Alcohol abuse and dependence is a major public health problem, with substantial human and health care costs. Although alcohol dependence describes the most severely affected person, the majority of health care costs related to alcohol can be attributed to the high-risk and problem drinker. The proposed study, Project Health-II, requests funds to take advantage of the opportunity to continue to follow at 48, 60 and 72 months post-randomization an intact co-hort (n-527; Project Health-I) of high risk and problem drinkers identified in a primary care setting.
The specific aims of the study include evaluating the long term effects of the original brief (1-2 contacts over six months), provider delivered, patient-centered special intervention (SI) on the drinking behavior of high risk and problem drinkers, and to continue to describe the natural history of high-risk and problem drinkers in the usual care (UC) comparison condition. The original intervention was effective and significantly reduced (p<.01) drinking in SI participants at six month follow-up. There was a decrement in the difference at 12 months (p<.11). The SI was also effective at significantly (p<.001) increasing the proportion of participants drinking at safe levels at 6 months as compared to the UC. There was decrement in the difference at 12 months (p<.05). Project Health-II proposes to reinstate an expanded repetitive brief intervention over two years, initially implemented by primary care providers and sustained by health counselor via telephone counseling, to evaluate the moderate and long term effects of repeated minimal interventions on high risk drinkers. Outcome of the expanded intervention will be assessed at 1 and 2 years post reinstatement of the intervention. The cost effectiveness of this intervention also will be evaluated. If funded, the proposed study will be the longest follow-up study (72 months) of the natural history of high-risk and problem drinkers in the primary care population.
