Brief motivational interview and educational brochure in emergency room settings for adolescents and young adults with alcohol related problems: a randomized single blind clinical trial

Abstract

Objective: To evaluate the effectiveness of brief motivational interviewing and an educational brochure when delivered in emergency room to reduce alcohol abuse and related problems among adolescents and young adults. Method: A randomized single-blind clinical trial with a three-month follow-up was carried out at three emergency rooms from October 2004 to November 2005; subjects assessed were 16-25 years old treated for alcohol related events up to 6 hours after consumption. Socio-demographic data, quantity, frequency and negative consequences of alcohol consumption, motivation to change habits and future risk perception were evaluated. Statistical analysis was performed on subjects who completed follow-up (completers). ANCOVA model was used to analyze the difference between the intervention groups with statistical significance level α = 5% and confidence interval (CI) of 95%. Results: 186 subjects formed the initial sample, being 175 included and randomized to the educational brochure group (n = 88) or motivational interviewing group (n = 87). Follow-up assessment was performed in 85.2% of the sample. No significant difference between groups was observed. However, significant reductions (p < 0.01) in related problems and alcohol abuse were found in both groups. Conclusion: In this sample a reduction of alcohol use and related problems was observed. Preliminary data indicate that controlled clinical trials with motivational interviewing, educational brochure and nonintervention should be of future interest among Brazilian adolescent populations. Descriptors

Effectiveness of Psychosocial Interventions Targeting Hazardous and Harmful Alcohol Use and Alcohol-Related Symptoms in Low- and Middle-Income Countries: A Systematic Review

“…Although promising, we are unable to draw conclusions regarding the effectiveness of pure CBT-interventions in LMIC from only one study. On the other hand, among the seven studies where between-condition effect-size values were below .20 or negative, all employed a MI-component as well (88,89,91,97,99,101,103). Taken together, the current evidence regarding MI-based interventions in LMIC is by far not as clear as one would expect considering its wide-spread use in therapeutic practice and scientific trials in LMIC settings.…”

“…The diversity of alcohol-related inclusion criteria accounted for a rather heterogeneous overall sample in terms of symptom severity. The samples of six studies either completely (90,91) or partially [40% (88), 63% (92), 73.2% (93), and "about 50%" (94)] consisted of alcohol-dependent individuals. In eight studies, dependent drinking is neither controlled for nor explicitly addressed, although the respective samples are likely to include dependent drinkers as the studies either used lower but no upper screening limits (95-99), did not specify a cut-off score at all (87), or used an upper score potentially including dependent drinkers (100).…”

“…(98)] or in the form of written material [e.g. (88)]. In trials that embedded MI-based treatments into other health programs, the information component was often specific for alcohol consumption in relation to the respective health issue, such as education on how alcohol affects communication skills and sexual behaviors and increases risk for HIV or sexually transmitted infections [STI; e.g.…”

“…(89)] as communication styles to be employed by the practitioners. Among the 18 studies employing an MI-based approach, only six used it as stand-alone intervention without any further additional components (88,97,100,101,104,105), while the remaining used the MI-based approach as one method and blended it with other treatment components extending beyond the scope of MI. Two studies (89,98) delivered cognitive and behavioral components within their MI-frameworks, with examples being problem-solving, drink refusal skills training, and handling of peer pressure or difficult emotions.…”

“…Four studies employed alcohol-related endpoints that could not be allocated to either of our two main outcome categories (87,88,95,100). Calculations of within-condition effect sizes yielded a range from g av = 0.45 to 1.58 at 3-months FU.…”