title: The efficacy of a brief intervention in reducing hazardous drinking in working age men in Russia: the HIM (Health for Izhevsk men) individually randomised parallel group exploratory trial.
abstract: BACKGROUND
  Russia has particularly low life expectancy for an industrialised country, with mortality at working ages having fluctuated dramatically over the past few decades, particularly among men. Alcohol has been identified as the most likely cause of these temporal variations. One approach to reducing the alcohol problem in Russia is 'brief interventions' which seek to change views of the personal acceptability of excessive drinking and to encourage self-directed behaviour change. Very few studies to evaluate the efficacy of brief interventions in Russia have been conducted. Motivational Interviewing (MI) is a person-centred counselling style which can be adapted to brief interventions in which help is offered in thinking through behaviour in the context of values and goals, to decide whether change is needed, and if so, how it may best be achieved.
  
  
  METHODS
  This paper reports on an individually randomised two-armed parallel group exploratory trial. The primary hypothesis is that a brief adaptation of MI will be effective in reducing self-reported hazardous and harmful drinking at 3 months. Participants were drawn from the Izhevsk Family Study II, with eligibility determined based on proxy reports of hazardous and harmful drinking in the past year. All participants underwent a health check, with MI subsequently delivered to those in the intervention arm. Signed consent was obtained from those in the intervention arm only at this point. Both groups were then invited for 3 and 12 month follow ups. The control group did not receive any additional intervention.
  
  
  RESULTS
  441 men were randomised. Of these 61 did not have a health check leaving 190 in each trial arm. Follow up at 3 months was high (97% of those having a health check), and very similar in the two trial arms (183 in the intervention and 187 in the control). No significant differences were detected between the randomised groups in either the primary or the secondary outcomes at three months in the intention to treat analyses. The unadjusted odds ratio (95% CI) for the effect of MI on hazardous and harmful drinking was 0.77 (0.51, 1.16). An adjusted odds ratio of 0.52 (0.28, 0.94) was obtained in the pre-specified per protocol analysis.
  
  
  CONCLUSIONS
  This trial demonstrates that it is possible to engage Russian men who drink hazardously in a brief intervention aimed at reducing alcohol related harm. However the results with respect to the efficacy are equivocal and further, larger-scale trials are warranted.
  
  
  BACKGROUND
  ISRCTN: ISRCTN82405938.
authors: Medical Statistics Department, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. elizabeth.allen@lshtm.ac.uk
authors: Elizabeth
authors: E
authors: Allen
authors: Olga
authors: O
authors: Polikina
authors: Lyudmila
authors: L
authors: Saburova
authors: Jim
authors: J
authors: McCambridge
authors: Diana
authors: D
authors: Elbourne
authors: Sergey
authors: S
authors: Pakriev
authors: Nadezhda
authors: N
authors: Nekrasova
authors: Maxim
authors: M
authors: Vasilyev
authors: Keith
authors: K
authors: Tomlin
authors: Alexey
authors: A
authors: Oralov
authors: Artyom
authors: A
authors: Gil
authors: Martin
authors: M
authors: McKee
authors: Nikolay
authors: N
authors: Kiryanov
authors: David A
authors: DA
authors: Leon
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care; D012426:Russia