Search

Background: There is limited evidence of the efficacy of smartphone applications to reduce unhealthy alcohol use. We tested the efficacy of providing access to a smartphone-based brief intervention for unhealthy alcohol use.Methods: We conducted a two parallel-group randomized controlled trial with follow-up at 6 months, among 977 individuals with an Alcohol Use Disorder Identification Test ≥8 and drinking 15 or more drinks/week. Participants were randomized to receive (or not) access to a smartphone application consisting of personalized feedback, risk assessment and self-monitoring. The primary outcome was the mean number of drinks/week. An intention to treat analysis (ITT) and a per protocol analysis (PP) were conducted.Results: Mean age of participants was 34.2(9.8), 46% were female. The baseline mean number of drinks per week was 28.9(16.7). Results differed by type of analysis: ITT: all 977 participants were included in the analysis. Follow-up rate was 70.7% (n = 691). There was no significant intervention effect: the Incidence Rate Ratio (IRR) (95%CI) for number of drinks per week was 0.93(0.84; 1.03). PP: 702 participants were included in the analysis. Follow-up rate was 78.1% (n = 548). There was a significant intervention effect: the IRR for number of drinks per week was 0.88(0.78; 0.99).Conclusions: Providing access to a smartphone-based brief intervention had no impact on drinking at 6 months and does not appear to be an effective intervention in reducing drinking. Those who downloaded the app appear to benefit from it, nevertheless downloads were limited and further development of similar apps should focus on increasing use. [ABSTRACT FROM AUTHOR]

Background: Drug use is an established risk factor for HIV. Brief Interventions (BIs) targeting reductions in both drug use and HIV risk behaviors may help curtail these related epidemics. The present study evaluates the impact of BIs for drug use and HIV risk reduction on sexual HIV risk behaviors among a primarily marijuana-using sample during a 12-month post-intervention follow-up period.Methods: We conducted a randomized controlled trial of 780 adult patients in an Emergency Department (ED) with past 3-month drug use (primarily non-injecting). This study used a 3 × 2 factorial design (3 ED-based conditions: computer-delivered brief intervention [Computer BI], therapist-delivered, computer-guided BI [Therapist BI], or enhanced usual care (EUC-ED) for drug-using adults; 2 follow-up conditions at 3 months: booster or control). This analysis examines the outcomes of the BIs on sexual HIV risk behaviors at 3-, 6-, and 12-months.Results: Compared to the enhanced usual care control, the combined Therapist BI with booster resulted in significant reductions in scores on the sexual risk subscale of the HIV Risk Taking Behaviour Scale over 12-months, when controlling for baseline sexual risk, gender, and drug dependency status. The baseline interventions alone, booster alone, and Computer BI plus booster did not differ from the comparison group (EUC plus control).Conclusions: A therapist-delivered BI for drug use and HIV risk behaviors, combined with a follow-up therapist-delivered booster, shows promise for reducing sexual HIV risk behaviors among a primarily marijuana using, non-injecting sample. [ABSTRACT FROM AUTHOR]

Background: QUIT is the only primary care-based brief intervention that has previously shown efficacy for reducing risky drug use in the United States (Gelberg et al., 2015). This pilot study replicated the QUIT protocol in one of the five original QUIT clinics primarily serving Latinos.Design: Single-blind, two-arm, randomized controlled trial of patients enrolled from March-October 2013 with 3-month follow-up.Setting: Primary care waiting room of a federally qualified health center (FQHC) in East Los Angeles.Participants: Adult patients with risky drug use (4-26 on the computerized WHO ASSIST): 65 patients (32 intervention, 33 control); 51 (78%) completed follow-up; mean age 30.8 years; 59% male; 94% Latino.Interventions and Measures: Intervention patients received: 1) brief (typically 3-4 minutes) clinician advice to quit/reduce their risky drug use, 2) video doctor message reinforcing the clinician's advice, 3) health education booklet, and 4) up to two 20-30 minute follow-up telephone drug use reduction coaching sessions. Control patients received usual care and cancer screening information. Primary outcome was reduction in number of days of drug use in past 30days of the highest scoring drug (HSD) on the baseline ASSIST, from baseline to 3-month follow-up.Results: Controls reported unchanged HSD use between baseline and 3-month follow-up whereas Intervention patients reported reducing their use by 40% (p<0.001). In an intent-to-treat linear regression analysis, intervention patients reduced past month HSD use by 4.5 more days than controls (p<0.042, 95% CI: 0.2, 8.7). Similar significant results were found using a complete sample regression analysis: 5.2 days (p<0.03, 95% CI: 0.5, 9.9). Additionally, on logistic regression analysis of test results from 47 urine samples at follow-up, intervention patients were less likely than controls to test HSD positive (p<0.05; OR: 0.10, 95% CI: 0.01, 0.99).Conclusions: Findings support the efficacy of the QUIT brief intervention for reducing risky drug use. [ABSTRACT FROM AUTHOR]