Motivational interviewing with hazardous drinkers
Abstract
PURPOSES: To test the effectiveness of motivational interviewing in a population of hazardous drinkers utilizing community health care centers in rural southeastern Idaho. DATA SOURCES: This study targeted rural people at risk for alcohol dependence utilizing low-income community health care centers in rural southeastern Idaho. The Alcohol Use Disorders Identification Test (AUDIT) was used to screen interested clients' alcohol use. Clients achieving an AUDIT score indicating hazardous alcohol use were recruited into the study and randomized into a control or treatment group. Twenty-six hazardous drinkers attending five low-income community health centers participated in the study. The experimental group participated in one motivational interviewing session with the investigator, a family nurse practitioner (NP). The comparison group received no treatment. Alcohol use was tracked for 6 weeks after successful recruitment into the program. CONCLUSIONS: Participants in the study significantly decreased their average number of drinks per day. At time 1 (pretreatment), the control group drank 4.37 drinks per day and the treatment group drank 4.65 drinks per day. At time 2 (posttest), the control group drank 3.77 drinks per day and the treatment group drank 1.95 drinks per day. The effects of the motivational interviewing treatment on hazardous drinking also were measured by serum gamma-glutamyltransferase (GGT), a liver function test. There was also a significant decrease in the GGT from pretest to posttest in the treatment group. IMPLICATIONS FOR PRACTICE: The results of this investigation found that motivational interviewing shows promise as an effective intervention for hazardous drinkers attending low-income community clinics. Although other possible explanations could be postulated for the positive changes in sample participants, the data indicate that the motivational interviewing approach was responsible for a significant portion of the positive changes within the current sample. The information collected from the study adds to the literature on hazardous drinking, research, and treatment of this significant problem. Negotiating change in behavior is part of the practice of NPs. People struggling with alcohol use are more likely to encounter NPs, family doctors, or social workers than counselors specializing in alcohol treatment. Motivational interviewing is specifically designed for preparing people for change. Because most people resist being told what to do, that is, "you have to stop drinking," use of motivational interviewing principles can decrease resistance and optimize change. Additionally, identifying and intervening with hazardous drinking in a primary care setting can reduce healthcare costs and reduce the stigma of specialist care. Adding this valuable communication skill to the competencies of NPs is important to both clients and NPs.
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Efficacy/effectiveness scores ranged from 4.5 to 12.
“Efficacy/effectiveness scores ranged from 4.5 (Beckham 2007;Fleming 2004;Romelsjö 1989) to 12 (Lock 2006).”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Seven studies compared brief intervention to no or minimal intervention and reported gamma-glutamyltransferase (GGT).
“We included seven studies that compared brief intervention to no or minimal intervention and reported gamma-glutamyltransferase (GGT) (Aalto 2000;Beckham 2007;Noknoy 2010;Romelsjö 1989;Scott 1990;Tomson 1998;Wallace 1988).”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
22 studies could not be included in meta-analyses, either because outcomes were not reported at 12 months, or outcome measures differed from those prespecified for this review (such as AUDIT score).
“We could not include 22 studies in metaanalyses (Aalto 2000;Bazargan-Hejazi 2005;Beckham 2007;Crawford 2010;D'Amico 2008;Dent 2008;Désy 2010;Díez 2002;Drummond 2009;Heather 1987;Kunz 2004;L'Engle 2014;Lane 2008;McDevitt-Murphy 2014;Mello 2008;Mertens 2014;Noknoy 2010;Rodríguez 2003;Segatto 2011;Sommers 2006;Tait 2004;Woolard 2013), either because outcomes were not reported at 12 months, or outcome”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
In five studies, losses to follow-up were not reported according to study arm.
“Losses to follow-up were not reported according to study arm in five studies (Beckham 2007;Helstrom 2014;Israel 1996;Longabaugh 2001;McIntosh 1997).”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 had high risk of bias for blinding of treatment providers.
“Blinding of treatment providers High risk Not blinded; no reported attempt to reduce bias.”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 did not use intention-to-treat analysis.
“ITT: no.”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 had unclear risk of bias for allocation concealment.
“Allocation concealment (selection bias) Unclear risk Allocation concealment not described.”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 had low risk of bias for selective reporting.
“Selective reporting (reporting bias) Low risk Outcomes specified in methods were reported in results.”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 had unclear risk of bias for blinding of outcome assessment.
“Blinding of outcome assessment (detection bias) All outcomes Unclear risk Blinding of outcome assessor not described.”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 had high risk of bias for blinding of participants.
“Blinding of participants High risk No reported attempt to blind participants.”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 had unclear risk of bias for incomplete outcome data.
“Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up not reported.”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
Beckham 2007 had low risk of bias for random sequence generation.
“Random sequence generation (selection bias) Low risk”
From Effectiveness of brief alcohol interventions in primary care populations (2018) · cites this paper as Beckham 2007
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Effectiveness of brief alcohol interventions in primary care populations
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Motivational interviewing for substance use reduction
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- Authors
- Beckham, N.
- Affiliations
- Gonzaga University (US)
- Corresponding author
- Beckham, Nancy
- Venue
- Journal of the American Academy of Nurse Practitioners
- Publisher
- Wiley
- Published
- 2007-02
- Volume
- 19
- Issue
- 2
- Pages
- 103-110
- ISSN
- 1041-2972 (ISSN-L)
- 1745-7599
- OpenAlex
- W2088585832
- Cited by
- 44
- References
- 69
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 3 · 2014: 2 · 2013: 3 · 2012: 3
- FWCI
- 2.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Nurse Practitioners (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- motivational interviewing, hazardous drinking, alcohol consumption reduction, family nurse practitioners, rural population, alcohol dependence risk, gamma-glutamyl transferase, alcohol screening, primary care intervention
- MeSH terms
- Alcohol Drinking, Alcoholism, Community Health Centers, Female, Humans, Idaho, Interview, Psychological, Male, Motivation, Nurse Practitioners, Nurse-Patient Relations, Rural Health, Nurse's Role, Risk Reduction Behavior
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