Mentored Research on Improving Alcohol Brief Interventions in Medical Settings

The NIAAA estimates that 16% (40 million) of adults in the US are drinking at unsafe levels,
placing them at risk for a variety of physical, mental health, and social consequences. More
than 50% of alcohol health consequences occur in risky, non-dependent drinkers. Increasing
the efficacy and efficiency of brief interventions in medical setting could significantly
reduce the public health impacts of risky drinking. Despite overall positive findings for
brief interventions, there are high levels of variability in effects, with meta-analyses
reporting significant unexplained heterogeneity in outcomes that is likely accounted for by
differences in intervention components and strategies. There is intense interest in
conducting motivational interviewing (MI) informed brief interventions for risky alcohol use
in medical settings, but little empirical information is available regarding which MI
behavioral and interpersonal style components drive effectiveness.

Following promising efficacy trials from counseling applications, MI was translated into
brief (5-15 minute) interactions and subjected to randomized controlled trial methodology.
Lack of mixed-methods, Stage 1 treatment development is evidenced by our inability to provide
consistent delineation of key intervention components and mechanisms of action. Variability
in these factors is likely responsible for the wide variability in effects observed in
meta-analyses of brief interventions. Many MI skills and behaviors require significant
training and supervision and increased patient-provider interaction time. The field would
benefit greatly from empirically-based Stage 1 treatment development and modeling studies to
delineate the degree to which adding motivational interviewing components to brief
intervention improves outcome.

Inclusion Criteria: patient in University of New Mexico Family and Community Medicine
Clinic (e.g. Family Practice, Southeast Height, Northeast Height, University Clinic, South
Valley), positive NIAAA single question screen (>0), AUDIT-C score <7, >18 years old,
ability to read and speak English, and willing to be contacted for follow-up.

Exclusion Criteria: active suicidality, incarceration, obvious cognitive impairment, unable
to provide informed consent, current involvement in an alcohol research study or people who
are specifically seeking help for alcohol problems, and pregnancy or intent to become
pregnant.