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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA009153-09
Application #
6509191
Study Section
Health Services Research Review Subcommittee (AA)
Project Start
1993-03-01
Project End
2004-05-31
Budget Start
2002-06-01
Budget End
2004-05-31
Support Year
9
Fiscal Year
2002
Total Cost
$292,001
Indirect Cost
Name
University of Massachusetts Medical School Worcester
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
660735098
City
Worcester
State
MA
Country
United States
Zip Code
01655
Ockene, Judith K; Reed, George W; Reiff-Hekking, Sarah (2009) Brief patient-centered clinician-delivered counseling for high-risk drinking: 4-year results. Ann Behav Med 37:335-42
Reiff-Hekking, Sarah; Ockene, Judith K; Hurley, Thomas G et al. (2005) Brief physician and nurse practitioner-delivered counseling for high-risk drinking. Results at 12-month follow-up. J Gen Intern Med 20:7-13
Rosal, M C; Ockene, J K; Hurley, T G et al. (2000) Prevalence and co-occurrence of health risk behaviors among high-risk drinkers in a primary care population. Prev Med 31:140-7
Ockene, J K; Adams, A; Hurley, T G et al. (1999) Brief physician- and nurse practitioner-delivered counseling for high-risk drinkers: does it work? Arch Intern Med 159:2198-205
Adams, A; Ockene, J K; Wheller, E V et al. (1998) Alcohol counseling: physicians will do it. J Gen Intern Med 13:692-8
Ockene, J K; Wheeler, E V; Adams, A et al. (1997) Provider training for patient-centered alcohol counseling in a primary care setting. Arch Intern Med 157:2334-41