A Randomized Clinical Trial of Computer Delivered Personal Feedback for Hazardous Drinkers in Primary Care

Problem drinking has been identified as a major public health concern. Early identification and intervention are of primary importance in order to address the morbidity, mortality, and the economic costs associated with problem drinking. Based on a growing body of literature, influential national and international organizations have endorsed the implementation of brief alcohol interventions (BAIs) in primary care (PC) to address this problem. However, the dissemination of BAIs into PC has been slow, and researchers have begun to investigate key mechanisms of BAIs. One component with compelling research evidence is personalized feedback (PF). Increasingly, computer delivered PF is gathering momentum as a cost-effective, autonomous strategy, but investigations with adult patients in the setting of PC are lacking. The purpose of the following preliminary study was to develop and test the efficacy of computer delivered PF for hazardous drinkers in PC. Additionally, theoretical mechanisms of change associated with PF immediately following the intervention were examined as potential predictors of drinking outcomes. Forty-three veterans identified as hazardous drinkers (95.3% male, 65.1% Caucasian) in PC completed an alcohol assessment and then were randomized to either receive brief advice (BA) or BA and computer delivered PF. Results revealed no significant treatment effect for any of the drinking outcomes at 3-months follow-up for the entire sample. However, a significant treatment effect was found for male veterans for weekly binge drinking episodes. Furthermore, signficant changes in perceived drinking norms and normative discrepancy were found for the entire sample and for men only at post-session. Additionally, male veterans also evidenced significant changes in motivation to change immediately following the intervention. However, changes in perceived drinking norms and motivation to change did not predict binge drinking for male veterans three months after receiving the brief intervention. The results of this preliminary study with veterans in PC suggest that computer delivered PF may be efficacious in reducing weekly binge drinking episodes for male hazardous drinkers. In addition, results provide preliminary support for the immediate impact of PF on some of the theoretical mechanisms of change underlying brief motivational interventions