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Cited by 58Substance Abuse Treatment and OutcomesMobile Health and mHealth ApplicationsDigital Mental Health Interventions

A Randomized Clinical Trial of Mobile Phone Motivational Interviewing for Alcohol Use Problems in Kenya

Open access
Harder, Valerie S., Musau, Abednego M., Musyimi, Christine W., Ndetei, David M., Mutiso, Victoria N.·2020·Addiction
DOI 10.1111/add.14903PMC PMC8353663
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Abstract

Aim: To test the effectiveness of a motivational interviewing (MI) intervention using the mobile phone among adults with alcohol use problems. Design: A randomized clinical trial of mobile MI and standard in‐person MI with 1‐ and 6‐month follow‐up, including a 1‐month waitlist control followed by mobile MI. Setting: A primary health center in rural Kenya. Participants: Three hundred adults screening positive for alcohol use problems were randomized and received immediate mobile MI (n = 89), in‐person MI (n = 65) or delayed mobile MI (n = 76) for waiting‐list controls 1 month after no treatment, with 70 unable to be reached for intervention. Intervention and comparator: One MI session was provided either immediately by mobile phone, in‐person at the health center or delayed by 1 month and then provided by mobile phone. Measurements: Alcohol use problems were repeatedly assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the shorter AUDIT‐C. The primary outcome was difference in alcohol score 1 month after no intervention for waiting‐list control versus 1 month after MI for mobile MI. The secondary outcomes were difference in alcohol score for in‐person MI versus mobile MI one and 6 months after MI. Findings: For our primary outcome, average AUDIT‐C scores were nearly three points higher (difference = 2.88, 95% confidence interval = 2.11, 3.66) for waiting‐list controls after 1 month of no intervention versus mobile MI 1 month after intervention. Results for secondary outcomes supported the null hypothesis of no difference between in‐person and mobile MI at 1 month (Bayes factor = 0.22), but were inconclusive at 6 months (Bayes factor = 0.41). Conclusion: Mobile phone‐based motivational interviewing may be an effective treatment for alcohol use problems among adults visiting primary care in Kenya. Providing mobile motivational interviewing may help clinicians in rural areas to reach patients needing treatment for alcohol use problems.

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Crossref · 10.1111/add.14903

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  • In an MI study in Kenya involving 300 adults with problematic alcohol use, mobile MI showed a significant improvement in AUDIT scores, with a difference of 2.88 points compared to waiting-list controls at 1 month.

    “Results showed a significant improvement with mobile MI, with a difference of 2.88 points compared to waiting-list controls.”

    From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [119]

    The Results (Impact of the Intervention; page unavailable) report significantly lower scores with mobile MI than with waitlist control at one month, and the Findings give the difference as 2.88 points. The Participants section confirms 300 adults with alcohol-use problems. The 2.88-point difference was measured on the shorter AUDIT-C, however, not the full AUDIT as the claim states. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In one study, the intervention was delivered either face to face or by mobile phone.

    “In one study, the intervention was delivered either face to face or by mobile phone [54].”

    From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [54]

  • Interventions in the exploratory search utilized varied strategies including cognitive behavioral therapy, problem solving therapy, motivational interviewing, and advice.

    “interventions utilized varied strategies including cognitive behavioral therapy [32], problem solving therapy [33]MI [25], and advice [34] either offered alone or in combination.”

    From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [25]

  • Single-session brief interventions resulted in reduced alcohol use at month 1.

    “Concerning alcohol use, single session BI resulted in reduced use at month 1 [50,54]; 6 weeks [72], 3 months [50,61–64], and 6 months [50,52,60,72].”

    From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [54]

  • In that study, secondary outcomes indicated no significant difference between in-person and mobile MI at 1 month, while results at 6 months were inconclusive.

    “Secondary outcomes indicated no significant difference between in-person and mobile MI at 1 month, while results at 6 months were inconclusive”

    From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [119]

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Research works printed but not linked: 10

  1. [26]Bennett G Motivational Interviewing - Preparing People to Change Addictive Behavior - Miller,Wr, Rollnick,S. J Community Appl Soc. 1992; 2(4): 299– 300.
  2. [28]Rollnick S, Miller WR, Butler C. Motivational interviewing in health care: helping patients change behavior. New York: Guilford Press; 2008. xiv, 210 p. p.
  3. [30]Markland D, Ryan RM, Tobin VJ, Rollnick S. Motivational interviewing and selfdetermination theory. J Soc Clin Psychol. 2005; 24(6): 811– 31.
  4. [39]Thevos AK, Quick RE, Yanduli V. Motivational Interviewing enhances the adoption of water disinfection practices in Zambia. Health Promot Int. 2000; 15(3): 207– 14.
  5. [45]Gisore P, Kaseje D, Were F, Ayuku D. Motivational Interviewing Intervention on Health-Seeking Behaviors of Pregnant Women in Western Kenya. J Appl Biobehav Res. 2014; 19(2): 144– 56.
  6. [46]Beckerleg S Counselling Kenyan heroin users: cross‐cultural motivation? Health Education. 2001; 101(2): 69– 73.
  7. [63]Marsch LA, Dallery J. Advances in the psychosocial treatment of addiction: the role of technology in the delivery of evidence-based psychosocial treatment. Psychiatr Clin North Am. 2012; 35(2): 481– 93. 22640767 PMC3362794
  8. [70]Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Arch Intern Med. 1998; 158(16): 17– 95. 9738608
  9. [71]Bradley KA, Bush KR, Epler AJ, Dobie DJ, Davis TM, Sporleder JL, Two brief alcohol-screening tests from the Alcohol Use Disorders Identification Test (AUDIT): Validation in a Female Veterans Affairs Patient Population. Arch Intern Med. 2003; 163(7): 821– 9. 12695273
  10. [83]Madhombiro M, Dube-Marimbe B, Dube M, Chibanda D, Zunza M, Rusakaniko S, A cluster randomised controlled trial protocol of an adapted intervention for alcohol use disorders in people living with HIV and AIDS: impact on alcohol use, general functional ability, quality of life and adherence to HAART. BMC Psychiatry. 2017; 17(1): 44. 28129756 PMC5273845

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Authors
Harder, V. S., Musau, A. M., Musyimi, C. W., Ndetei, D. M., & Mutiso, V. N.
Affiliations
  • University of Vermont (US)
  • Africa Mental Health Foundation (KE)
  • University of Nairobi (KE)
Corresponding author
Harder, Valerie S.
ORCID
Venue
Addiction
Publisher
Wiley
Published
2020-01-03
Volume
115
Issue
6
Pages
1050-1060
ISSN
  • 0965-2140 (ISSN-L)
  • 1360-0443
DOI
10.1111/add.14903
PMC
PMC8353663
OpenAlex
W2990832301
Cited by
58
References
66
Citations by year
2026: 3 · 2025: 11 · 2024: 6 · 2023: 19 · 2022: 12 · 2021: 4 · 2020: 3
FWCI
3.62
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Addiction (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (R21TW009786)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
motivational interviewing, mobile phone intervention, alcohol use problems, alcoholism, primary care, rural health care, AUDIT-C, brief intervention, Kenya
MeSH terms
Adult, Alcohol Drinking, Bayes Theorem, Female, Humans, Kenya, Male, Middle Aged, Primary Health Care, Treatment Outcome, Alcohol-Related Disorders, Cell Phone, Motivational Interviewing

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