Evaluation of Alcohol Screening and Community-Based Brief Interventions in Rural Western Kenya: A Quasi-Experimental Study

Abstract

Community-based alcohol brief interventions implemented by community-health workers accompanied by motivational talks by former drinkers were associated with reduced hazardous and harmful alcohol consumption in a rural setting in western Kenya.

Psychosocial interventions for reducing alcohol consumption in sub‐Saharan African settings: a systematic review and meta‐analysis

“…Of the 24 reports judged eligible for meta‐analysis, five were excluded due to missing data on eligible outcomes. In total, 18 studies [25–42] included in 19 reports (Rotheram‐Borus, unpublished data and report provided by the study authors) met criteria for inclusion and contributed data for meta‐analysis for the following outcomes: AUDIT score ( k = 11) [25,29–33,37,38,40–42], drinks per drinking day (DDD) ( k = 3) [28,34,38], percentage of drinking days (PDD) ( k = 3) [9,27,38] and alcohol abstinence ( k = 7) [25–28,34–36]. No eligible studies included alcohol biomarkers.…”

“…The 18 studies included spanned seven sSA countries: South Africa ( k = 9) [29–35,39], Kenya ( k = 5) [25–28,37], Namibia ( k = 1) [36], Rwanda ( k = 1) [42], Uganda ( k = 2) [38], Tanzania ( k = 1) [25] and Zambia ( k = 1) [25] (including one multi‐country study) [25]. Study designs were primarily randomized controlled trials (RCTs) ( k = 11) [26–28,30–32,36,38–40,42].…”

“…Study designs were primarily randomized controlled trials (RCTs) ( k = 11) [26–28,30–32,36,38–40,42]. Eight studies tested interventions focused solely or primarily on alcohol reduction ( k = 5) [29–31,37,38] or abstinence ( k = 3) [26–28], as opposed to dual or multi‐outcome focused interventions ( k = 10) [25,32–36,39–42]. The majority of studies included special subpopulations: people living with HIV ( k = 7) [25,27,28,38–40,42], adolescents ( n = 3, including one with adolescents living with HIV) [35,36,40], female sex workers ( k = 1) [26], pregnant women ( k = 2) [34,41] and TB patients ( k = 1) [29].…”

“…Nineteen interventions were tested across the 18 studies (one three‐armed study tested an intervention and an enhanced version of that intervention) [37]. All studies evaluated psychosocial interventions; one structural‐level intervention was identified but was excluded because of a lack of appropriate data for meta‐analysis.…”

“…Seven interventions [26,29–31,37,41] were based on or expanded upon WHO's alcohol BI manual [18], five explicitly stated using motivational interviewing or motivational therapy (inclusive of two of the WHO BI studies) [26,32,37,38,41], three were grounded in cognitive–behavioral therapy [27,28,40] and four were informed by a behavior change model [29–31,36]. The most common intervention setting was a health facility ( k = 8) [25–29,38,40,41], followed by community venues ( k = 5) [30–33,39], schools ( k = 3) [35–37] and participants’ homes ( k = 2) [34,42]. Three interventions were delivered in a single session [30,31,38], two did not report the number of sessions [25,33], while all others were multi‐session interventions.…”