TELECOM & BIBLIOTHERAPY PROGRAMS FOR PROBLEM DRINKERS

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DESCRIPTION (provided by applicant): This study will develop and perform a preliminary evaluation of an easily disseminated, population-based, low cost intervention for problem drinking using a computer-based, automated telephone system (Telephone-Linked Communications for Alcohol [TLC-ALC]). TLC-ALC will be modeled after the content and behavioral strategies used in the self-help book, How to Control Your Drinking (2004). The development protocol will entail five sequential tasks: 1) preparing TLC-ALC design specifications, 2) writing the actual TLC dialogues, 3) computer programming the final TLC-ALC content, logic, and database, 4) voice recording the TLC dialogues, and 5) computer software testing (debugging) of the programmed TLC-ALC system and its speech recognition function. Each step involves an iterative process whereby the work is reviewed and revised by the appropriate project staff and the outside reviewer. Potential participants are involved in each step. TLC-ALC will be tested in an evaluation study, in which there will be a control group that will receive a minimal intervention/attention control program consisting of a NIAAA information and referral pamphlet plus a computer-based automated telephone (TLC) system that reinforces the pamphlet's messages and provides general health information. The 200 study participants will be problem drinkers, recruited from responses to newspaper ads in the Boston metropolitan area. They will be randomly assigned to 2 study groups (100 per group). Study subjects will be followed for 6 months, with the first 3 months for the intervention. Each study participant will be evaluated at baseline, and at 3 and 6 months through telephone interviews. The intervention will target 2 primary outcomes: drinking frequency (percent days abstinent [PDA]) and drinking intensity (drinks per drinking day (DDD), in the past month and 2 secondary outcomes: drinking within guidelines (DWG) for safe drinking, and the negative consequences of alcohol use. The study will evaluate the effect of participant characteristics on outcome, and assess the impact of the intervention on postulated mediating (intervening) behavioral variables: stage of change for drinking, self-efficacy for avoiding heavy drinking and alcohol related expectancies. The following hypotheses will be tested. During a 3 month intervention period: (1) participants receiving TLC-ALC will significantly decrease their frequency and intensity of alcohol use compared to controls; (2) participants receiving the intervention will be more likely to decrease their drinking to within NIAAA guidelines and decrease the negative consequences for alcohol use compared to controls; (3) these intervention effects will be maintained to the 6 month follow-up point. The study will also explore moderating and intervening variable effects and the time course of intervention effects across 6 months.