Controlled study of brief personalized assessment-feedback for drinkers interested in self-help.

AIMS: Brief alcohol interventions typically have been directed to heavy-drinking patients seeking primary health care and college students. This study examined the efficacy of mailing brief personalized assessment-feedback to interested drinkers recruited from the general public. We hypothesized that problem drinkers would benefit more from the intervention than individuals who were not problem drinkers. DESIGN: A two-arm, double-blinded, community-based randomized controlled trial with 6-month follow-up. SETTING AND PARTICIPANTS: A screening interview was administered to a stratified random sample of 10 014 Canadians 18 years of age and older (5621 women and 4393 men; M age = 43.3 years, SD = 15.99; response rate = 65.4%). INTERVENTION: Current drinkers interested in receiving alcohol self-help materials (n = 1727) were assigned randomly to receive brief personalized assessment-feedback on male and female population drinking norms by mail, or to a delayed-treatment control group, and were contacted 6 months later (76% retention rate). MEASUREMENTS: Problem drinking status at baseline [using sex-specific Alcohol Use Disorders Identification Test (AUDIT) cut scores], and frequency and quantity of alcohol use at follow-up. FINDINGS: Analysis of covariance identified the hypothesized interaction of baseline problem drinking status and treatment condition (P < 0.01). Among problem drinkers identified at baseline the intervention caused a 10.1% reduction in per-occasion binge drinking compared to controls, whereas there was no difference in binge drinking across conditions for non-problem drinkers. CONCLUSIONS: The continuum of care for alcohol problems can be broadened by providing brief interventions to interested drinkers in the general population.

Exploring the social and cultural context of sexual health for young people in Mongolia: implications for health promotion.

Recent political, economic, and cultural changes in Mongolia make its large proportion of young people vulnerable to HIV infection. While there had been only two clinical cases of HIV in Mongolia by the year 2000, the incidence of sexually transmitted infections (STIs) is on the rise, especially among people aged 15-24. Little is known about the social and cultural context in which the sexual knowledge, attitudes, and behaviour of Mongolian young people are created and negotiated. This context must be better understood in order to promote safer sex practices. This study employed qualitative research methods to explore and describe the social and cultural context in which sexual behaviour is negotiated among secondary school students in Ulaanbaatar, Mongolia. Students and teachers from two schools in Ulaanbaatar and health professionals were selected by purposeful sampling to participate in six semi-structured focus group interviews in autumn 2000. Thematic content analysis was conducted on the focus group transcripts. Seven themes were extracted including embarrassment, lack of knowledge, concepts of sex, perceptions of condoms, gender roles, peer norms, and the influence of drinking on sexual activity. Results presented are the first description of the social and cultural context of sexual health and highlight the combined impact of these themes on safer sex practices in Mongolia. These findings are not generalizable, but their agreement with the Mongolian and the international literature indicates that they may be transferable. Implications for STI and HIV/AIDS prevention efforts and further research in Mongolia are discussed.

Alcohol problems and interest in self-help: a population study of Alberta adults.

BACKGROUND: We quantified the prevalence of alcohol problems among Alberta adults and determined relationships between sociodemographic characteristics, problem drinking status, and interest in self-help materials to reduce alcohol use. METHODS: A computer-aided telephone interview was administered to a stratified random sample of 10,014 Albertans, 18 years of age or older (5,621 women and 4,393 men; M age = 43.3 years, SD = 16.0), with a response rate of 65.4%. Measures included: 1) current drinking status, 2) prior alcohol treatment, 3) problem drinking status (using the Alcohol Use Disorders Identification Test; AUDIT), and 4) interest in receiving free self-help materials to encourage safe drinking. Data were weighted to reflect age, sex, and regional Alberta population. RESULTS: Of the total sample, 19.3% abstained from drinking in the past year, 4.2% had received treatment for alcohol problems at some point in their lives, and 80.7% were current drinkers (i.e., consumed alcohol in the previous year). Some 15.2% (n = 1,193) of current drinkers were classified as having a drinking problem. Logistic regression analyses showed that problem drinkers had 3.5 times greater odds of being male and 2.3 times greater odds of being interested in self-help interventions, compared to other current drinkers. Being single, of younger age, and not being exposed to post-secondary education also significantly predicted problem drinking status. INTERPRETATION: Alcohol misuse is common among Alberta drinkers, but many of them are interested in receiving brief public health interventions designed to help them assert control over their behaviour.

Compulsory substance abuse treatment: an overview of recent findings and issues.

An overview of research trends and issues in the area of compulsory substance abuse treatment is presented, using a sample of 170 English-language articles obtained from a search of 4 databases (Medline, PubMed, Embase, PsychINFO, supplemented by a manual search). About half (51%) of these articles were non-empirical (i.e. literature reviews, policy proposals, legal and ethical commentaries on compulsory treatment). A subsample of empirical studies published since 1988 (n = 71) was coded to summarize research trends in relation to 3 key issues: (1) how compulsory treatment was studied (country of origin; type of compulsory treatment; treatment population), (2) the evidence base for judging effectiveness of compulsory treatment (research design; sampling; type, timing and results of outcome measures), and (3) the relationship between compulsory treatment and coercion (measurement strategies). Directions for future research are discussed.