Proceedings of the 17th Annual International INEBRIA Conference

O1 A learning collaborative to improve care for unhealthy alcohol use: barriers and facilitatorsFern McCree1*, Liu Junqing1, Jennifer Strohmeyer1, Ashli Barnes1, Danielle Rainis1, Serene Olin1, Emily Morden1, Natalie Omar1, Patricia Santora2, Lela McKnight-Eily3 1National Committee for Quality Assurance, USA; 2Substance Abuse and Mental Health Services Administration, USA; 3Centre for Disease Control and Prevention, USACorrespondence: Fern McCree (mccree@ncqa.org)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O1

Background: Excessive alcohol use is a leading cause of death in the U.S. Alcohol screening and brief interventions reduce unhealthy alcohol use but are underutilized in primary care. The HEDIS Unhealthy Alcohol Use Screening and Follow-Up (ASF) measure assesses unhealthy alcohol use screening among adults, and among those who screen positive, receipt of follow-up care. Reporting the measure requires use of electronic clinical data to which health plans may not have ready access. This study identified barriers and facilitators to improving reporting and performance of the ASF measure.

Methods: We convened a three-year (2017–2020) Quality Improvement (QI) Learning Collaborative with three health plans differing in enrollment size, geographic location, and network type. Plans engaged in QI activities (e.g. plan-do-study-act) reported HEDIS data and participated in cross-site learning meetings.

Results: Overall, from 2017–2019, data submitted at the health plan level showed screening rates ranged from 0 to 46% and follow-up rates from 0.4% to 79%. Screening rates increased for one plan after accessing data from one practice but decreased for two plans due to more accurate measure calculations in the last two years. Plans improved follow-up rates due to increased engagement with providers. The Collaborative revealed unique barriers and facilitators underlying performance variation.

Barriers encountered were plans limited access to clinical data, inconsistent capture of alcohol use information at practice level, reluctance of providers and patients to discuss alcohol use due to stigma, and limited brief intervention resources in primary care.

Facilitators identified were the ability to standardize data fields in provider electronic health records, establishment of data sharing agreements with large practices, education of providers, and incorporation of the ASF measure into clinical workflows.

Conclusions: Obtaining clinical data from providers for HEDIS ASF measure reporting was challenging. Strategic and persistent QI efforts increased data access and improved care and follow-up.

O2 A novel computer-based avatar-delivered alcohol reduction intervention: feasibility, adaptability and acceptability among PLHIV/TB adults in Indian clinical settingsNishi Suryavanshi1,2*, Gauri Dhumal1, Samyra R. Cox2, Shashikala Sangle3, Andrea Deluca4, Manjeet Santre3, Amita Gupta2, Geetanjali Chander2, Heidi Hutton2 1Byramjee Jeejeebhoy Government Medical College/Johns Hopkins University Clinical Trials Unit, Jai Prakash Narayan Road, Pune, Maharashtra, India; 2Johns Hopkins University, School of Medicine, 600 North Wolfe Street, Baltimore, MD, USA; 3Byramjee Jeejeebhoy Government Medical College/Sassoon General Hospital, Jai Prakash Narayan Road, Pune, Maharashtra, India; 4Johns Hopkins University, Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, USACorrespondence: Nishi Suryavanshi (nishisuryavanshi@hotmail.com)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O2

Background: Hazardous alcohol use is associated with increased morbidity and mortality among persons with HIV and Tuberculosis (TB). In the US, Computer-Based Avatar-Delivered (CBAD) interventions can reduce hazardous alcohol use, are scalable, and thus, have the potential to improve outcomes among HIV/TB patients. We assessed the feasibility and acceptability of an innovative CBAD intervention for unhealthy alcohol reduction in HIV/TB clinical settings.

Materials and methods: In Pune, India we conducted ten in-depth interviews (IDIs) with HIV/TB patients with alcohol use disorder (AUD), two focus group discussions (FGDs) with health care providers (HCPs) from a Public hospital-based HIV clinic and one FGD with peer educators from alcoholics anonymous (AA). Participants reviewed and provided feedback on an innovative Avatar; 3-D bird, Peedy delivered intervention for AUD. Data were analyzed using structured framework analysis.

Results: Majority (n = 9/10) of IDI respondents were males with median age 42 (IQR; 38–45) years. HCPs of FGDs were mainly females (n = 17/22) and members of AA group were males with AUD (n = 13). Results were organized into 4 domains: Avatar Acceptability; Feedback on intervention content and time spent; Recommendations for improvement; and Feasibility in clinic settings. Overall, HIV/TB participants found Peedy to be acceptable and were comfortable honestly answering alcohol-related questions. FGD participants felt that CBAD provides systematic counselling and the intervention would be more effective with the addition of in person counseling. All participants reported the 15–20-min delivery time and the amount of information provided as appropriate. Adding visuals and an option to choose a human avatar were additional suggestions. HCPs thought CBAD could be easily implemented in clinic settings.

Conclusions: A CBAD alcohol reduction intervention is acceptable and feasible in Indian settings with the inclusion of in-person counseling and a human avatar to increase engagement. The findings will enhance the intervention by making culturally appropriate modifications as recommended by the participants.

Center For AIDS Research micro grant, Johns Hopkins University.

O3 A pilot study evaluating self-reported outcomes among hepatologists attending a program for training on alcohol use disorder managementJayant Mahadevan1, Udit Panda1, Daniel PR Kavati1, C. Likhitha1, N. Kubenthiran1, Prabhat K. Chand1*, Ashwani Singhal2, Pratima Murthy1, Sanjeev Arora3 1Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India; 2Department of Internal Medicine, University of South Dakota, Vermillion, South Dakota, USA; 3Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USACorrespondence: Prabhat K. Chand (chand@nimhans.ac.in)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O3

Background: Alcohol related liver disease (ARLD) is the most common end organ complication linked to heavy alcohol use. Abstinence from alcohol is paramount in the treatment of ARLD. However, treatment for the same often does not occur in medical settings due to a lack of mental health professionals. Hepatologists are ideally placed to provide interventions for AUD, in many settings. But, a lack of specialised training in delivering interventions has been cited by many as a deterrent. Given this felt need, NIMHANS has initiated a Program for Advanced Training of Hepatologists in Alcohol Use Disorder Management (PRATHAM) using the ECHO model.

Methods: The training program consists of weekly virtual tele-mentoring sessions based on the ECHO model, for a duration of 8 weeks. The focus is screening, pharmacotherapy and brief psychological interventions for AUD. Multi-point video conferencing is being used by the 'HUB' (NIMHANS) to conduct didactics, case discussions and share best practices with the 'SPOKES' (Hepatologists from USA, France, Spain, Chile and India). The program evaluation consists of a pre-post design using a survey questionnaire to document the impact of the training on knowledge, attitudes, practices and self-efficacy of the participants.

Results: A total of 20 hepatologists were invited to participate in the program, of whom 18 completed the baseline evaluation. A majority (12/18) had been practicing for greater than 10 years. In general, positive attitudes towards patients with AUD were noted, with 14/18 totally agreeing that treatment was possible. A lack of self-perceived competency was observed in the areas of long-term pharmacotherapy and psychological interventions such as relapse prevention.

Conclusion: This first of its kind program aims to work with hepatologists from around the world to upgrade their skills to manage patients with AUD. This will likely help them to provide comprehensive services to patients with ARLD.

O4 Alcohol use patterns during COVID-19 pandemic in India: an exploratory online studyGayatri Bhatia1*, Arpit Parmar2, Siddharth Sarkar3 1National AIDS Control Organization, New Delhi, Indi; 2All India Institute of Medical Sciences, Bhubaneshwar, Orissa, India; 3Associate Professor, All India Institute of Medical Sciences, New Delhi, IndiaCorrespondence: Gayatri Bhatia (gayatribhatia90@gmail.com)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O4

Background: The COVID 19 pandemic and the nation-wide lockdown instituted in India in March, 2020 led to ban over sales of alcohol initially which was later lifted. Combined with restriction of movement and disruption in daily routine, change in alcohol use patterns of the population was anticipated. This study aimed to assess alcohol use patterns during COVID 19 pandemic in India.

Methods: An online survey link enquiring about alcohol use was shared through social media employing snowball sampling techniques. Responses were gathered in the last week of May 2020 and first week of June 2020.

Results: The findings suggest that 65% of those participants who had consumed alcohol at least once in the previous year had continued alcohol consumption during the pandemic. More than 60% reported an increase in the money spent on alcohol consumption. While 17.5% reported problematic alcohol use, more than 30% had attempted cut-down/cessation. Help or treatment seeking was extremely low. The most common reasons for continuing alcohol use during the pandemic were stress reduction and mood upliftment. Those who continued alcohol use had several misconceptions regarding alcohol use in COVID 19 pandemic.

Conclusion: Lockdown in India did not result in complete cessation of alcohol use for many individuals. Use of alcohol to address negative emotional states would need to be countered to prevent emergence of alcohol use disorders.

O5 An exploration of the feasibility and acceptability of delivering screening and brief interventions to women in prisonJennifer Ferguson, Maggie LesseTeesside University, England, UK

Addiction Science & Clinical Practice 2022,17(Suppl 1): O5

Background: Whilst it is well evidenced that the prevalence of alcohol misuse is high in the criminal justice system (Newbury-Birch, 2016), and it can be shown it is for women on their own also, it is important to investigate the differences between men and women, in order to tailor interventions to this specific population. More females are found to be risky drinkers when they arrive in prison (24%) compared to males (18%)(Ministry of Justice., 2018). This research aimed to approach this unmet need.

Methods: 12 in depth qualitative interviews were completed with residents in an open prison and 6 with relevant staff and stakeholders. Thematic analysis of the transcripts was undertaken and recommendations for a future pilot study were made.

Results: The research highlighted the importance of using the 10 question AUDIT to establish rapport as well as its main purpose of screening. Participants discussed pragmatic issues such as follow up in this vulnerable population, timing of the intervention components and the visual aid used to guide the intervention itself. One of the main findings was the element of staff rapport within the setting. It was surprisingly a uniformed officer who was most favoured for delivery of the intervention. The findings aligned with the already evidenced pains of imprisonment (Sykes, 1958, Crewe et al., 2017).

Conclusions: SBI with women in an open prison setting is both feasible and acceptable provided time the results of this study are implemented in the delivery.

O6 Application of BI module for persons with cannabis dependence (CD)Mohammad A. Shah*, K. S. Sengar.Department of Clinical Psychology, Ranchi Institute of Neuro-Psychiatry & Allied Sciences, Ranchi, India.Correspondence: Mohammad A. Shah (shahpsych@outlook.com)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O6

Background: Cannabis use among people continues to rise and is at an all-time high as many states in the US and other countries lifted ban on cannabis use. With more use, more problems are expected as people develop dependence related issues. Extensive evidence shows the promising results of BI's in reducing substance abuse. Our study aims to increase healthcare access for CD by using BI module for people with CD in Indian setting.

Methods: The sample is composed of individuals (N = 12) having CD as diagnosed by psychiatrist with associated symptoms of depression, anxiety, poor quality of life and poor interpersonal relationships. Among these 12 individuals, 6 have been assigned to experimental group and other 6 to control group. A purposive sampling technique with pre and post test design was used. Tools used in the study include WHOQOL-BREF, DASS-21, and WCQ. The intervention was delivered to the participants in an experimental group while control group was put on treatment as usual (TAU). At 2-month follow-up participants were interviewed to understand the appropriateness of the intervention. The impact was studied in both groups through changes in consumption of cannabis and associated symptoms.

Results: Initial results were promising as patient's symptoms related to depression and anxiety and adjustment to the surroundings improved drastically. The patients (83.33%) were ready to discuss their relationship problems with family members as they found themselves educated about issues within the family. Almost sixty-six (66.66) percent of patients improved symptomatically after attending BI module. Further findings will be ready for presentation at the conference.

Conclusion: These findings provided important insights regarding interventions for people with CD. More focus on family-based intervention is needed as all participants had conflict with family members. Given these findings, further research is needed with large group of participants regarding the effectiveness of BI's in CD.

O7 Are nurses in government hospitals of a metro city equipped with knowledge and skill to manage psychoactive substance use in their patients?K. Sugavanaselvi*, Prasanthi Nattala, Pratima Murthy, B. A. ArvindNational Institute Of Mental Health & Neuro Sciences, Bengaluru, Karnataka, IndiaCorrespondence: K. Sugavanaselvi (selvarshsugi@rediffmail.com)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O7

Background: Psychoactive substance use is a major cause of various illnesses affecting almost every system in the body. However,nurses in general medical care are under-utilized with regard to the detection and provision of substance use cessation interventions for patients during their routine care. The purpose of this study was to conduct a survey on the nurses' knowledge, skill, and confidence level, with regard to providing integrated interventions for psychoactive substance use, as part of the routine nursing care.

Materials and methods: A cross-sectional survey was conducted among nurses (N = 207) in Bruhat Bengaluru Mahanagara Palike (BBMP) hospitals from different clinical specialties. Pre designed Self-Administered Questionnaires were filled by the respondents to assess their knowledge, skill, and confidence level in delivering interventions for medical-surgical (including obstetrics) patients with substance use.

Results: Participants' mean age was 34.20 (SD-9.12), 71% were female. Majority (85.5%) of the nurses had not assessed their patients for addictive substance use. Only one-third had advised some patients to stop use of substances. Although some of the nurses said that they are aware of the role of addictive substances in causing various illnesses, majority (> 80%) said that they are not sure how to assist them in quitting, as part of their routine nursing care.

Conclusion: The findings were used to develop a comprehensive integrated nursing intervention, which is currently being pilot-tested among the same group of nurses, and will subsequently be used to train them to provide integrated interventions in general medical settings for patients whose medical symptoms may be caused/maintained by psychoactive substance use. Keywords: Nurses, psychoactive substance use, knowledge, attitude, skill, confidence level, integrated nursing intervention, general medical settings.

O8 Barriers for treatment and coping with alcohol use disorders (AUD)—A consumer's perspectiveAnja Bischof*, Hannah Schmidt, Miriam Brandes, Hans-Jürgen Rumpf, Gallus BischofDepartment of Psychiatry and Psychotherapy, University of Lübeck, LübeckCorrespondence: Anja Bischof (anja.bischof@uksh.de)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O8

Background: Despite a well-developed and effective treatment system, individuals with AUD are significantly less likely to seek formal help compared with people with other mental health conditions. Most studies on barriers for treatment are based on standardized surveys, which are deficient at capturing underlying causes. Reasons for non-utilization of help in qualitative studies are insufficiently known so far.

Methods: In the project "Alcohol-related treatment—a consumer's perspective" (ART-COPE), barriers to treatment in a biographical context were assessed with semi-structured narrative interviews. The sample consisted of 27 predominantly untreated individuals with AUD recruited in general health practices and other health settings. Interviews were transcribed and coded with MAXQDA and analyzed using qualitative content analysis. In addition, participants filled out a standardized questionnaire on barriers to treatment used in population-based surveys.

Results: As barriers to treatment, fear of stigmatization, shame, milieu-related factors, institutional and personal conditions, inadequate availability of treatment, negative experiences of others within treatment, a lack of drive and self-abandonment were identified. There were clear gender differences. Perceived barriers were related to problem recognition. If alcohol use was not perceived as deviating from social norms, participants did not consider seeking help and thus did not report cognizant barriers. Individually significant barriers were only insufficiently covered with the standardized questionnaire.

Conclusions: The central results indicate that significant factors of disease processing are not present in the sense of cognitively represented schemata and, accordingly, could not be adequately represented in previous questionnaire-based studies. Previous intervention approaches mainly focused exclusively on problem-centered, individual-focused strategies to increase the use of treatment. However, our results indicate that these approaches insufficiently correspond to the life circumstances of those affected. Instead, a careful contextualization of alcohol-related problems in various health care settings and measuring structural prevention appear to be necessary.

O9 Brief motivational intervention combined with serious game to improve treatment retention in patients with alcohol related liver diseaseElsa Caballeria1, Clara Oliveras1, Maria Teresa Pons2, Pol Bruguera1, Ana Isabel López-Lazcano1, Soraya Sabater1, Cristal Martínez2, Laura Nuño1, Neus Freixa1, Mercedes Balcells-Oliveró1, Martina Pérez3, Anna Lligoña1, Antoni Gual1, Hugo López-Pelayo1 1Grup Recerca Addicions Clínic (GRAC-GRE), Addictions Unit, Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS, RTA (RETICS), Barcelona, Spain; 2Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain; 3Liver Unit, Hospital Clínic, Faculty of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

Elsa Caballeria, Clara Oliveras and Maria Teresa Pons share first authorship

Addiction Science & Clinical Practice 2022,17(Suppl 1): O9

Background: Adherence to addiction treatment in patients with alcohol-related liver disease (ARLD) is low, despite the harmful effects derived from alcohol use. Although some therapeutic approaches have shown promising results, the scarcity of studies prevents from determining their efficacy. Serious games (games with a therapeutic aim) have improved treatment adherence in several pathologies. We aim to explore the effectiveness of a brief therapeutic intervention to increase the retention and adherence to addiction treatment. This intervention will be based on the use of a serious game together with a brief face-to-face intervention conducted by professionals not specialists in the field of Addictions. The intervention will be designed using a co-creative approach.

Methods: The co-creation process with liver specialists, patients, psychologists, psychiatrists, game designers and social workers will be organized to establish the basis for the serious games and brief motivational intervention. A pilot study (n = 10) aiming to assess the usability and feasibility of the intervention will be conducted. Next, and after incorporating the required changes to the intervention, an open randomised clinical trial will explore the retention and adherence to addiction treatment of the patients with ARLD who received the serious game-based brief intervention (n = 69) in comparison to the ones who were treated as usual (n = 69).

Results: Addiction treatment retention and adherence, as well as clinical parameters such as the decrease in alcohol use, abstinence, quality of life, evolution of hepatic disease and motivation towards treatment, will be assessed at months one, three and six after the intervention. Retention to addiction treatment at six months follow-up will be the main variable.

Conclusions: We aim to offer a flexible, innovative, and integrated intervention, adapted to patients' needs, and explore its efficacy to improve addiction treatment adherence and retention in patients with ARLD.

O10 Brief online negative affect focused functional imagery training improves two-week intermediate drinking outcomes among hazardous student drinkers: a pilot studyRuichong Shuai*, Alexandra E. Bakou, Jackie Andrade, Leanne Hides, Lee HogarthSchool of Psychology, University of Exeter, Exeter, United KingdomCorrespondence: Ruichong Shuai (rs614@exeter.ac.uk)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O10

Background: Negative affect motivates problematic alcohol use, whereas training alternative adaptive strategies to cope with negative affect can reduce alcohol use. The current study tested whether personalised online functional imagery training (FIT) on how to use positive imagery of adaptive strategies in response to negative affect would improve intermediate drinking outcomes.

Methods: Participants were 52 hazardous student drinkers who drink to cope with negative affect. Participants in the active intervention group (n = 24) were trained online over two weeks to respond to personalised negative drinking triggers by retrieving an adaptive strategy they might use in future to cope with negative affect, whereas participants in the control intervention group (n = 28) received standard risk information about binge drinking at university. Measures of daily drinking quantity, drinking motives, self-efficacy and use of protective behavioural strategies were obtained at baseline and two weeks follow-up.

Results: There were three significant interactions between group and time in a per-protocol analysis: the active intervention group showed increased self-efficacy over negative affect drinking and control over alcohol consumption and decreased social drinking motives from baseline to two-week follow-up, relative to the control intervention group.

Conclusions: These findings provide initial evidence that online training to respond to negative affect drinking triggers by retrieving images of adaptive strategies can improve intermediate drinking outcomes in hazardous, student, negative affect drinkers, whilst adding to growing beneficial effects of FIT based interventions in the field.

Already published in the International Journal of Behavioural Medicine: https://doi.org/10.1007/s12529-021-10019-9.

O11 Community pharmacists and their roles, attitudes and knowledges about detection and advise of alcohol use in CataloniaJoan Colom, Toni Veciana, Gemma Galofré, Berta Torres-Novellas, Jorge Palacio-Vieira, Lidia SeguraCatalan Agency of Public Health (GENCAT), Barcelona, Spain

Addiction Science & Clinical Practice 2022,17(Suppl 1): O11

Background: Community pharmacists (CP) represent one of the closest health professionals to the general population and, due to accessibility, opening hours, territorial balance, and level of trust of the population; they could play a key role in the screening and brief interventions (SBI) of alcohol problems. The aim of this study is to analyse the attitudes, knowledge, and perspectives on alcohol SBI in a sample of community pharmacists in Catalonia (Spain).

Methods: An online survey was addressed to the CP registered in one of the four Official Pharmacists Associations of Catalonia (n = 8,027), followed by three email reminders. The questionnaire covered socio-demographic information, previous training and experience in alcohol and drugs programmes, perceptions of the CP on their abilities to perform SBI, role security (RS) and therapeutic commitment (TC) for the provision of alcohol SBI and their frequency of alcohol use (AUDIT-C).

Results: The final response reached 7.9% (n = 639), 79.9% were women, 63.9% were 41 years or older and more than the half had 21 years of experience. Twenty-five percent of respondents had received training on alcohol or drugs during the last five years and only 9.1% participated in any alcohol or drugs prevention program. Scores of TC were higher than RS (18.1 vs. 13.2) and both measures were higher among men, those who received previous training, those pharmacies with fewer workers and those who had participated in other preventive or public health initiatives. Abilities to perform SBI were higher among older CP (56 years or more) and those with higher scores of TC and RS.

Conclusions: This is the first study aimed at the analysis of SBI at community pharmacies in Catalonia. The design and implementation of alcohol SBI initiatives in community pharmacies need intensive training of their professionals, specially to increase their perception of role security and therapeutic commitment.

O12 Delivering adolescent SBIRT as part of a cluster randomized trial in rural U.S. health centers: provider fidelity to delivery of the interventionShannon Gwin Mitchell, Laura B. Monico, Jan Gryczynski, Mishka TerplanFriends Research Institute, Baltimore, Maryland, USA

Addiction Science & Clinical Practice 2022,17(Suppl 1): O12

Background: This presentation will include an update of an on-going stepped-wedge randomized trial of adolescent SBIRT. The FaCES intervention includes a prescribed set of responses (anticipatory guidance, abbreviated BI, full BI) based on S2BI screening results. Adolescent patients, age 12–17 years, receive either the FaCES intervention or standard care, depending on when their provider is randomized and trained.

Methods: As of February 2021, a total of 1,239 patients had been recruited into the study and 14 of 20 providers had been trained to deliver FaCES across 5 U.S. health centers in two states—New Mexico (NM) and Tennessee (TN). Of those, 938 patients saw an untrained provider and 301 saw a provider trained to deliver FaCES. Screening results were compared with provider checklist responses to gauge fidelity of intervention delivery based on S2BI risk level.

Results: Among the 1,239 participants enrolled there were significant differences between states in patient distribution of female gender (57% TN vs. 47% NM, p = 0.001), white race (88% TN vs. 44% NM, p < 0.000), and Hispanic ethnicity (5% TN vs. 69% NM, p < 0.000). At baseline, past year use of tobacco, alcohol, and marijuana were reported by 19%, 20%, and 16% of adolescent patients, respectively. Fourteen providers were trained to deliver the FaCES intervention (6 physicians and 8 physician's assistants/nurse practitioners). Ninety-eight percent of patients with no reported substance use received anticipatory guidance, while 76% of those reporting past year substance use received a BI (9% of patients declined). A change plan was documented for 53%. Among patients who qualified for a BI, 77% appropriately received abbreviated BI and 49% received full BI.

Conclusions: Pediatric providers trained for the present study are utilizing their clinical judgement and providing patient-centered SBIRT services, which is encouraged in the FaCES intervention. Study findings will need to take such factors into consideration.

O13 Delivering brief intervention in group: strategies to assess harmful alcohol use at primary health careErika G. L. Ramírez*, Divane de Vargas, Stephen StrobbeNursing School of São Paulo University, São Paulo, BrazilCorrespondence: Erika G. L. Ramírez (egleonr@usp.br)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O13

Background: The problematic alcohol use in the male population continues to be a public health problem in the world. In Brazil, the prevalence of harmful alcohol use in a population over 15 years old is 5.2% for women, while among men it is 20.7%. In this sense, the application of Brief Intervention (BI) has been suggested as an effective strategy in changing the risk and harmful alcohol use in the population. More recently, due to the limitations of individual IB, regarding the optimization of human resources and greater coverage in health services, the Brief Group Intervention (BGI) has been proposed as a strategy with the potential to face these limitations. The aim of this study was to evaluate the effectiveness of the BGI in reducing the alcohol in men with risk and harmful alcohol use treated in primary health care.

Materials and methods: Randomized clinical trial, with a follow-up of 30 and 90 days, conducted in a primary health care unit in Brazil. Were randomized 112 men, of which 55 were allocated to the experimental group and 57 to the control group. The alcohol use was assessed in both groups, using the Alcohol Use Disorders Identification Test (AUDIT). The experimental group received a brief group intervention session with the FRAMES model, and the control group was instructed to continue with the usual care of the unit. The data were analyzed using the GEE method (Generalized Equations Estimating).

Results: A significant difference (p < 0.001) between the experimental (GE) and control (CG) groups was evidenced, showing a decrease in alcohol use in the GE.

Conclusions: The results of this study suggest the application of IBG is an effective approach with the potential to reduce alcohol use in the male population at primary health care settings.

Trial Registration: Registered in the Brazilian Clinical Trials Registry/Registro Brasileiro de Ensaios Clínicos (ReBEC). REBEC registration number: RBR-6zk87m-UTN number: U1111-1205-8313.

O14 Development of a training module on substance abuse awareness and prevention for field functionaries working in grassroots communitiesSonia Sain*, Aparna KhannaDepartment of Development Communication and Extension, Lady Irwin College, University of Delhi, New Delhi, IndiaCorrespondence: Sonia Sain (soniasain174@gmail.com)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O14

Background: Substance abuse is a sensitive issue and lot is to be done to improve the knowledge, communication and counselling skills of field functionaries because they are the frontline workers and key persons who are directly involved with the communities. The study aims to assess the training needs of field functionaries working in grassroots communities on the issue of substance abuse. The study will find what knowledge and skills are required by the field functionaries and challenges they face while doing their job. An assessment of their training needs would help in designing of a training module on the issue of substance abuse.

Methods: The population of the study consisted all functional organisations working directly with adolescents and youth (13–35 years of age) on any development programme or issue. Purposive sampling technique was used to select the sample in Delhi and NCR. Total of 120 field functionaries, 30 NGO Heads and Management Staff and 10 experts from the field of substance abuse were included in the study. Semi-structured interview schedules has been prepared for different set of respondents. The data obtained from different groups were compiled and analysed in various aspects of the study.

Results and conclusion: The major findings of the study shows that there is no pre-service and in-service training given to field functionaries on the issue of substance abuse and it causes difficulty in working in the community because field functionaries has not sufficient knowledge related to substance abuse. Drug addiction is too much in the communities and people need information on how to prevent and overcome it. Field functionaries expressed a need for training and information should be given through innovative methods. Content suggested for training programme can be basic knowledge about drugs and their physical and psychosocial effects, preventive measures, Rehabilitation centers and their address.

O15 Development of an informed text-message library and telephone health coaching intervention for diverse community health center patients who use drugs in Los AngelesDallas Swendeman1,*, Stephanie Sumstine1, Zachary Jacobs2, Efren Aguilar2, Whitney Akabike2, Lillian Gelberg2 1Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, USA; 2Department of Family Medicine, UCLA, Los Angeles, USACorrespondence: Dallas Swendema (dswendeman@mednet.ucla.edu)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O15

Background: The objective of this analysis was to identify barriers and facilitators to drug use reduction to inform development of content for theory-based automated feedback text-messages, sent in response to weekly self-monitoring surveys, and to inform telephone health coaching for patients with moderate risk drug use (ASSIST score 4–26; ASAM 0.5) in the new NIDA-funded QUIT-Mobile study.

Methods: Two researchers conducted thematic content analysis of the health educator coaching log data from the original Quit Using Drugs Intervention Trial (QUIT) and the subsequent Binational QUIT (LA and Mexico). Common themes were identified through iterative rounds of coding and discussion with the study team.

Results: The most commonly cited barriers to reducing or stopping drug use were relaxation and increased QoL; works better than prescribed medication; pain relief; sleep; peers/social environment. Feedback messages were developed for the most commonly cited facilitators for drug use reduction, which overlapped with barriers, and all codes were collapsed into general "domains" patients would have the opportunity to opt-in to (ex. Health, Activities, Social, Lifestyle, Positive Future Orientation, and Services). Each code was also assigned as a "Motivator" or "Technique/Strategy" to support patients in maintaining their drug use reduction goals. Messages were developed based on Social Cognitive Theory, Health Belief Model, and Social Support Theory and aimed to provide tailored feedback messages with affirmations, motivational text messages, and drug use reduction technique tips. Messages were also drawn and adapted from text-message libraries used in prior studies to reduce substance use in diverse communities.

Conclusion: Results from qualitative data analysis suggest there are unique barriers and facilitators to drug use reduction in diverse low-income primary care patients. Feedback messages in interventions utilizing mobile self-monitoring should be tailored to individuals' noted barriers and facilitators to enhance motivation and reinforce alternatives to drug use.

O16 Development and feasibility testing of an intervention to help women in the community to quit addictive substance useT.S. Sunitha, Prasanthi Nattala, Girish N. Rao, K. S. Meena National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India

Addiction Science & Clinical Practice 2022,17(Suppl 1): O16

Background: The use of alcohol and smokeless tobacco among women in India is rising, however, there are no known structured interventions and testing their feasibility. The purpose of this study was to develop an intervention for women to help them quit addictive substance use (ASU), based on their own narratives as to what help they need to quit.

Methods: An intervention was developed for women from selected rural and urban communities in Bangalore, Karnataka. The intervention comprises of: a) Information on the adverse health impact of ASU (including during pregnancy and lactation), specifically smokeless tobacco and alcohol, through graphic illustrations (b) PowerPoint video to clarify myths and misconceptions (c) Ways of quitting ASU, presented through a video (d) Adaptive coping, demonstrated through a short film.

Results: Feasibility testing of the Intervention is currently ongoing in the same communities.

Conclusion: The study findings can help to understand the relevance and acceptability of the developed Intervention among the women. Based on this, the Intervention can be refined and finalized for women in the community, to help them quit ASU.

O17 Development, feasibility, and preliminary validation of a Spanish language version of the TAPS Tool for substance use screening in primary careJan Gryczynski1, Katherine Sanchez2, Steven B Carswell1, Robert P Schwartz1 1Friends Research Institute, Baltimore, USA; 2School of Social Work, University of Texas at Arlington, Arlington, USA

Addiction Science & Clinical Practice 2022,17(Suppl 1): O17

Background: The TAPS Tool, developed through the U.S. National Institute on Drug Abuse Clinical Trials Network, is a validated two-stage screening and brief assessment for unhealthy substance use in primary care. Although the U.S. has a large Spanish-speaking population, the TAPS has only been validated in English.

Methods: We developed a Spanish language version of the TAPS Tool and conducted a small study of its feasibility, acceptability, and preliminary validity. Participants were adult primary care patients ages 18 or older with Spanish as their primary language (N = 10 for development/refinement using qualitative cognitive interviewing; N = 100 for the preliminary validation study). The TAPS Tool was examined in interviewer-administered and electronic self-administered formats, with participants assigned at random to the order of administration. We examined disclosure of substance use on the TAPS by administration format, and compared it with established measures (modified CIDI; WHO ASSIST).

Results: The Spanish language TAPS was feasible to use and participants reported high levels of acceptability. The sample had low rates of past 12-month substance use (11% tobacco, 28% risky alcohol, 4% illicit drugs, 1% non-medical prescription drugs) and use disorders (7% tobacco, 2% alcohol, 1% other substances). The self-administered TAPS elicited 1, 3, and 1 additional disclosures of tobacco, risky, alcohol, and marijuana use than the interviewer-administered TAPS, respectively. Rates of disclosure on the TAPS were similar to those on established measures for past 12-month and 3-month time frames.

Conclusions: The current study represents a starting point for expanding the availability of the TAPS Tool beyond its original English language version into Spanish. The Spanish language TAPS Tool could expand options for substance use screening in primary care settings with Spanish-dominant/preferred populations. Future directions for validating and disseminating the Spanish-language TAPS will be discussed.

O18 Drinking risk situations and strategies to deal with them reported by Brazilian users of the Bebermenos" (Drinkless) e-health programMaria L. O. Souza-Formigoni1*, Micaella L. Silva2, Keith M. Soares3 1Universidae Federal de Sao Paulo, Brazil; 2Graduate Program on Psychobiology, Universidae Federal de Sao Paulo, Brazil; 3Associação Fundo de Incentivo a Pesquisa (AFIP), Sao Paulo, BrazilCorrespondence: Maria L. O. Souza-Formigoni (mlosformigoni@unifesp.br)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O18

Background: In a study supported by the WHO Department of Mental Health and Substance Abuse, in partnership with researchers from the Netherlands, Belarus, India and Mexico, we developed an e-health screening and intervention directed to alcohol risk users, named in Portuguese "Bebermenos" (Drinkless).

Methods: Brazilian alcohol users, classified according to their AUDIT (Alcohol Use Disorders Inventory Test) scores as "at-risk" or "suggestive of dependence" were included in the program. Among the diverse tools available, one was the record. Of their most common drinking situations followed by intended strategies to avoid drinking, or at least to do it in a low risk pattern. Using a qualitative approach (content analysis), in the present study we categorize the main drinking situations and strategies to deal with them reported by the users of the program. We classified the drinking situations according to the 8 categories proposed by Annis et al. (1982). The classification of strategies was defined by consensus among three researchers who had previously classified them, independently. We analyzed data from 130 participants who had filled out those forms.

Results: The most prevalent categories of drinking situations were: Pleasant Times With Others, Social Pressure to Drink, Unpleasant Emotions and Urges and Temptations. As regards the strategies to avoid drinking, the most frequently reported were: increase water or soda ingestion, reject events in which there are alcoholic beverages, share the decision to stop drinking with others, practice physical activity, hang out with people who drink under control or do not drink, and stay at home. At follow-up they reported this kind of "exercise" was helpful to control their drinking.

Conclusion: These data indicate the importance of encouraging alcohol problem users to be aware of their drinking risk situations and to thinking about them in advance, in order to develop better strategies to deal with them and prevent relapses.

Trial Registration: This study was developed with data from the Brazilian participants of the project “Alcohol e-Help self-help intervention”. Trial registration: ISRCTN14037475, https://doi.org/10.1186/ISRCTN14037475

O19 Effect of health behaviours on risky drinking amongst adolescents in the UK: Secondary data analysis from the SIPS JR-HIGH pilot study in North East EnglandSrinidhi Koya, Dorothy Newbury- BirchSchool of Social Sciences, Humanities and law, Teesside University, Middlesbrough, UK

Addiction Science & Clinical Practice 2022,17(Suppl 1): O19

Background: Risky drinking continues to be the leading cause of death and disability-adjusted life-years amongst young people, globally. The study examined the effect of health behaviours on risky drinking amongst adolescents aged 14–15 years old in North East England, UK.

Methods: Secondary data analysis of the NIHR PHR-funded SIPS JR-HIGH pilot study was conducted using the baseline survey data. The questionnaire consisted of tools used for alcohol screening (A-SAQ), measuring risky alcohol use (AUDIT), a general lifestyle questionnaire (diet, smoking, sexual behaviour, and exercise), and general psychological health (WEMWBS). Descriptive and analytical statistics were obtained using measures of central tendency, proportions, and logistic regression.

Results: Amongst the 1280 respondents who took part in the study, half were females and the majority belonged to the White ethnic group. While half of the respondents reported adequate fruit and vegetable (F&V) consumption, only 10% had adequate levels of physical activity and one-third of them were smokers. A quarter of the respondents had AUDIT-C scores ≥ 5 and 40% of the respondents had drunk more than 3 units of alcohol in the past 6 months. Logistic regression showed that females (OR: 1.49, p-value: 0.001) and adolescents with inadequate F&V consumption (OR: 1.32, p-value: 0.015) had higher odds of risky drinking. Non-smokers had lower odds of risky drinking (OR: 0.124, p-value: < 0.001). Also, females had higher odds of having an inadequate physical activity (OR: 1.76, p-value: 0.005), lower odds of abstaining from smoking (OR: 0.51, p-value: < 0.001) and, lower odds of mental well-being (OR: 0.51, p-value: < 0.001), than males.

Conclusion: To develop successful interventions for risky drinking amongst adolescents, future studies need to address these determinants. My PhD study will examine the interaction between these determinants and alcohol consumption as a result of socio-cultural factors.

O20 Effects of adolescent SBIRT education using simulated learning technology in health professional trainingTracy McPherson*, Hildie Cohen, Weiwei Liu, Jackie SheridanPublic Health Department, NORC at the University of Chicago, Chicago, USACorrespondence: Tracy McPherson (Mcpherson-tracy@norc.org)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O20

Background: Substance use in adolescence is linked to a range of negative life consequences. Consequently, there is a great need for social workers, nurses, and other health professionals to help prevent and reduce substance use with youth. NORC at the University of Chicago along with leading professional education associations and experts partnered to develop and test an adolescent screening, brief intervention, and referral to treatment (SBIRT) curriculum for use in nursing, social work, and interprofessional education. Since 2015, the curriculum has been implemented with more than 10,000 students in over 200 programs in the U.S. This study evaluated the impact of the education on students' attitudes towards working with people who drink alcohol; perceived readiness, confidence, and competence; knowledge and skills.

Materials and methods: Students completed a pre-training survey, received adolescent SBIRT education including an online simulation training, and a post-training survey. A pretest–posttest within-subjects design was used to investigate the effects on student attitudes; confidence, competence, and readiness; knowledge and skills. Differences between groups were also explored for program-level variables using OLS Regression. The sample included 18 schools with 556 students. The analysis compared subgroups (e.g., undergraduate/graduate, prior training) on pre-post differences in outcomes using independent sample t-tests and OLS regressions. Through review of implementation progress reports, qualitative data was analyzed to assess the impact of implementation format and dosage on training outcomes.

Results: Outcomes on perceived confidence, competence, readiness, knowledge and skills were significantly higher after SBIRT education. Implementation format and dosage did not significantly impact outcome measures when controlling for other participant demographic covariates.

Conclusions: The findings suggest that adolescent SBIRT education including simulation-based training can positively affect student outcomes as they prepare to implement adolescent SBIRT in the field. The findings can also inform educators on the differences in outcomes among groups and inform curriculum infusion.

O21 Effectiveness, cost-effectiveness and cost-utility of a digital smoking cessation intervention for cancer survivors: health economic evaluation and outcomes of a pragmatic randomized controlled trialAjla Mujcic1,2, Matthijs Blankers1,3,4, Brigitte Boon5,6, Irma M. Verdonck-de Leeuw7,8, Filip Smit1,8,9, Margriet van Laar1, Rutger Engels2 1Trimbos Institute, The Netherlands National Institute of Mental Health and Addiction, Utrecht, The Netherlands; 2Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands; 3Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands; 4Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, The Netherlands; 5Department Scientific Research, Academy het Dorp, Arnhem, The Netherlands; 6Department Scientific Research, Siza, Arnhem, The Netherlands; 7Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands; 8Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands; 9Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands

Addiction Science & Clinical Practice 2022,17(Suppl 1): O21

Background: Smoking cessation (SC) interventions may contribute to the wellbeing of cancer survivors.

Methods: A health economic evaluation alongside a pragmatic two-arm parallel-group randomised controlled trial (RCT) with follow-ups at 3, 6 and 12 months comparing a digital interactive SC intervention compared to a non-interactive online information brochure for cancer survivors. The study was conducted from November 2016 to September 2019. Participants were Dutch adult cancer survivors who were current smokers with the intention to quit smoking. In total, 165 participants were included and analysed; 83 in the intervention group and 82 in the control group. Primary outcome was self-reported 7-day smoking abstinence at 6-month follow-up. Secondary outcomes were quality adjusted life years (QALYs) gained, number of cigarettes smoked, nicotine dependence, and treatment satisfaction. For the health economic evaluation, healthcare costs, and societal costs (including productivity losses and intervention costs) and effects were assessed over a 12-month horizon.

Results: At 6-month follow-up the quit rates were 27.7% (n = 23) and 25.6% (n = 21) in the MyCourse and control group, respectively (OR = 0.47 95%CI 0.03 to 7.86, P = 0.60). The number of cigarettes decreased more over time and the MyCourse group demonstrated a significantly greater reduction at 12-month follow-up (IRR = 0.87, 95% CI 0.76 to 1.00, P = 0.04). In the cost-utility analysis, the MyCourse intervention was not preferred over the control group when taking the societal perspective. In addition, with actual smoking behaviour as the outcome, the MyCourse group led to marginally better results per reduced pack-year against higher societal costs, with a mean incremental cost-effectiveness ratio of US$52,067 (95% CI 32,515 to 81,346).

Conclusions: At 6 months, there was no evidence found for a differential effect on cessation rates. At 12 months, the MyCourse intervention led to a greater reduction of number of smoked cigarettes at higher costs compared to the control group.

O22 Effectiveness of a nurse-conducted brief interventions in patients with alcohol use disorders admitted in gastroenterology ward, using a house-to-house survey—A case–control studyJohnson R. Pradeep1, Abiya N. Vinnarasi1, Harshad Devarbhavi2, Sumithra Selvam3, Ashok Mysore1* 1Department of Psychiatry, St. John's Medical College, Bengaluru, Karnataka, India; 2Department of Gastroenterology, St. John's Medical College, Bengaluru, Karnataka, India; 3Division of Epidemiology, Biostatistics & Population Health, St. John's Research Institute, St. John's Medical College, Bengaluru, Karnataka, IndiaCorrespondence: Ashok Mysore (ashok.mv@stjohns.in)

Addiction Science & Clinical Practice 2022,17(Suppl 1): O22

Background: In India, 14.6% of the population use alcohol, among them 5.2% are problem drinkers and it is a huge burden. Alcohol use disorders (AUD) have the widest treatment gap and one important reason is the shortage of specialists in India. Hence, task-shifting to health care professionals such as Nurses to deliver brief interventions is needed. There are limited studies where a house-to-house follow-up has been carried out to assess the drinking status in India. This study aimed to assess the effectiveness of Nurse-Conducted Brief Intervention (NCBI) using a house-to-house survey to objectively confirm the drinking status of the patients.

Methods: Using a case–control design, 51 patients from the Intervention Group (IG) and 20 in the Non-Intervention Group (NIG) were selected from the BIG service. A House-to-house survey was carried out by a trained Research Assistant (RA). The RA administered a semi-structured proforma to capture sociodemographic data and alcohol use-related data such as drinking status, PHQ-9, and AUDIT questionnaire.

Results: Significant reduction in the median AUDIT score was found in the IG during the visit (Before intervention = 15 [IQR = 8–21) vs. House visit = 12 [IQR 9–14], p value = 0.005), compared to NIG (Before intervention = 10 [IQR 9.25–11] vs. House visit 9.50 [IQR 9–11], p value = 0.371). There were significantly more number of abstainers in the IG (NIG n = 14 vs. IG = 48) and few relapsers (NIG n = 6 vs. IG n = 3) compared to NIG (p = 0.012). The odds ratio of those who abstained due to the NCBI was 2.33.

Conclusions: The findings from this study support the effectiveness of an NCBI in patients with AUD using an objective method (House-to-house) of confirmation of the drinking status.

O23 Efficacy of Brief Intervention among university students with different levels of severity of alcohol use related problemsPaula V. Gimenez, Mariana Cremonte, Raquel Peltzer, Tomás Salomón, Karina CondeResearch Group on Psychoactive substances and injuries-Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina

Addiction Science & Clinical Practice 2022,17(Suppl 1): O23

Background: Brief Intervention (BI) is often considered less effective among people with higher alcohol use related problems, but the evidence is mixed. We evaluated the efficacy of BI with and without Normative Feedback (NF) in reducing alcohol consumption among university students with different severity levels.

Methods: 821 students from a national public university in Argentina were randomized into BI without NF (BI), BI with NF (BI-NF) or a screening control group (CG). Students with heavy episodic drinking

留言 (0)

沒有登入
gif