title: Factors associated with alcohol reduction in harmful and hazardous drinkers following alcohol brief intervention in Scotland: a qualitative enquiry.
abstract: Alcohol Brief Intervention (ABI) uses a motivational counselling approach to support individuals to reduce excessive alcohol consumption. There is growing evidence on ABI's use within various health care settings, although how they work and which components enhance success is largely unknown. This paper reports on the qualitative part of a mixed methods study. It explores enablers and barriers associated with alcohol reduction following an ABI. It focuses on alcohol's place within participants' lives and their personal perspectives on reducing consumption. There are a number of randomised controlled trials in this field though few ABI studies have addressed the experiences of hazardous/harmful drinkers. This study examines factors associated with alcohol reduction in harmful/hazardous drinkers following ABI.
  
  
  
  This qualitative study was underpinned by a realist evaluation approach and involved semi-structured interviews with ten harmful or hazardous alcohol drinkers. Participants (n = 10) were from the intervention arm of a randomised controlled trial (n = 124). All had received ABI, a 20 min motivational counselling interview, six months previously, and had reduced their alcohol consumption. Interviews were recorded, transcribed verbatim and thematically analysed.
  
  
  
  Participants described their views on alcohol, its' place in their lives, their personal perspectives on reducing their consumption and future aspirations.
  
  
  
  The findings provide an insight into participants' views on alcohol, ABI, and the barriers and enablers to change. Participants described a cost benefit analysis, with some conscious consideration of the advantages and disadvantages of reducing intake or abstaining from alcohol. Findings suggest that, whilst hospital admission can act as a catalyst, encouraging individuals to reflect on their alcohol consumption through ABI may consolidate this, turning this reflective moment into action. Sustainability may be enhanced by the presence of a 'significant other' who encourages and experiences benefit. In addition having a purpose or structure with activities linked to employment and/or social and leisure pursuits offers the potential to enhance and sustain reduced alcohol consumption.
  
  
  
  Trial registration number TRN NCT00982306 September 22nd 2009.
authors.affiliation: Institute of Health and Wellbeing, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. jean.mcqueen@glasgow.ac.uk.
authors.forename: Jean M
authors.initials: JM
authors.lastname: McQueen
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Ballinger
authors.affiliation: School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Howe
mesh_terms: D000328:Adult; D000368:Aged; D064829:Alcohol Abstinence / Q000523:psychology; D000428:Alcohol Drinking / Q000191:economics / Q000517:prevention & control* / Q000523:psychology; D000437:Alcoholism / Q000191:economics / Q000517:prevention & control* / Q000523:psychology; D001294:Attitude to Health; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D036301:Qualitative Research; D012008:Recurrence; D012606:Scotland; D055815:Young Adult
keywords: Alcohol; Behaviour change; Brief intervention; General Hospital; Mixed methods; Motivational counselling; Realist synthesis