress than those who are not high-volume drinkers or binge drinkers (Makela, Raitasalo, & Wahlbeck, 2015).…”

Section: Introductionmentioning

confidence: 99%

Does Mental Health Differ by Alcohol Use in Elderly Male Veterans?

Shaffer

Perryman

et al. 2019

Gerontology and Geriatric Medicine

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Introduction: With limited research for mental health and alcohol use among veterans in the general population and none for elderly male veterans only, the purpose is to assess whether mental health differs by alcohol use in elderly male veterans in the general population. Method: This cross-sectional analysis uses 2017 Behavioral Risk Factor Surveillance System data for male veterans aged 65 and older in general population samples from Florida ( n = 1,700), Maryland ( n = 1,060), New York ( n = 552), and Washington ( n = 1,031). Multiple logistic regression by state assessed the relationship between mental health and alcohol use, after controlling for health-related, demographic, and socioeconomic factors. Results: Across states, most participants reported good mental health (80%-84%) and more than half reported drinking (53%-63%). Adjusted results indicated that mental health did not differ by alcohol use in any state; however, it was related to physical health and activity limitations across states. Conclusion: Overall, alcohol use was not related to mental health in elderly male veterans in the general population; however, physical health status and activity limitations were. Practitioners should always screen for alcohol use and should automatically screen for mental health, physical health, and activity limitations when symptoms present for any and assess concurrent treatment and management strategies.

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Are brief alcohol interventions targeting alcohol use efficacious in military and veteran populations? A meta-analysis

Abstract: Based on these findings, existing BAIs do not seem to be efficacious in reducing alcohol use in military populations, despite some encouraging results from one electronic intervention which was of extensive duration.

Cited by 30 publications

References 29 publications

Brief Interventions in Primary Care: an Evidence Overview of Practitioner and Digital Intervention Programmes

Brief Interventions in Primary Care: an Evidence Overview of Practitioner and Digital Intervention Programmes

Evaluating the Efficacy of a Mobile App (Drinks:Ration) and Personalized Text and Push Messaging to Reduce Alcohol Consumption in a Veteran Population: Protocol for a Randomized Controlled Trial

Does Mental Health Differ by Alcohol Use in Elderly Male Veterans?

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