1. Ultra-brief intervention for problem drinkers
Steps to a full intervention trial
John Cunningham

2. What I’m interested in How do people change their behaviour?
What tools do clinicians use to motivate this change?
Can these tools be applied in different settings to help motivate people who do not come to treatment?
How do we demonstrate that these tools are effective?

3. United Kingdom Final Report For Jim
How do you compare to males your age from the United Kingdom? The highlighted slice of the pie chart below is where your drinking fits compared to other males in your age range from the United Kingdom.
                                                                                                                                                                                                                        
                                                                                                                                                                                                                        
Average drinks per week for males aged from the United Kingdom. This chart just contains people who drank in the last year. 3

6. Mailing pamphlets to households
Study 1
Mailing pamphlets to households

7. Randomization by postal walk
Household
received
pamphlet

8. One-month follow-up - Total drinks in last week

9. Alberta study: Mailing pamphlets to households

10. Alberta study: Mailing pamphlets to households
Problem drinkers identified on a general population telephone survey
Said they were interested in self-help materials
Randomly assigned to be sent or not sent ‘Evaluate Your Drinking’ Pamphlet

11. Six-month follow-up % drinking 5+ drinks/drinking day

12. Full intervention trial
Study 3
Full intervention trial

13. Why is it needed? Because I am a skeptic
Set up implementation to mimic public health initiative
Recruit people who are not interested in help seeking
Examine mechanisms of change
Is it the normative feedback or just receiving a pamphlet?

14. Study Design
12,200 weekly drinkers to be contacted in RDD telephone survey
Identify problem drinkers (AUDIT > 8)
Estimated sample, N = 2,440
Recruit for 3- and 6-month follow-ups
Estimated sample, N = 1,830
Randomly assign to be sent intervention pamphlet, control pamphlet, or nothing

15. Explanation provided to participants:
“The Centre for Addiction and Mental Health is in the process of mailing a safe-drinking pamphlet to some households in Toronto. I do not know if this pamphlet is being sent to your household, but if you do see it, the six-month follow-up survey will ask about your impressions of the materials.”

16. Study Results? Predict impact of intervention pamphlet
Will it work? Who knows.

17. References
Cunningham, J. A., Wild, T. C., Bondy, S. J., & Lin, E. (2001). Impact of normative feedback on problem drinkers: A small-area population study. Journal of Studies on Alcohol, 62,
Wild, T. C., Cunningham, J. A., & Roberts, A. B. (2007). Controlled study of brief personalized assessment-feedback for drinkers interested in self-help. Addiction, 102(2),
Cunningham, J. A., Neighbors, C., Wild, C., & Humphreys, K. (2008). Ultra-brief intervention for problem drinkers: research protocol. BMC Public Health, 8, 298.

18. Collaborators and Funding
Keith Humphreys, Clayton Neighbors, Cameron Wild
Sources of Funding:
Centre for Addiction and Mental Health
National Institute on Alcohol Abuse and Alcoholism
Contact: