ENHANCING BRIEF INTERVENTION OF PRIMARY CARE PHYSICIANS

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Interactive Voice Response (IVR) is a computer-based telephone technique that allows subjects to respond to a recorded voice asking scripted questions. The caller inputs brief, numeric answers using the telephone touch pad. In a series of studies, we have been using the IVR as a reporting device to examine the evolution of alcohol consumption over time and its relation to alcohol problems. In this study we propose to test IVR in a primary care practice as treatment tool to enhance physicians' brief alcohol interventions with heavy and problem drinkers. Method: After brief alcohol intervention by their physician in participating primary care clinics, consenting patients meeting our selection criteria will be randomized to one of four study groups. The first three of these are: 1) brief intervention only; II) brief intervention plus daily calls by the subject to the IVR; and III) brief intervention plus daily IVR calls with periodic feedback of IVR consumption data to the patient via the physician. Group IV will receive the same treatment as Group III, but subjects in Group IV will receive a financial incentive to help ensure a high IVR call compliance rate. Goals: We will assess: 1) the feasibility of using IVR as an intervention in primary care patients including call compliance rates and the validity of consumption reports, and 2) whether an IVR, with or without patient feedback, enhances the effect of brief alcohol intervention by a physician. Our long-term objective is to develop interventions specifically designed to capitalize on the unique advantages of an IVR system. The public health implications of effective, low cost interventions for heavy and problem drinking that can be accessed remotely and are applicable in primary care and HMO settings are considerable.