Screening & Brief Intervention of Problem Drinking Women

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DESCRIPTION (provided by applicant): Early identification and intervention among problem-drinking women may avert the more severe, adverse consequences of alcohol abuse and dependence. Among nonpregnant women of childbearing age, the use of alcohol and, in particular, the riskier practices of frequent and binge drinking have not changed since 1995. Moreover, 12% of women 60 years and older regularly drink in excess of recommended amounts, and as a group are underscreened and underdiagnosed, despite being the largest group of health care users in the United States. Screening and intervention, while generally effective, have not been adequately tested among women who account for only 27% of brief intervention trial subjects since 1995, despite the NIH guidelines on inclusion of women in clinical trials. This is concerning, as women in general are more vulnerable to alcohol's negative effects due to differences in metabolism. The purpose of this randomized trial is to test the effectiveness of screening and brief intervention for risk drinking by nonpregnant women with specific medical problems exacerbated by excessive alcohol consumption. The medical problems are female factor infertility, hypertension, and diabetes, conditions that are costly to treat and difficult to manage. 552 nonpregnant women with risk drinking (exceeding NIAAA sensible drinking limits of 7 drinks a week or 1-2 drinks per episode) and infertility, hypertension, or diabetes will be randomized to receive either a nurse practitioner delivered brief intervention using Personal Steps to a Healthy Choice: A Woman's Guide or medical treatment as usual. The specific aim of this randomized clinical trial is to test the hypothesis that 45% of the women who receive the medically oriented brief intervention and 30% of the control group will achieve NIAAA sensible drinking limits in the 12 months after study enrollment. This proposed targeted study of women responds to PA-02-168, which seeks research on screening and interventions in medical settings, and builds upon our previous research on brief interventions for pregnant women.