Effect of motivational interviewing on reduction of alcohol use.
BACKGROUND
Methadone-maintained (MM) clients who engage in excessive alcohol use are at high risk for HIV and hepatitis B virus (HBV) infection. Nurse-led hepatitis health promotion (HHP) may be one strategy to decrease alcohol use in this population.


OBJECTIVE
To evaluate the impact of nurse-led HHP, delivered by nurses compared to motivational interviewing (MI), delivered by trained therapists in group sessions or one-on-one on reduction of alcohol use.


METHODS
A three-arm randomized, controlled trial, conducted with 256 MM adults attending one of five MM outpatient clinics in the Los Angeles area. Within each site, moderate-to-heavy alcohol-using MM participants were randomized into one of three conditions: (1) nurse-led hepatitis health promotion group sessions (n=87); (2) MI delivered in group sessions (MI-group; n=79), or (3) MI delivered one-on-one sessions (MI-single, n=90).


RESULTS
Self-reported alcohol use was reduced from a median of 90 drinks/month at baseline to 60 drinks/month at 6-month follow-up. A Wilcoxon sign-rank test indicated a significant reduction in alcohol use in the total sample (p<.05). In multiple logistic regression analysis controlling for alcohol consumption at baseline and other covariates, no differences by condition were found.


CONCLUSIONS
As compared to two programs delivered by MI specialists, a culturally-sensitive and easy to implement nurse-led HHP program produced similar reductions in alcohol use over 6 months. Employing nurse-led programs may allow cost savings for treatment programs as well as a greater integration of alcohol reduction counseling along with a more comprehensive focus on general health-related issues than previously conducted.
Nyamathi
Adeline
A
School of Nursing, University of California-Los Angeles, Los Angeles, CA 90095-1702, USA. anyamath@sonnet.ucla.edu
Shoptaw
Steven
S
Cohen
Allan
A
Greengold
Barbara
B
Nyamathi
Kamala
K
Marfisee
Mary
M
de Castro
Viviane
V
Khalilifard
Farinaz
F
George
Daniel
D
Leake
Barbara
B
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006505:Hepatitis / Q000517:prevention & control; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009042:Motivation; D024802:Nurse's Role; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
D008691:Methadone