Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults?

Bradley, Katharine A.; Lapham, Gwen T.

doi:10.1111/add.13235

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…22 Brief interventions, however, should not be expected to exert any more than short term effects, 23 although these are likely to be highly cost effective if effectiveness can be reliably ascertained. 24 Almost all identified effects are on self reported alcohol consumption 25 ; effects on other outcomes (eg, injuries, liver disease, or use of acute healthcare) are neither consistent nor convincing. 26 Self reported effects on consumption are vulnerable to social desirability bias, since people are aware they have been advised to drink less and are then asked to report whether they have done so.…”

Section: Questions About Efficacymentioning

confidence: 99%

Rethinking brief interventions for alcohol in general practice

McCambridge

Saitz

2017

BMJ

107

105

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Section: Questions About Efficacymentioning

confidence: 99%

Rethinking brief interventions for alcohol in general practice

McCambridge

Saitz

2017

BMJ

107

105

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Brief Interventions as Evidence-Based Prevention Strategies

Tanner‐Smith

Grant

2019

Advances in Prevention Science

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It is time to develop appropriate tools for assessing minimal clinically important differences, performance bias and quality of evidence in reviews of behavioral interventions

et al. 2016

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trials could account fully for any small effects found in our review.Other forms of performance and detection bias are also important. For example, in a systematic review and metaanalysis of 300 randomized trials, Petrosino et al. [3] looked at the impact of non-independent researchers and found that in those trials where programme developers were also the researchers the mean effect size was 0.47, compared with 0.00 when the evaluation team were external and independent. Petrosino et al. concluded that: 'studies in which evaluators were greatly influential in the design and implementation of treatment report consistently and substantially larger effect sizes than other types of evaluators'. The Cochrane risk of bias approach does not include an assessment of this particular risk of bias, and the extent to which programme evaluators were involved in developing and delivering the intervention is not always clear from studies. Therefore, we cannot rule out the possibility that the effect sizes obtained in the current review may be inflated by a conflict-of-interest bias.The fourth point should be discussed more widely among researchers and policymakers: what sort of effect size is good enough? Our interpretation of the effect sizes we were finding across a series of meta-analyses was that they were very small, and unlikely to be of any meaningful benefit on their own, regardless of any possible but unknown reductions in effect sizes due to bias. For example, in the original review, we estimated that the obtained effect sizes would mean (approximately, on average): a decrease in the number of days per week that alcohol was consumed from 2.7 days to 2.5 days; a decrease in the number of drinks consumed each week from 13 to 11 drinks per week; and a decrease in the 69-point Rutgers Alcohol Problems Index (RAPI) from a score of 8.9 to 8.7. We suggest that these achieved effect sizes may fall short of a minimally important clinical difference (MCID). Grant et al. disagree with our interpretation, and that is alright: users of research evidence should make up their own minds on the right interpretation of the evidence.Perhaps an even more important question for the field is this: even if the effects of motivational interviewing for alcohol misuse prevention in young adults are really small, does that mean that we should forget about motivational interviewing as part of a portfolio of different types of prevention interventions [4]? This would be premature, because it is plausible that the whole is greater than the sum of the parts; that the combined effect of multiple single (but individually weak) interventions is worthwhile. However, this should not be seen as a green light for policymakers and practitioners to ignore evidence from randomized controlled trials of single interventions. Rather, it should serve as a focus for the research community. We need better methods for evaluating the combined effect of interventions within prevention systems, and for selecting well-evidenced interventions to incorporate into prev...

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Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults?

Cited by 3 publications

References 21 publications

Rethinking brief interventions for alcohol in general practice

Rethinking brief interventions for alcohol in general practice

Brief Interventions as Evidence-Based Prevention Strategies

It is time to develop appropriate tools for assessing minimal clinically important differences, performance bias and quality of evidence in reviews of behavioral interventions

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