Plenary Session 4

New insights into the potentials of brief alcohol interventions in and beyond health care

Per Nilsen, Department of Medical and Health Science at Linkoping University, Sweden

Chair: J. McNeely

Abstract: Brief alcohol interventions (BAI) are expected to help detract the burden of disease attributable to alcohol. Despite good evidence that BAI can reduce alcohol use in at-risk drinking health care patients, the implementation of evidence-based approaches into health care is lacking. May evidence not have been convincing enough? For example, evidence on BAI efficacy concerning health, and on long-term efficacy is still scarce. Have the dimensions of public health impact been sufficiently considered? For example, BAI often fail to reach the majority of the target population and particularly those most in need. Barriers on the providers’ side such as high workload and lacks of financial resources and self-efficacy may hinder adoption, implementation and maintenance in routine care. Web-based approaches using psycho-social robots are expected to relieve staff and provide a cost-effective alternative. However, we know little about whether electronic interventions may actually be as effective as trained counselors or physician advice in improving health and well-being. And if so, are there subgroups of people that may benefit more from one or the other way of delivery? The randomized controlled trial “Testing delivery channels of individualized motivationally tailored alcohol interventions among general hospital inpatients: in-person versus computer-based (PECO)” conducted as part of the Research Collaboration Early Substance Use Intervention in Germany intended to investigate these issues. PECO included 961 proactively recruited hospital patients with at-risk alcohol use identified through systematic, electronic screening. Participants were allocated to three study groups: in-person intervention, computer-generated written feedback and assessment only. Alcohol and health outcomes were assessed after 6, 12, 18 and 24 months. Problem severity, motivation and socio-demographics were investigated as moderators of differential efficacy. I intend to present and discuss the overall picture of what we have learned so far from PECO and other related trials testing proactive BAI in and beyond health care.

Jennis Freyer-Adam is a psychologist and researcher dedicated to the development of interventions that can help people change unhealthy behaviors and improve their health. She is passionate about supporting medical students and staff in practicing patient-centered communi­cation skills including Motivational Interviewing. Jennis is Adjunct Professor for Medical Psychology at the University Medicine Greifswald, and scientist at the German Center for Cardiovascular Research. She has received funding from the German Research Foundation, the German Cancer Aid and the German Federal Ministry for Education and Research. Jennis is the principle investigator of various randomized controlled trials on the efficacy of brief interventions delivered either in-person or through computer-generated feedback.  She has authored more than 90 original papers and book chapters. Jennis is Editor for Sucht, the German Scientific Journal on Addiction, and member of the Motivational Interviewing Network of Trainers. In 2016, she was awarded the INEBRIA 2016 Best Abstract Award; and in 2015, the ICTAB 2015 New Investigator Award.