Health Behavior Change for Hospitalized Veterans
Study Details
Study Description
Brief Summary
Veterans drink, binge drink, and drive under the influence of alcohol at higher rates than non-Veterans do. Addressing alcohol misuse, the range of alcohol consumption from risky drinking to alcohol abuse and alcoholism, is a national priority for the VA. It is recommended that people keep their alcohol consumption below limits established by the National Institutes of Health (NIH). A type of 10-15 minute counseling known as "brief intervention" (BI) has been shown to help risky drinkers cut back to the NIH-recommended limits. This study will examine the impact of a nurse-delivered alcohol BI on hospitalized Veterans' weekly number of drinks, monthly number of binge drinking episodes, readiness to change drinking behavior, and alcohol-related problems. This preventative approach for reducing alcohol consumption is intended to help Veterans avoid many of the physical and psychosocial consequences of alcohol misuse.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Improving the identification and management of alcohol misuse is a VA priority. Alcohol misuse includes the spectrum of alcohol consumption ranging from hazardous drinking to alcohol use disorders (alcohol abuse and dependence). The VA recommends using a set of clinical strategies referred to as Screening, Brief Intervention, and Referral to Treatment (SBIRT) to identify and address alcohol misuse in primary care settings. Brief intervention (BI), a core component of SBIRT, significantly reduces alcohol consumption, morbidity, and healthcare utilization in hazardous drinkers, but its efficacy is not well-established outside of outpatient settings. In the hospital setting, nurses are well-positioned to deliver BI, but research is needed to determine the efficacy of inpatient nurse-delivered BI, particularly with hazardous drinkers. The few previous trials of BI in the inpatient setting demonstrated limited effects on alcohol consumption and alcohol-related problems, potentially due to assessment reactivity--extensive patient assessment that inadvertently raises patient awareness about drinking in both groups, mimicking the effect of BI and thus driving findings towards the null. Additionally, very few of these trials involved nurse delivery of the intervention and many included patients with alcohol use disorders, patients believed to be beyond the "therapeutic reach" of BI.
The primary goal of this 3-arm randomized controlled trial is to examine the efficacy of nurse-delivered alcohol BI with hospitalized patients who are hazardous drinkers and to identify barriers and facilitators to implementation of BI in inpatient settings. Arm 1 (BI) consists of Veterans randomized to nurse-delivered BI, Arm 2 (AC) consists of Veterans randomized to an attention control, and Arm 3 (AC-LA) consists of Veterans randomized to an attention control with limited assessment of readiness to change and adverse consequences of alcohol use so as to reduce and evaluate assessment reactivity.
Specific Aim 1 is to determine the impact of a nurse-led BI on the alcohol screening status, number of drinks/week, number of binge drinking episodes, readiness to change drinking behavior, and adverse consequences of alcohol use in hospitalized hazardous drinkers. Specific Aim 2 is to formatively evaluate the process of the intervention implementation to inform the design and execution of a future, multi-site randomized effectiveness trial of the intervention. A secondary aim is to identify factors, issues, and themes related to Veterans' interest and motivation for changing their alcohol consumption.
We will recruit 320 hospitalized Veterans admitted to one of the three medical-surgical units at the VA Pittsburgh Healthcare System. Veterans will be included who are >21 years old, able to speak English, and are hazardous, non-dependent drinkers, as defined by criteria established by the National Institute for Alcohol Abuse and Alcoholism and by the Composite International Diagnostic Interview Substance Abuse Module. Patients randomized to Arm 1 will receive a three-part nurse-delivered BI. Patients randomized to Arms 2 and 3 will receive usual care plus healthy lifestyle brochures addressing general healthy lifestyle behaviors, such as limited alcohol consumption, tobacco cessation, and weight management. For Specific Aim 1, we will use various multivariable linear and logistic regressions that account for continuous outcomes, dichotomous outcomes, and clustering within medical units. Poisson regressions or negative binomial regressions will be used if the continuous outcome measures are not normally distributed. For Specific Aim 2, we will use basic descriptive statistics in order to describe the numbers of deviations and interruptions to intervention delivery as planned. Based on interventionist field notes, we will categorize the types of deviations/interruptions. We will also use these descriptive statistics to describe duration of the audio-recorded intervention; the presence/absence of various techniques within the BI; the receipt/nonreceipt of additional alcohol feedback, advice, or counseling; and patient responsiveness to/perceptions of the BI. We will also code brief free-text perceptions responses using a modified grounded theory approach.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Brief Alcohol Intervention (BI) The 3-part Brief Intervention (BI) consists of . Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. |
Behavioral: Brief Alcohol Intervention
3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I.
|
| Active Comparator: Attention Control These subjects receive a set of Lifestyle brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity. Two weeks later, the Research Assistant calls subjects in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. This intervention is designed to provide all the information and assessments that that Brief Intervention participants as well as all the alcohol consumption and motivation to change measures-- it is designed to control for the attention that the BI participants receive w/o the motivational interventions |
Other: Lifestyle brochures
Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have.
|
| Active Comparator: Control These subjects receive a set of Lifestyle brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. Subjects complete only drinking quantity measures at baseline and 6 months post baseline. The inclusion of this group tests whether completing more extensive questionnaires (in comparison the Attention Control group) decreases alcohol consumption. |
Other: Lifestyle brochures
Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have.
|
Outcome Measures
Primary Outcome Measures
- Number of Standard Drinks Per Week [6 months]
Number of Drinks per Week was determined by the product of responses to the following two NIAAA questions during the recruitment and screening processes : (1) On average, how many days a week do you have an alcoholic drink?; (2) On a typical drinking day, how many standard-sized drinks do you have? (Appendix 2). "Standard-sized drink" will refer to 12 ounces beer, 5 ounces wine, or 1.5 ounces liquor/spirits.
Secondary Outcome Measures
- Alcohol Screening Status [6 months]
Alcohol Screening Status will be assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) (Appendix 2), the 3-item short form of the 10-item Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization. AUDIT-C data will be collected during the recruitment and screening processes. AUDIT-C scores range from 0-12, with higher values representing a worse outcome (a score of 4 indicating hazardous drinking in males and 3 hazardous drinking in females).Generally, the higher the AUDIT-C score, the more likely it is that the patient's drinking is affecting his/her health and safety.
- Number of Binge Drinking Episodes Over Past 30 Days [6 months]
Number of Binge Drinking Episodes will be assessed through a third NIAAA question during the recruitment and screening processes: (3) How many times in the past 30 days have you had 5 or more standard-sized drinks in a day (men), or 4 or more standard-sized drinks in a day? (women)
- Readiness to Change Drinking Behavior [6 months]
We will assess readiness to change with the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), Version 8.This instrument was created by one of the initial developers of Motivational Interviewing, the therapeutic style on which SBIRT is based. SOCRATES is a 19-item instrument with 3 subscales where minimum score is 19 and the maximum score is 95. Lower totals representing lesser readiness/eagerness for change and higher totals representing greater readiness/eagerness to change. With the three sub scales (Recognition, Ambivalence, and Taking Steps), higher scores indicate greater recognition, ambivalence and taking steps and scores range from 7 to 35, 4 to 20, and 8 to 40, respectively.
- Adverse Consequences of Alcohol Use [6 months]
We will assess adverse consequences of alcohol use with the Short Inventory of Problems (SIP-2R), a widely used 15-item stand-alone short version of the Drinker Inventory of Consequences (DrInC).The SIP-2R will be administered at baseline (for BI and Attention Control) and at 6 months post-hospital discharge (all groups) to assesses adverse consequences of alcohol use over the past three months in five areas: Interpersonal, Physical, Social, Impulsive, and Intrapersonal. The SIP-2R was used as a continuous measure with possible scores from 0-45, where each item has a score from 0-3 (0=Never, 1=once or a few times, 2=once or twice a week, 3=daily or almost daily). Higher scores indicate a worse outcome.
Other Outcome Measures
- Number of Participants Who Were Interested and Motivated to Change Their Alcohol Consumption [Baseline]
Among Veterans randomized to Arm 1, we will analyze the transcripts of Part I of the audio-recorded brief intervention. Descriptive statistics (e.g., frequency distributions, measures of central tendency) will be used to characterize the anonymous sociodemographic, educational, and patient care characteristics of the participants. Transcript data will be analyzed using the grounded theory technique of constant comparison. Similar or related codes will be collapsed into focused codes in order to represent interrelationships, variations, and underlying patterns in the data, allowing for the identification of factors, issues, and themes related to Veterans interest and motivation for changing their alcohol consumption.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
U.S. Veterans admitted to one of the three medical-surgical units at VA Pittsburgh Healthcare System (VAPHS)
-
age 21 years or older
-
ability to speak English
-
hazardous, non-dependent alcohol consumption
Exclusion Criteria:
-
Alcohol dependence (as determined using Section C (Alcohol) from the Composite International Diagnostic Interview Substance Abuse Module (CIDI-SAM)
-
Current participation (past 6 months) in substance abuse treatment or 12-step program
-
age <21 years
-
significant cognitive impairment (as determined by the Short Blessed test , score >10)
-
bipolar disorder or active psychosis
-
sensory impairment precluding communication
-
medically-related inability to participate or consent to study participation
-
current pregnancy
-
current incarceration
-
lack of telephone access or unwillingness to be contacted for follow-up
-
enrollment in the study during a prior inpatient admission at VAPHS
-
current enrollment in other substance use trials (due to the potential influence of dual participation on study outcomes)
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA | Pittsburgh | Pennsylvania | United States | 15240 |
Sponsors and Collaborators
- VA Office of Research and Development
Investigators
- Principal Investigator: Lauren M. Broyles, PhD RN, VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
None provided.- NRI 11-339
Study Results
Participant Flow
| Recruitment Details | Recruitment occurred December 2012 to June 2014 on three medical-surgical units at the VA Pittsburgh Healthcare System. |
|---|---|
| Pre-assignment Detail | Not applicable; no enrolled participants were excluded from the trial prior to randomization. |
| Arm/Group Title | Brief Alcohol Intervention (BI) | Attention Control | Control |
|---|---|---|---|
| Arm/Group Description | Brief Intervention Condition--3 part motivational discussion in and out of hospital Brief Alcohol Intervention: 3 part intervention: Part I was a 15-minute multi-component motivational discussion in hospital which included personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II was a 15-minute follow-up in hospital to reinforce Part I. Part III was 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Traditional Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contained information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant called patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) had. | Attention Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contained information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant called patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) had. |
| Period Title: Overall Study | |||
| STARTED | 37 | 23 | 22 |
| COMPLETED | 32 | 17 | 22 |
| NOT COMPLETED | 5 | 6 | 0 |
Baseline Characteristics
| Arm/Group Title | Brief Alcohol Intervention (BI) | Attention Control | Control | Total |
|---|---|---|---|---|
| Arm/Group Description | Brief Intervention Condition--3 part motivational discussion in and out of hospital Brief Alcohol Intervention: 3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Traditional Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. | Attention Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. | Total of all reporting groups |
| Overall Participants | 37 | 23 | 22 | 82 |
| Age (years) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [years] |
57.3
(13.16)
|
62.70
(9.10)
|
58.68
(11.02)
|
59.18
(11.67)
|
| Sex: Female, Male (Count of Participants) | ||||
| Female |
2
5.4%
|
0
0%
|
0
0%
|
2
2.4%
|
| Male |
35
94.6%
|
23
100%
|
22
100%
|
80
97.6%
|
| Race/Ethnicity, Customized (Count of Participants) | ||||
| White |
31
83.8%
|
19
82.6%
|
19
86.4%
|
69
84.1%
|
| Black |
6
16.2%
|
4
17.4%
|
3
13.6%
|
13
15.9%
|
| Alcohol Use Disorders Identification Test-Consumption (units on a scale) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [units on a scale] |
6.11
(2.47)
|
7.43
(2.25)
|
6.36
(1.97)
|
6.54
(2.33)
|
| Weekly number of drinks (count of drinks per week) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [count of drinks per week] |
17.36
(16.53)
|
20.78
(14.76)
|
18.04
(11.81)
|
18.52
(14.77)
|
| Number of Binge Episodes/Week (count of binge episodes per week) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [count of binge episodes per week] |
4.22
(7.31)
|
7.61
(9.90)
|
5.36
(8.68)
|
5.48
(8.48)
|
| Socrates Score (units on a scale) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [units on a scale] |
21.86
(8.43)
|
16.52
(10.48)
|
19.82
(4.72)
|
|
| SIP-2R Score (units on a scale) [Mean (Standard Deviation) ] | ||||
| Mean (Standard Deviation) [units on a scale] |
4.43
(5.19)
|
5.17
(9.24)
|
4.72
(6.96)
|
|
Outcome Measures
| Title | Number of Standard Drinks Per Week |
|---|---|
| Description | Number of Drinks per Week was determined by the product of responses to the following two NIAAA questions during the recruitment and screening processes : (1) On average, how many days a week do you have an alcoholic drink?; (2) On a typical drinking day, how many standard-sized drinks do you have? (Appendix 2). "Standard-sized drink" will refer to 12 ounces beer, 5 ounces wine, or 1.5 ounces liquor/spirits. |
| Time Frame | 6 months |
Outcome Measure Data
| Analysis Population Description |
|---|
| Reflects number of participant that completed the 6 month interview |
| Arm/Group Title | Brief Intervention | Attention Control | Control |
|---|---|---|---|
| Arm/Group Description | 3-part Brief Intervention Brief Alcohol Intervention: 3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Traditional Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. | Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. |
| Measure Participants | 32 | 17 | 22 |
| Mean (Standard Deviation) [days/week drink * amt of drinks in day] |
11.19
(14.39)
|
13.12
(10.93)
|
14.00
(4.05)
|
| Title | Alcohol Screening Status |
|---|---|
| Description | Alcohol Screening Status will be assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) (Appendix 2), the 3-item short form of the 10-item Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization. AUDIT-C data will be collected during the recruitment and screening processes. AUDIT-C scores range from 0-12, with higher values representing a worse outcome (a score of 4 indicating hazardous drinking in males and 3 hazardous drinking in females).Generally, the higher the AUDIT-C score, the more likely it is that the patient's drinking is affecting his/her health and safety. |
| Time Frame | 6 months |
Outcome Measure Data
| Analysis Population Description |
|---|
| Only participants that completed the 6 month interview |
| Arm/Group Title | Brief Intervention | Attention Control | Control |
|---|---|---|---|
| Arm/Group Description | 3-part Brief Intervention Brief Alcohol Intervention: 3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Traditional Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. | Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. |
| Measure Participants | 32 | 17 | 22 |
| Mean (Standard Deviation) [units on a scale] |
5.09
(3.03)
|
5.41
(2.98)
|
5.27
(2.35)
|
Statistical Analysis 1
| Statistical Analysis Overview | Comparison Group Selection | Brief Intervention, Attention Control, Control |
|---|---|---|
| Comments | Measures were compared with linear mixed effects regression models to compare impact of BI compared to usual care conditions. Analyses reported here included only those that completed the 6 month interview (71/82 baseline participants). | |
| Type of Statistical Test | Equivalence | |
| Comments | Results of the regression models were used to reject null hypotheses of equivalence with p-values of comparisons across groups in changes in alcohol related measures using p-values < 0.05 as significant. | |
| Statistical Test of Hypothesis | p-Value | .05 |
| Comments | First, significance of the regression model was viewed. When the overall model was significant, tests of the co-efficients were viewed. Primary effects of interest were the treatment group X time interactions. | |
| Method | Mixed Models Analysis | |
| Comments | ||
| Title | Number of Binge Drinking Episodes Over Past 30 Days |
|---|---|
| Description | Number of Binge Drinking Episodes will be assessed through a third NIAAA question during the recruitment and screening processes: (3) How many times in the past 30 days have you had 5 or more standard-sized drinks in a day (men), or 4 or more standard-sized drinks in a day? (women) |
| Time Frame | 6 months |
Outcome Measure Data
| Analysis Population Description |
|---|
| Participants the completed the 6 month interviews |
| Arm/Group Title | Brief Intervention | Attention Control | Control |
|---|---|---|---|
| Arm/Group Description | 3-part Brief Intervention Brief Alcohol Intervention: 3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. | Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. |
| Measure Participants | 32 | 17 | 22 |
| Mean (Standard Deviation) [binge drinking episodes] |
2.25
(4.72)
|
4.65
(7.72)
|
4.14
(8.29)
|
| Title | Readiness to Change Drinking Behavior |
|---|---|
| Description | We will assess readiness to change with the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), Version 8.This instrument was created by one of the initial developers of Motivational Interviewing, the therapeutic style on which SBIRT is based. SOCRATES is a 19-item instrument with 3 subscales where minimum score is 19 and the maximum score is 95. Lower totals representing lesser readiness/eagerness for change and higher totals representing greater readiness/eagerness to change. With the three sub scales (Recognition, Ambivalence, and Taking Steps), higher scores indicate greater recognition, ambivalence and taking steps and scores range from 7 to 35, 4 to 20, and 8 to 40, respectively. |
| Time Frame | 6 months |
Outcome Measure Data
| Analysis Population Description |
|---|
| Individuals that completed the 6 month interview |
| Arm/Group Title | Brief Alcohol Intervention (BI) | Attention Control | Control |
|---|---|---|---|
| Arm/Group Description | 3-part Brief Intervention Brief Alcohol Intervention: 3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Traditional Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. | Attention Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. |
| Measure Participants | 32 | 17 | 22 |
| Mean (Standard Deviation) [units on a scale] |
23.16
(9.09)
|
17.88
(8.48)
|
17.00
(6.52)
|
| Title | Adverse Consequences of Alcohol Use |
|---|---|
| Description | We will assess adverse consequences of alcohol use with the Short Inventory of Problems (SIP-2R), a widely used 15-item stand-alone short version of the Drinker Inventory of Consequences (DrInC).The SIP-2R will be administered at baseline (for BI and Attention Control) and at 6 months post-hospital discharge (all groups) to assesses adverse consequences of alcohol use over the past three months in five areas: Interpersonal, Physical, Social, Impulsive, and Intrapersonal. The SIP-2R was used as a continuous measure with possible scores from 0-45, where each item has a score from 0-3 (0=Never, 1=once or a few times, 2=once or twice a week, 3=daily or almost daily). Higher scores indicate a worse outcome. |
| Time Frame | 6 months |
Outcome Measure Data
| Analysis Population Description |
|---|
| Participants the completed the 6 month interview |
| Arm/Group Title | Brief Alcohol Intervention (BI) | Attention Control | Control |
|---|---|---|---|
| Arm/Group Description | 3-part Brief Intervention Brief Alcohol Intervention: 3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Traditional Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. | Attention Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. |
| Measure Participants | 32 | 17 | 22 |
| Mean (Standard Deviation) [units on a scale] |
5.09
(3.03)
|
5.41
(2.98)
|
5.27
(2.35)
|
| Title | Number of Participants Who Were Interested and Motivated to Change Their Alcohol Consumption |
|---|---|
| Description | Among Veterans randomized to Arm 1, we will analyze the transcripts of Part I of the audio-recorded brief intervention. Descriptive statistics (e.g., frequency distributions, measures of central tendency) will be used to characterize the anonymous sociodemographic, educational, and patient care characteristics of the participants. Transcript data will be analyzed using the grounded theory technique of constant comparison. Similar or related codes will be collapsed into focused codes in order to represent interrelationships, variations, and underlying patterns in the data, allowing for the identification of factors, issues, and themes related to Veterans interest and motivation for changing their alcohol consumption. |
| Time Frame | Baseline |
Outcome Measure Data
| Analysis Population Description |
|---|
| Data were not collected from the Attention Control and Control Groups |
| Arm/Group Title | Brief Intervention | Attention Control | Control |
|---|---|---|---|
| Arm/Group Description | 3-part Brief Intervention. Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. Brief Alcohol Intervention: 3 part intervention: Part I is 15-minute multi-component motivational discussion in hospital which includes personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II is 15-minute follow-up in hospital to reinforce Part I. Part III is 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Participants in this arm will complete all the screening and outcome measures that the Brief Intervention participants complete but will not receive any of the Brief Intervention treatments. They will receive a set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. | Participants in this arm will complete only drinking quantity measures at baseline and 6 months post baseline. They will receive a set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. Lifestyle brochures: Set of educational brochures/brochures which contain information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant will call patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) may have. |
| Measure Participants | 37 | 0 | 0 |
| Count of Participants [Participants] |
37
100%
|
Adverse Events
| Time Frame | 6 months | |||||
|---|---|---|---|---|---|---|
| Adverse Event Reporting Description | ||||||
| Arm/Group Title | Brief Alcohol Intervention (BI) | Attention Control | Control | |||
| Arm/Group Description | Brief Intervention Condition--3 part motivational discussion in and out of hospital Brief Alcohol Intervention: 3 part intervention: Part I was a 15-minute multi-component motivational discussion in hospital which included personalized risk feedback, advice to abstain or reduce consumption, and the negotiation of an individual change plan. Part II was a 15-minute follow-up in hospital to reinforce Part I. Part III was 15-minute follow-up telephone call at 2 weeks to reinforce Part I. | Traditional Attention Control Condition Lifestyle brochures: Set of educational brochures/brochures which contained information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant called patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) had. | Attention Control, Limited Assessment Lifestyle brochures: Set of educational brochures/brochures which contained information and tips for healthy lifestyle behaviors such as alcohol and tobacco use, weight management, and physical activity to discuss with the Research Assistant. Approximately two weeks later, the Research Assistant called patients in this condition at home for a 5-15 minute session to review the brochures and discuss any questions that s(he) had. | |||
All Cause Mortality |
||||||
| Brief Alcohol Intervention (BI) | Attention Control | Control | ||||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 1/37 (2.7%) | 3/23 (13%) | 0/22 (0%) | |||
Serious Adverse Events |
||||||
| Brief Alcohol Intervention (BI) | Attention Control | Control | ||||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 0/37 (0%) | 0/23 (0%) | 0/22 (0%) | |||
Other (Not Including Serious) Adverse Events |
||||||
| Brief Alcohol Intervention (BI) | Attention Control | Control | ||||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 5/37 (13.5%) | 0/23 (0%) | 0/22 (0%) | |||
| General disorders | ||||||
| Participant entered palliative care | 1/37 (2.7%) | 0/23 (0%) | 0/22 (0%) | |||
| Investigations | ||||||
| Unable to administer part B of intervention | 3/37 (8.1%) | 0/23 (0%) | 0/22 (0%) | |||
| Psychiatric disorders | ||||||
| Participant became alcohol dependent | 1/37 (2.7%) | 0/23 (0%) | 0/22 (0%) | |||
Limitations/Caveats
More Information
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
| Name/Title | Lauren M. Broyles, PhD, RN |
|---|---|
| Organization | VA Pittsburgh Healthcare System |
| Phone | 412-360-2269 |
| Lauren.Broyles@va.gov |
- NRI 11-339