Who benefits from computer-based brief alcohol intervention? Day-to-day drinking patterns as a moderator of intervention efficacy

Drug Alcohol Depend. 2017 Jun 1;175:119-126. doi: 10.1016/j.drugalcdep.2017.01.040. Epub 2017 Mar 31.

Abstract

Objective: to test if people with different day-to-day drinking patterns benefitted differently from two brief alcohol interventions (BAIs).

Methods: A total of 1243 job-seekers with at-risk alcohol use aged 18-64 years (64% men) were randomized to (a) intervention tailored to the motivational stage (ST), (b) non-stage tailored intervention (NST), or (c) assessment only (AO). ST and NST contained individualized computer-generated feedback letters. Follow-ups were conducted at months 3, 6, and 15. Using growth mixture models, day-to-day drinking patterns were identified based on the number of drinks consumed on each day in the week prior to baseline assessment. To test drinking pattern-specific intervention effects, zero-inflated growth models were used. Outcomes were (1) the 15-month change in the likelihood of any alcohol use and (2) the 15-month change in the total number of drinks per week when alcohol was consumed.

Results: Four day-to-day drinking patterns were found: daily medium use (2-4 drinks/day; 47%), daily low use (1-2 drinks/day; 29%), weekend only use (18%), and no use (6%). Only persons with daily low use benefitted from intervention, with higher odds of being abstinent after 15 months in the ST group compared to AO (odds ratio, OR=1.67, p=0.001) and NST group (OR=1.43, p=0.035). ST worked better among persons with daily low use compared to daily medium use (OR=1.91, p=0.001).

Conclusions: Among at-risk drinking persons with regular low-quantity alcohol use, stage tailored BAIs may be superior over no BAI and non-stage tailored BAIs.

Keywords: Alcohol; Brief intervention; Computerized intervention; Drinking patterns; Growth mixture modeling; Stage tailored intervention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / therapy*
  • Alcoholism / therapy*
  • Behavior Therapy / methods*
  • Counseling / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Treatment Outcome
  • Young Adult