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Randomized Controlled Trial
. 2020 Jun;115(6):1050-1060.
doi: 10.1111/add.14903. Epub 2020 Jan 3.

A randomized clinical trial of mobile phone motivational interviewing for alcohol use problems in Kenya

Valerie S Harder  1   2 , Abednego M Musau  2 , Christine W Musyimi  2 , David M Ndetei  2   3 , Victoria N Mutiso  2
Affiliations
Randomized Controlled Trial

A randomized clinical trial of mobile phone motivational interviewing for alcohol use problems in Kenya

Valerie S Harder et al. Addiction. 2020 Jun.

Abstract

Aim: To test the effectiveness of a motivational interviewing (MI) intervention using the mobile phone among adults with alcohol use problems.

Design: A randomized clinical trial of mobile MI and standard in-person MI with 1- and 6-month follow-up, including a 1-month waitlist control followed by mobile MI.

Setting: A primary health center in rural Kenya.

Participants: Three hundred adults screening positive for alcohol use problems were randomized and received immediate mobile MI (n = 89), in-person MI (n = 65) or delayed mobile MI (n = 76) for waiting-list controls 1 month after no treatment, with 70 unable to be reached for intervention.

Intervention and comparator: One MI session was provided either immediately by mobile phone, in-person at the health center or delayed by 1 month and then provided by mobile phone.

Measurements: Alcohol use problems were repeatedly assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the shorter AUDIT-C. The primary outcome was difference in alcohol score 1 month after no intervention for waiting-list control versus 1 month after MI for mobile MI. The secondary outcomes were difference in alcohol score for in-person MI versus mobile MI one and 6 months after MI.

Findings: For our primary outcome, average AUDIT-C scores were nearly three points higher (difference = 2.88, 95% confidence interval = 2.11, 3.66) for waiting-list controls after 1 month of no intervention versus mobile MI 1 month after intervention. Results for secondary outcomes supported the null hypothesis of no difference between in-person and mobile MI at 1 month (Bayes factor = 0.22), but were inconclusive at 6 months (Bayes factor = 0.41).

Conclusion: Mobile phone-based motivational interviewing may be an effective treatment for alcohol use problems among adults visiting primary care in Kenya. Providing mobile motivational interviewing may help clinicians in rural areas to reach patients needing treatment for alcohol use problems.

Keywords: Alcohol use disorders; HIV/AIDS; Kenya; mHealth; mobile intervention; motivational interviewing.

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Conflict of interest statement

Conflict of interest declaration: None

Figures

Figure 1:
Figure 1:
Flow of eligible participants through random assignment to three study modalities, follow-up reassessment of alcohol use at one and six months after motivational interviewing intervention, and analyses.
Figure 2:
Figure 2:
Average alcohol score at one month was significantly higher for waitlist controls compared to mobile MI. There were no differences in average alcohol scores between in-person and mobile MI at either one month or six months.
See this image and copyright information in PMC

Comment in

References

    1. World Health Organization. Global Status Report on Alcohol and Health. 2018.
    1. Parry C, Rehm J, Poznyak V, Room R. Alcohol and infectious diseases: an overlooked causal linkage? Addiction. 2009;104(3):331–2. - PubMed
    1. Bagasra O, Kajdacsy-Balla A, Lischner HW, Pomerantz RJ. Alcohol intake increases human immunodeficiency virus type 1 replication in human peripheral blood mononuclear cells. J Infect Dis. 1993;167(4):789–97. - PubMed
    1. Bagasra O, Bachman SE, Jew L, Tawadros R, Cater J, Boden G, et al.Increased human immunodeficiency virus type 1 replication in human peripheral blood mononuclear cells induced by ethanol: potential immunopathogenic mechanisms. J Infect Dis. 1996;173(3):550–8. - PubMed
    1. Samet JH, Cheng DM, Libman H, Nunes DP, Alperen JK, Saitz R. Alcohol consumption and HIV disease progression. J Acquir Immune Defic Syndr. 2007;46(2):194–9. - PMC - PubMed

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