Commitment strength, alcohol dependence and HealthCall participation: Effects on drinking reduction in HIV patients

Aharonovich, Efrat; Stohl, Malka; Ellis, James W.; Amrhein, Paul C.; Hasin, Deborah S.

doi:10.1016/j.drugalcdep.2013.11.015

Cited by 9 publications

(10 citation statements)

References 47 publications

(59 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Readiness to change showed significant conditional effects in the prediction of the outcomes ‘Participation in psychosocial mental health care options’ and ‘Having approached psychosocial mental health options’, and it moderated the treatment effects of BRIA. These findings are consistent with previous research showing positive associations between higher motivation to change and treatment outcomes of psychotherapy [ 3 , 11 – 18 ]. Like in previous studies readiness was positively associated with pretreatment psychological distress [ 21 , 22 , 26 , 27 , 30 , 31 ].…”

Section: Discussionsupporting

confidence: 93%

“…Numerous psychotherapy studies have shown positive associations between higher motivation to change and treatment outcomes [ 3 , 11 – 18 ]. Other studies, however, reported no, ambiguous or even negative associations [ 19 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…Theoretical models assume that motivation to change acts as a moderator of the efficacy of psychosocial therapy. However, previous treatment outcome research showed conflicting results [ 11 , 12 , 14 , 15 , 17 , 20 , 21 , 23 – 25 , 27 , 32 – 41 ]. The findings of several studies suggest that motivational readiness to change is positively associated with pretreatment severity of problems and symptoms of those disorders for which patients seek therapy [ 21 , 22 , 26 , 27 , 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial

et al. 2017

View full text Add to dashboard Cite

BackgroundReadiness to change is a pivotal construct for psychotherapy research and a major target of motivational interventions. Our primary objective was to examine whether pre-treatment readiness to change moderated therapy effects of Bridging Intervention in Anesthesiology (BRIA), an innovative psychotherapy approach for surgical patients. This stepped care program aims at motivating and supporting surgical patients with mental disorders to engage in psychosocial mental health care.MethodsThe major steps of BRIA are two motivational interventions with different intensity. The first step of the program consists of preoperative computer-assisted psychosocial self-assessment including screening for psychological distress and automatically composed computerized brief written advice (BWA). In the second step, patients participate in postoperative psychotherapy sessions combining motivational interviewing with cognitive behavioural therapy (BRIA psychotherapy sessions).We performed regression-based moderator analyses on data from a recent randomized controlled trial published by our research group. The sample comprised 220 surgical patients with diverse comorbid mental disorders according to ICD-10. The most frequent disorders were mood, anxiety, substance use and adjustment disorders. The patients had a mean age of 43.31 years, and 60.90% were women. In a regression model adjusted for pre-treatment psychological distress, we investigated whether readiness to change moderated outcome differences between (1) the BRIA psychotherapy sessions and (2) no psychotherapy / BWA only.ResultsMultiple regression analyses showed that readiness to change moderated treatment effects regarding the primary outcomes "Participation in psychosocial mental health care options at month 6" (p = 0.03) and "Having approached psychosocial mental health care options at month 6" (p = 0.048) but not regarding the secondary outcome "Change of general psychological distress between baseline assessment and month 6" (p = 0.329). Probing the moderation effect with the Johnson-Neyman technique revealed that BRIA psychotherapy sessions were superior to BWA in patients with low to moderate readiness, but not in those with high readiness.ConclusionsReadiness to change may act as moderator of the efficacy of psychosocial therapy. Combinations of motivational interviewing and cognitive behavioural therapy may be effective particularly in patients with a variety of mental disorders and low readiness to change.Trial registration clinicaltrials.gov Identifier: NCT01357694.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial

et al. 2017

View full text Add to dashboard Cite

show abstract

“…HealthCall's mechanisms of change are hypothesized to include the following: (1) increased awareness of the target behavior through self-monitoring; (2) improved accuracy about change through personalized feedback; (3) goal setting and attainment; (4) increased participant commitment to change (Aharonovich, Stohl, Ellis, Amrhein, & Hasin, 2014), and (5) improved self-efficacy (Gause et al, 2016). HealthCall-S satisfaction ratings and end of treatment debriefing indicated that participants positively endorsed these components.…”

Section: Discussionmentioning

confidence: 99%

HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial

Aharonovich

Stohl

Cannizzaro

et al. 2017

Journal of Substance Abuse Treatment

Self Cite

View full text Add to dashboard Cite

Aims Co-occurrence of drug and alcohol use among people living with HIV is linked to poor medication adherence and lack of viral suppression. HealthCall, a technological enhancement of brief Motivational Interviewing (MI), involves brief daily self-monitoring, positive reinforcement, and personalized feedback. This randomized pilot study among people living with HIV investigated the feasibility and efficacy of reducing non-injection drug and alcohol use with MI + HealthCall as adapted for smartphone technology. Design An urban, largely-minority community sample of adults living with HIV were screened for eligibility: last 30 day use of non-injection drugs (≥4 days of crack/cocaine, methamphetamine, or heroin use) and binge drinking (≥1 day of 4+ standard drinks). Those eligible were randomized to one of two groups: MI-only (n = 21) and MI + HealthCall-S (n = 21). Trained counselors delivered the brief MI at baseline. Drug and alcohol use assessments were completed at baseline, 30 and 60 days (end of treatment). Primary outcomes derived from a Timeline Follow Back (TLFB) of the past 30 days included (1) total number of days used primary drug (NumDU) (2) total quantity of primary drug used (dollar amount spent per day; QuantU), (3) total number of drinking days (NumDD) and (4) mean number of drinks per day (QuantDD). Feasibility was determined by HealthCall use rates, patient satisfaction questionnaire (1–5 scale, 5 being best), and retention. Findings The median daily use rate for HealthCall was 95%, patient satisfaction was excellent (4.5) and retention was high (93%). Both treatment groups reduced drug and alcohol use by end of treatment, with MI+Healthcall-S showing significantly greater reductions than MI-only in QuantU (p=0.01) and NumDU (p=0.046). P-values for reductions in alcohol quantity and frequency in the MI+Healthcall group were 0.09–0.11. Conclusions This proof-of-concept randomized trial indicates that HealthCall on the smartphone is a highly feasible intervention in urban, minority individuals with HIV, and suggests efficacy in reducing co-occurring drug and alcohol use. Results suggest opportunities for brief behavioral intervention that may be enhanced through interactive mobile technology to address complex alcohol and drug use patterns that interfere with HIV care, medication adherence and ultimately, viral suppression. A larger randomized trial is warranted to replicate and extend present results.

show abstract

“…These findings suggest that those with a more challenging clinical presentation associated with comorbid drug use 47 and low motivation could benefit from MI. 48 Limited research has examined alcohol use interventions among HIV-positive patients, and outcomes to date have been mixed. [49][50][51] In the current study, one possible explanation for the overall lack of significant differences was that all arms included clinician-delivered alcohol screening following the SBIRT model.…”

Section: Discussionmentioning

confidence: 99%

Interventions to Reduce Unhealthy Alcohol Use among Primary Care Patients with HIV: the Health and Motivation Randomized Clinical Trial

et al. 2019

View full text Add to dashboard Cite

BACKGROUND: Unhealthy alcohol use has adverse effects on HIV treatment. Screening, brief intervention, and referral to treatment (SBIRT) has some evidence of efficacy but may not be sufficient for those with low motivation or comorbid substance use. OBJECTIVE: To examine the effectiveness of motivational interviewing (MI) and emailed feedback (EF) among primary care HIV-positive patients, compared with treatment as usual care (UC) only, which included SBIRT. DESIGN: Randomized clinical trial. PARTICIPANTS: Six hundred fourteen adult HIV-positive patients in Kaiser Permanente Northern California who reported prior-year unhealthy alcohol use. INTERVENTION: Participants were randomized to either three sessions of MI (one in person and two by phone), information regarding alcohol risks via EF through a patient portal, or UC alone. MI and EF participants who reported unhealthy alcohol use at 6 months were offered additional MI and EF treatment, respectively. MAIN MEASURES: Participant-reported unhealthy alcohol use (defined as ≥ 4/≥ 5 drinks per day for women/ men), alcohol problems at 12 months, based on blinded telephone interviews. Secondary outcomes included drug use and antiretroviral (ART) adherence. KEY RESULTS: At 12 months, there were no overall group differences, but in all three arms, there were declines in unhealthy alcohol use and alcohol-related problems (p < 0.001). Participants reporting low motivation to reduce drinking at baseline were less likely to report unhealthy alcohol use if they received MI vs. EF and UC (p = 0.013). At 6 months, reported illegal drug use/misuse of prescription drugs other than marijuana was lower in the MI arm than EF or UC (p = 0.012). There were no differences in ART adherence between groups. CONCLUSIONS: In a randomized trial of HIV-positive patients using two behavioral interventions compared with SBIRT alone, participants in all three conditions reduced unhealthy alcohol use. MI may provide added benefit for patients with low motivation or who report illegal drug use/misuse of prescription drugs.

show abstract

Commitment strength, alcohol dependence and HealthCall participation: Effects on drinking reduction in HIV patients

Cited by 9 publications

References 47 publications

Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial

Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial

HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial

Interventions to Reduce Unhealthy Alcohol Use among Primary Care Patients with HIV: the Health and Motivation Randomized Clinical Trial

Contact Info

Product

Resources

About