The efficacy of a brief intervention in reducing hazardous drinking in working age men in Russia: the HIM (Health for Izhevsk men) individually randomised parallel group exploratory trial

Abstract

BackgroundRussia has particularly low life expectancy for an industrialised country, with mortality at working ages having fluctuated dramatically over the past few decades, particularly among men. Alcohol has been identified as the most likely cause of these temporal variations. One approach to reducing the alcohol problem in Russia is 'brief interventions' which seek to change views of the personal acceptability of excessive drinking and to encourage self-directed behaviour change. Very few studies to evaluate the efficacy of brief interventions in Russia have been conducted. Motivational Interviewing (MI) is a person-centred counselling style which can be adapted to brief interventions in which help is offered in thinking through behaviour in the context of values and goals, to decide whether change is needed, and if so, how it may best be achieved.MethodsThis paper reports on an individually randomised two-armed parallel group exploratory trial. The primary hypothesis is that a brief adaptation of MI will be effective in reducing self-reported hazardous and harmful drinking at 3 months. Participants were drawn from the Izhevsk Family Study II, with eligibility determined based on proxy reports of hazardous and harmful drinking in the past year. All participants underwent a health check, with MI subsequently delivered to those in the intervention arm. Signed consent was obtained from those in the intervention arm only at this point. Both groups were then invited for 3 and 12 month follow ups. The control group did not receive any additional intervention.Results441 men were randomised. Of these 61 did not have a health check leaving 190 in each trial arm. Follow up at 3 months was high (97% of those having a health check), and very similar in the two trial arms (183 in the intervention and 187 in the control).No significant differences were detected between the randomised groups in either the primary or the secondary outcomes at three months in the intention to treat analyses. The unadjusted odds ratio (95% CI) for the effect of MI on hazardous and harmful drinking was 0.77 (0.51, 1.16). An adjusted odds ratio of 0.52 (0.28, 0.94) was obtained in the pre-specified per protocol analysis.ConclusionsThis trial demonstrates that it is possible to engage Russian men who drink hazardously in a brief intervention aimed at reducing alcohol related harm. However the results with respect to the efficacy are equivocal and further, larger-scale trials are warranted.Trial RegistrationISRCTN: ISRCTN82405938

Reduction of the Alcohol Consumption Among Workers Using a Brief Intervention

“…These studies also reported that the consumption reduction after the BI was greater among the participants that had high-risk consumption (10% to 15%), hazardous consumption, and probable dependence (10% to 19%). 7 The difference between AUDIT scores before and three months after the BI indicated a positive result, showing statistical significance, with a p-value lower than 0.001 (Z=-4.709) for the difference between scores obtained before (mean = 15.83) and after (mean = 3.46), especially among men. A study developed in Sweden reported similar results, with a more pronounced effect on men.…”

“…The authors confirmed the viability of alcohol consumption screening and the effect on the reduction of the consumption by workers, corroborating some international studies carried out in worker health services of some companies. 7,9,[16][17] The workers that had a high risk of alcohol consumption reduced their excessive consumption, although they did not consider themselves as people who drink too much. Some studies show that 9/12 the decrease is higher in the three first months after the BI and tends to diminish over time, which emphasizes the need for worker health teams to monitor the participants.…”

“…A study developed in Sweden reported similar results, with a more pronounced effect on men. 7,[18][19][20][21] Additionally, it is important to highlight the other characteristics of the sample profile. The consumption reduction obtained by applying the BI technique was higher in participants 50 years old or older, who declared to have white skin, were married, had higher education or a higher degree, had a per capita income lower than three minimum wages, and declared to have a religion.…”

“…Authors point out that high alcohol consumption reduces workers' performance, which results in an increase in the unemployment rate and low income. The excessive consumption causes problems in the work process, especially in the sphere of its organization, [7][8] given that it is carried out in an attempt to escape mental suffering and emotional overload related to or resulting from the work conditions and work organization imposed by companies. Therefore, some professionals find a way out of these problems in alcohol consumption, which leads to severe cases of alcohol dependence.…”

Prevalence of Alcohol Dependence in Therapeutic In-Patients

“…Motivational interviewing encourages people to find a good reason to change their alcohol behaviour themselves. In 2008-2009, Izhevsk State Medical Academy and London School of Hygiene & Tropical Medicine conducted a joint study in Izhevsk on the effectiveness of motivational interviewing [15]. Researchers found that short-term motivational interviewing may be advantageous in Russia.…”