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Effectiveness of a Brief Group Intervention for Harmful Alcohol Use in Men at a Primary Health Care Facility in Brazil: A Randomized Clinical Trial

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Abstract

To evaluate the effectiveness of a brief group intervention (BGI) in reducing the use of alcohol and increasing the readiness to change in men with risky and harmful alcohol use. A randomized clinical trial with follow-ups at 30 and 90 days that was conducted in a primary health care (PHC) facility in the central region of São Paulo (Brazil). A total of 112 men were randomized to the experimental group (EG) (n = 55) or the control group (CG) (n = 57). To identify the pattern of alcohol use and the readiness to change, the Alcohol Use Disorders Identification Test (AUDIT) and the readiness to change (RTC) rule were used. The EG received a BGI session applied by nurses using the Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy (FRAMES) model. The CG was instructed to continue with the standard service of the unit after an initial interview. Intergroup analyses using the generalized equation estimation (GEE) method were performed. A significant difference in the pattern of use was observed between the EG and CG at follow-up evaluated (EG T1 (7.73 ± 5.14), CG T1 (12, 48 ± 5.62)) and EG T2 (6.65 ± 4.83), CG T2 (11.68 ± 6.65)). When compared the baseline (T0) measures (13.04) with the last time (T2) (6.65) at EG, it was identified a reduction of 6.39 in the AUDIT score. Differences between groups were found for readiness to change at follow-up ((EG T1 (8.50 ± 2.44) and CG T1 (5.67 ± 3.10) and (EG T2 (8.80 ± 1.73) and CG T2 (5.36 ± 3.33)), when contrasting with the baseline. The data suggest that the BGI was effective when compared to the control condition, as there was a reduction in risky and harmful use of alcohol for low-risk use, according to the alcohol use scores, and an increase in the stages of readiness to change.

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Funding

This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.

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Authors and Affiliations

  1. School of Nursing, University of São Paulo, Brazil. Avenue Doutor. Enéas de Carvalho Aguiar, São PauloSão Paulo, 419-05403-000, Brazil

    Erika Gisseth León Ramírez & Divane de Vargas

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  1. Erika Gisseth León Ramírez
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  2. Divane de Vargas
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Contributions

All authors contributed to the study conception and design, material preparation, data collection and data analysis.

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Correspondence to Erika Gisseth León Ramírez.

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Ethical Approval

The investigation was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. It was approved by the Institutional Review Board (IRB) of São Paulo University School of Nursing (CAAE USP: 80385817.7.0000.5392/2018) and registered in the Brazilian Clinical Trials Registry (ReBEC), registration number: RBR-6zk87m – UTN number: U1111-1205–8313. Available in: https://ensaiosclinicos.gov.br/rg/RBR-6zk87m.

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Ramírez, E.G.L., de Vargas, D. Effectiveness of a Brief Group Intervention for Harmful Alcohol Use in Men at a Primary Health Care Facility in Brazil: A Randomized Clinical Trial. Prev Sci 23, 1507–1516 (2022). https://doi.org/10.1007/s11121-022-01430-z

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