Evaluation of a self-help program to reduce alcohol consumption among pregnant women. Brief intervention for alcohol use in pregnancy: a randomized trial. Findings of a pilot study of motivational interviewing with pregnant drinkers. A randomized controlled trial of a brief intervention after alcohol-related facial injury. Brief intervention for alcohol use by pregnant women. Maritally distressed women with alcohol problems: the impact of a short-term alcohol-focused intervention on drinking behaviour and marital satisfaction. A brief alcohol intervention for hazardously drinking incarcerated women. The effect of brief interventions on alcohol consumption among heavy drinkers in a general hospital setting. Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. A pilot study comparing motivational interviewing and an educational intervention in patients with schizophrenia and alcohol use disorders. Brief intervention in a primary care setting for hazardous drinkers.
This study tested a cognitive-behavioral intervention for reducing alcohol consumption among economically disadvantaged pregnant women. The intervention included a 10-minute educational session and a nine-step self-help manual. Women attending public health maternity clinics completed a screening questionnaire, a pretest questionnaire, were randomly assigned to receive the self-help intervention or usual clinic care, and completed a posttest questionnaire. A higher alcohol quit rate was observed among the intervention participants (88%) than controls (69%). The effect was strongest for "light" drinkers, African-Americans, and non-Protestants. This approach may be useful in clinics where staff time is limited. To assess the impact of a brief intervention on antepartum alcohol consumption.
                A randomized clinical trial.
                The obstetrics practices of the Brigham and Women's Hospital in Boston, MA, USA.
                Two hundred and fifty eligible women initiating prenatal care.
                A comprehensive assessment of alcohol use (assessment only, AO) or the same comprehensive assessment with a brief intervention (BI).
                Demographic background and obstetric history of subjects, current and lifetime use of alcohol and substances, composite Addiction Severity Index scores, and antepartum alcohol use.
                Of the 250, 247 (99%) subjects provided information on their antepartum drinking. Both the AO and BI groups had reductions in antepartum alcohol consumption, but differences in reductions by group were not statistically significant (p > 0.05). Risk of antepartum drinking after either the AO or BI was increased nearly threefold if the subject had any prenatal alcohol consumption before assessment (p = 0.0001). For the 143 subjects who were abstinent pre-assessment, however, those who received the BI maintained higher rates of abstinence (86% versus 72%, p = 0.04).
                After a comprehensive assessment of alcohol use, subjects in both the AO and BI groups reduced their antepartum alcohol consumption. The importance of screening for prenatal alcohol use is underscored by the findings that any prenatal alcohol consumption increases the risk of continued antepartum drinking. Cost-effective interventions are needed for counseling pregnant drinkers, in order to reduce risk of fetal alcohol effects.
                42 pregnant women who reported alcohol consumption participated in this pilot study of motivational interviewing. Following a comprehensive alcohol use assessment, the participants were randomly assigned to receive either written information about the risks related to drinking during pregnancy or a one-hour motivational interview. The motivational interview was an empathic, client-centered, but directive session focusing on the health of the participants' unborn babies.
                At the end of a 2-month follow-up period, the 34 women (81%) who remained in the study showed a significant reduction in alcohol consumption and peak intoxication levels. Women who had reported the highest blood alcohol concentration (BAC) levels during early pregnancy showed a significantly greater reduction in their estimated BACs at follow-up (during later pregnancy) if assigned to the treatment rather than the control condition.
                Motivational interviewing shows promise as a specific intervention for initiating a reduction in drinking among pregnant women who are at greatest risk. Simpler assessment and advice may suffice for women with lower initial consumption levels. To evaluate the effectiveness of a brief motivational intervention on alcohol consumption and misuse in young males with alcohol-related face injury.
                Randomized controlled trial.
                Oral and maxillofacial surgery out-patient clinic in an urban teaching hospital.
                One hundred and fifty-one participants were randomized to motivational intervention and control conditions.
                Control was treatment as usual. The intervention was treatment as usual plus a one-session brief motivational intervention administered by a nurse.
                Three sets of measurements were taken at baseline, 3-month and 1-year follow-up. Collateral measurements were also taken at 1-year follow-up. Primary outcome measures were total alcohol consumption, typical weeks consumption and days abstinent in preceding 3 months. Other outcome measures included the Alcohol Use Disorders Identification Test, a short form of the Alcohol Problems Questionnaire, and a measure of satisfaction with social relationships.
                There was a significant decrease in 84-day total alcohol consumption across the year (P < 0.006) and further, a significant effect for the motivational intervention was demonstrated (P < 0.029). This pattern was repeated for days abstinent and alcohol consumption in a typical week as well as alcohol-related problems. There was a significantly greater reduction in the percentage of hazardous drinkers in the motivational intervention group (from 60% to 27%, P < 0.009) compared to the control group (from 54% to 51%, NS).
                A proportion of young men change their alcohol consumption following alcohol-related injury. A nurse-led psychological intervention adds significantly to the proportion and magnitude of response. We examined the efficacy of brief intervention as a technique to help pregnant women achieve abstinence from alcohol. A second aim was to assess newborn outcomes as a function of brief intervention.
                Two hundred fifty-five pregnant women who were participants in the Public Health Foundation Enterprises Management Solutions Special Supplemental Nutrition Program for Women, Infants, and Children and who reported drinking alcohol were assigned to an assessment-only or a brief intervention condition and followed to their third trimester of pregnancy. Brief intervention consisted of 10- to 15-minute sessions of counseling by a nutritionist, who used a scripted manual to guide the intervention. Newborn outcomes of gestation, birth-weight, birth length, and viability were assessed.
                Women in the brief intervention condition were 5 times more likely to report abstinence after intervention compared with women in the assessment-only condition. Newborns whose mothers received brief intervention had higher birthweights and birth lengths, and fetal mortality rates were 3 times lower (0.9%) compared with newborns in the assessment-only (2.9%) condition.
                The success of brief intervention conducted in a community setting by nonmedical professionals has significant implications for national public health policies. To evaluate the efficacy of a short-term alcohol-focused intervention for maritally distressed women, and to explore changes in relationship functioning.
                Participants were assigned randomly to an alcohol-focused treatment or to a waiting-list control group. The waiting-list control group began the intervention at 1-month follow-up.
                The intervention took place at a research and training centre offering outpatient psychology services to the community.
                A sample of 32 women with alcohol and marital problems were recruited through the media. Participants reported protracted alcohol problems, moderate to severe impact of alcohol on social and occupational functioning, and moderate to severe marital distress.
                Measures of average alcohol consumption, marital distress, relational efficacy and depression were administered at pre- and post-therapy, and at 1, 6 and 12-month follow-up.
                The intervention involved six 1-hour sessions, consisting of clinical assessment, motivational interviewing, cognitive-behavioural strategies and relapse prevention.
                At 1-month follow-up, the intervention was associated with statistically significant improvements in alcohol consumption, marital satisfaction, relational efficacy and depression, and these effects were sustained at 12-month follow-up.
                At 1-month follow-up the intervention was associated with decreased alcohol consumption and depression, and increased marital satisfaction and relational efficacy, with evidence of maintained effects at 12-month follow-up. However, it is unlikely that reduced problem drinking and improved confidence in resolving problems were the only factors producing low marital quality in these couples. Further research is needed to identify those individuals who might benefit from marital interventions. To test the hypothesis that among hazardously drinking incarcerated women who are returning to the community, a brief alcohol intervention will result in less alcohol use at follow-up relative to standard of care.
                Eligible participants endorsed hazardous alcohol consumption-four or more drinks at a time on at least 3 separate days in the previous 3 months or a score of 8 or above on the Alcohol Use Disorders Identification Test. Participants were randomized to either an assessment-only condition or to two brief motivationally focused sessions, the first delivered during incarceration, the second 1 month later after community re-entry. Participants recalled drinking behaviors at 3 and 6 months after the baseline interview using a 90-day time-line follow-back method.
                The 245 female participants averaged 34 years of age, and were 71% Caucasian. The mean percentage of alcohol use days in the 3 months prior to incarceration was 51.7% and heavy alcohol use days was 43.9%. Intervention effects on abstinent days were statistically significant at 3 months (odds ratio = 1.96, 95% confidence interval 1.17, 3.30); the percentage of days abstinent was 68% for those randomized to intervention and 57% for controls. At 6 months the effect of the intervention was attenuated and no longer statistically significant.
                Among incarcerated women who reported hazardous drinking, a two-session brief alcohol intervention increased abstinent days at 3 months, but this effect decayed by 6 months. Study participants continued to drink heavily after return to the community. More intensive intervention pre-release and after re-entry may benefit hazardously drinking incarcerated women. (i) To evaluate the effect of receiving one of two brief interventions in reducing alcohol consumption among general hospital patients compared with usual care. (ii) To assess whether a brief intervention of self-efficacy enhancement was superior to a self-help booklet in reducing alcohol consumption.
                A three-arm cluster randomized controlled trial.
                Seven general medical, six general surgical, one dermatology and two otolaryngology wards of a large teaching hospital covering a large urban and rural area.
                A total of 215 of 789 in-patients aged 18-75 years, who screened positive for alcohol consumption in excess of national recommended limits according to a 7-day retrospective drinking diary.
                Participants were allocated to receive one of three interventions: (i) face-to-face self-efficacy enhancement; (ii) a self-help booklet; or (iii) usual care.
                The primary outcome measure was change in reported alcohol consumption at 6-month follow-up as measured by a 7-day retrospective drinking diary. Secondary outcomes were change in: number of alcohol drinking days in last week; the maximum units of alcohol consumed on any one day in last week; and Drinking Refusal Self-efficacy Expectancy Questionnaire score.
                Compared to the usual care group the self-efficacy enhancement group (-10.1 units 95% CI -16.1 to -4.1) and the self-help booklet group (-10.0 units 95% CI -16.0 to -3.9) had greater reductions in self-reported weekly alcohol consumption. There was no evidence that self-efficacy enhancement was superior to the self-help booklet (P = 0.96).
                Brief interventions delivered in hospital offer simple means of helping heavy drinkers to reduce their alcohol consumption. To determine effectiveness of advice from general practitioners to heavy drinkers to reduce their excessive alcohol consumption (35 U or more a week for men, 21 U or more for women).
                Randomised, controlled double blind trial over 12 months with interim assessment at six months.
                Group practices (n = 47; list size averaging 10,000) recruited from Medical Research Council's general practice research framework, mostly in rural or small urban settings.
                Patients recruited after questionnaire survey. Of total of 2571 (61.2%) of 4203 patients invited for interview who attended, 909 (35.4%) stated that in past seven days they had drunk above the limits set for study and had not received advice; they were randomised to control and treatment groups.
                Patients in treatment group were interviewed by general practitioner (who had had a training session) and received advice and information about how to reduce consumption and also given a drinking diary.
                Study aimed at detecting a reduction in proportion of men with excessive alcohol consumption of 30% in treatment group and 20% in control group (for women 40% and 20%, respectively) with a power of 90% at 5% level of significance. In addition, corroborative measures such as estimation of gamma-glutamyltransferase activity were included.
                At one year a mean reduction in consumption of alcohol of 18.2 (SE 1.5) U/week had occurred in treated men compared with a reduction of 8.1 (1.6) U/week in controls (p less than 0.001). The proportion of men with excessive consumption at interview had dropped by 43.7% in the treatment group compared with 25.5% in controls (p less than 0.001). A mean reduction in weekly consumption of 11.5 (1.6) U occurred in treated women compared with 6.3 (2.0) U in controls (p less than 0.05), with proportionate reductions of excessive drinkers in treatment and control groups of 47.7% and 29.2% respectively. Reduction in consumption increased significantly with number of general practitioner interventions. At one year the mean value for gamma-glutamyltransferase activity had dropped significantly more in treated men (-2.4 (0.9)IU/l) than in controls (+1.1(1.0)IU/l; t = 2.7, p less than 0.01). Reduction in gamma-glutamyltransferase activity tended to increase with number of intervention sessions in men. Changes in gamma-glutamyltransferase activity in women and changes in other indicators in both sexes did not differ significantly between treatment and control groups.
                If the results of this study were applied to the United Kingdom intervention by general practitioners could each year reduce to moderate levels the alcohol consumption of some 250000 men and 67500 women who currently drink to excess. General practitioners and other members of the primary health care team should therefore be encouraged to include counselling about alcohol consumption in their preventive activities. Thirty subjects with comorbid schizophrenia and alcohol use disorders were randomly assigned to receive either a Motivational Interviewing (MI) or Educational Treatment (ET) intervention with treatment goals of abstinence and/or decreased alcohol use. Subjects were followed up at 4, 8 and 24-weeks upon completion of the interventions. Outcome measures included number of drinking days, abstinence rates, average blood alcohol concentration and standard ethanol content per drinking day. Subjects randomized to the MI intervention had a significant reduction in drinking days and an increase in abstinence rates when compared to subjects receiving ET. Motivational Interviewing may be a useful treatment intervention for individuals with schizophrenia and alcoholism. The study was designed to test a brief intervention for reducing alcohol consumption among moderate to heavy (hazardous) drinkers in a busy HMO primary care setting.
                In a randomized controlled trial, hazardous drinkers (n = 516) were identified by the AUDIT screening questionnaire. Intervention included brief clinician advice (30 seconds), a 15-minute motivational session by counselors, and printed materials.
                At six-month follow-up, intervention subjects reported fewer total standard drinks in the past three months (176 versus 216, P = .04, one-tailed) and fewer drinking days per week (2.8 versus 3.3, P = .02) than controls, but similar drinks per drinking day (3.3 versus 3.5; P = .13). At 12 months, intervention subjects again reported fewer drinking days per week (2.7 versus 3.1; P = .04) than controls, but similar numbers of standard drinks (157 versus 179; P = .13) and drinks per drinking day (3.6 versus 3.3; P = .20). Intervention subjects were somewhat more likely than controls to report drinking within daily recommended limits (< or = 3 for men, < or = 2 for women) at both six months (79% versus 71%; P = .06) and 12 months (80% versus 73%; P = .07), but did not differ significantly from controls on other drinking outcomes (percent abstinent, frequency of drinking > or = 6 drinks per drinking occasion, estimated peak blood alcohol concentration), or use of medical care in the year following intervention.
                A one-time, brief motivational intervention using minimal clinician time supplemented by trained counselors resulted in a modest reduction in frequency of alcohol consumption in a busy primary care population. Future research should focus on strengthening and maintaining intervention effects.
The evidence from the limited number of studies suggests that psychological and educational interventions may result in increased abstinence from alcohol, and a reduction in alcohol consumption among pregnant women. However, results were not consistent, and the paucity of studies, the number of total participants, the high risk of bias of some of the studies, and the complexity of interventions limits our ability to determine the type of intervention which would be most effective in increasing abstinence from, or reducing the consumption of, alcohol among pregnant women.