Table 9Summary of effectiveness and strength of evidence of behavioral interventions compared with controls for improving intermediate outcomes, by population

PopulationConsumptiona (Mean Drinks/Week)Heavy Drinking EpisodesbRecommended Drinking Limits
AdultsReduction of 3.6 (2.4 to 4.8) from baseline ~23
Moderate SOE
12% fewer subjects reported heavy drinking episodes (7%, 16%) from ~52% at baseline
Moderate SOE
11% more subjects achieved (8%, 13%)
Moderate SOE
Older adultsReduction of 1.7 (0.6 to 2.8) from baseline ~16
Moderate SOE
Insufficient SOE9% more subjects achieved (2%, 16%)
Low SOE
Young adults or college studentsReduction of 1.7 (0.7 to 2.6) from baseline ~15
Moderate SOEc
0.9 fewer heavy drinking days (0.3, 1.5) from ~6.2 days per month at baseline
Moderate SOEc
Insufficient SOE
Pregnant womenData from 1 study found no difference
Low SOE
Insufficient SOEInsufficient SOE
AdolescentsInsufficient SOEInsufficient SOEInsufficient SOE

SOE = strength of evidence

a

Baseline consumption (drinks/week): adults, mean ~23, median ~19, range 8 – 62 (data from 16 trials); older adults, 15.2 to 16.6 (data from two trials); young adults/college students, mean ~15, median ~17, range 8 to 18 (two of the five trials did not report baseline consumption).

b

Heavy drinking generally defined by consumption of five or more standard drinks for men and four or more for women. Baseline % with heavy drinking episodes: adults, mean ~52, range 10 – 100.

c

These data are 6-month outcomes; for consumption for young adults, we were unable to calculate pooled point estimate for 12-month data, but range of reduction was 1.2 to 4.1 drinks per week at 12 months (moderate SOE); for heavy drinking for young adults, differences were not statistically significant at 12 months (low SOE).

Notes: Data presented are effect size (95% CI) for all interventions regardless of intensity of counseling; the effect sizes for brief multicontact interventions were generally greater than those shown; all outcomes are 12 months unless otherwise indicated with a footnote; all percentages reported are absolute risk differences (difference between intervention and control groups) from our meta-analyses.

Intensity of intervention: Brief multicontact interventions have the best evidence of effectiveness. Our meta-analyses of studies in adults found (1) very brief (up to 5 minutes) single-contact interventions to be ineffective for improving consumption (data from one very-brief-intervention study83) and less effective than brief multicontact interventions for achieving recommended drinking limits (data from one very-brief-intervention study84); and (2) brief single-contact interventions to be ineffective for reducing heavy drinking episodes and less effective than brief multicontact interventions for reducing consumption and achieving recommended drinking limits.

Baseline consumption (drinks/week): adults, mean ~23, median ~19, range 8 – 62 (data from 16 trials); older adults, 15.2 to 16.6 (data from two trials); young adults/college students, mean ~15, median ~17, range 8 to 18 (two of the five trials did not report baseline consumption).

Heavy drinking generally defined by consumption of five or more standard drinks for men and four or more for women. Baseline % with heavy drinking episodes: adults, mean ~52, range 10 – 100.

These data are 6-month outcomes; for consumption for young adults, we were unable to calculate pooled point estimate for 12-month data, but range of reduction was 1.2 to 4.1 drinks per week at 12 months (moderate SOE); for heavy drinking for young adults, differences were not statistically significant at 12 months (low SOE).

From: Results

Cover of Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse
Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse [Internet].
Comparative Effectiveness Reviews, No. 64.
Jonas DE, Garbutt JC, Brown JM, et al.

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