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Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2012

Open Access 01-12-2012 | Research

Feedback from recently returned veterans on an anonymous web-based brief alcohol intervention

Authors: Gwen T Lapham, Eric J Hawkins, Laura J Chavez, Carol E Achtmeyer, Emily C Williams, Rachel M Thomas, Evette J Ludman, Kypros Kypri, Stephen C Hunt, Katharine A Bradley

Published in: Addiction Science & Clinical Practice | Issue 1/2012

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Abstract

Background

Veterans of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) are at increased risk for alcohol misuse, and innovative methods are needed to improve their access to alcohol screening and brief interventions (SBI). This study adapted an electronic SBI (e-SBI) website shown to be efficacious in college students for OEF/OIF veterans and reported findings from interviews with OEF/OIF veterans about their impressions of the e-SBI.

Methods

Outpatient veterans of OEF/OIF who drank ≥3 days in the past week were recruited from a US Department of Veterans Affairs (VA) Deployment Health Clinic waiting room. Veterans privately pretested the anonymous e-SBI then completed individual semistructured audio-recorded interviews. Their responses were analyzed using template analysis to explore domains identified a priori as well as emergent domains.

Results

During interviews, all nine OEF/OIF veterans (1 woman and 8 men) indicated they had received feedback for risky alcohol consumption. Participants generally liked the standard-drinks image, alcohol-related caloric and monetary feedback, and the website’s brevity and anonymity (a priori domains). They also experienced challenges with portions of the e-SBI assessment and viewed feedback regarding alcohol risk and normative drinking as problematic, but described potential benefits derived from the e-SBI (emergent domains). The most appealing e-SBIs would ensure anonymity and provide personalized transparent feedback about alcohol-related risk, consideration of the context for drinking, strategies to reduce drinking, and additional resources for veterans with more severe alcohol misuse.

Conclusions

Results of this qualitative exploratory study suggest e-SBI may be an acceptable strategy for increasing OEF/OIF veteran access to evidenced-based alcohol SBI.
Appendix
Available only for authorised users
Literature
1.
Defense Manpower Data Center: CTS Deployment File Baseline Report for Operation Enduring Freedom and Operation Iraqi Freedom. 2011, US Department of Defense, Washington, DC
2.
Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL: Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004, 351: 13-22. 10.1056/NEJMoa040603.CrossRefPubMed
3.
Jacobson IG, Ryan MA, Hooper TI, Smith TC, Amoroso PJ, Boyko EJ, Gackstetter GD, Wells TS, Bell NS: Alcohol use and alcohol-related problems before and after military combat deployment. JAMA. 2008, 300: 663-675. 10.1001/jama.300.6.663.PubMedCentralCrossRefPubMed
4.
Milliken CS, Auchterlonie JL, Hoge CW: Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA. 2007, 298: 2141-2148. 10.1001/jama.298.18.2141.CrossRefPubMed
5.
Calhoun PS, Elter JR, Jones ER, Kudler H, Straits-Troster K: Hazardous alcohol use and receipt of risk-reduction counseling among U.S. veterans of the wars in Iraq and Afghanistan. J Clin Psychiatry. 2008, 69: 1686-1693. 10.4088/JCP.v69n1103.CrossRefPubMed
6.
Hawkins EJ, Lapham GT, Kivlahan DR, Bradley KA: Recognition and management of alcohol misuse in OEF/OIF and other veterans in the VA: a cross-sectional study. Drug Alcohol Depend. 2010, 109: 147-153. 10.1016/j.drugalcdep.2009.12.025.CrossRefPubMed
7.
McDevitt-Murphy ME, Williams JL, Bracken KL, Fields JA, Monahan CJ, Murphy JG: PTSD symptoms, hazardous drinking, and health functioning among U.S.OEF and OIF veterans presenting to primary care. J Trauma Stress. 2010, 23: 108-111.PubMedCentralPubMed
8.
Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Southwick SM: Perceived stigma and barriers to mental health care utilization among OEF-OIF veterans. Psychiatr Serv. 2009, 60: 1118-1122. 10.1176/appi.ps.60.8.1118.CrossRefPubMed
9.
Erbes CR, Curry KT, Leskela J: Treatment Presentation and Adherence of Iraq/Afghanistan Era Veterans in Outpatient Care for Posttraumatic Stress Disorder. Psychol Serv. 2009, 6: 175-183.CrossRef
10.
Kaner E, Beyer F, Dickinson H, Pienaar E, Campbell F, Schlesinger C, Heather N, Saunders J, Burnand B: Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007, CD004148
11.
Bradley KA, Williams EC, Achtmeyer CE, Volpp B, Collins BJ, Kivlahan DR: Implementation of evidence-based alcohol screening in the Veterans Health Administration. Am J Manag Care. 2006, 12: 597-606.PubMed
12.
Lapham GT, Achtmeyer CE, Williams EC, Hawkins EJ, Kivlahan DR, Bradley KA: Increased documented brief alcohol interventions with a performance measure and electronic decision support. Med Care. 2012, 50: 179-187. 10.1097/MLR.0b013e3181e35743.CrossRefPubMed
13.
Bradley KA, Lapham GT, Hawkins EJ, Achtmeyer CE, Williams EC, Thomas RM, Kivlahan DR: Quality concerns with routine alcohol screening in VA clinical settings. J Gen Intern Med. 2011, 26: 299-306. 10.1007/s11606-010-1509-4.PubMedCentralCrossRefPubMed
14.
Ouimette PC, Vogt D, Wade M, Tirone V, Greenbaum MA, Kimerling R, Laffaye C, Fitt JE, Rosen CS: Perceived barriers to care among veterans health administration patients with posttraumatic stress disorder. Psychol Serv. 2011, 8: 212-223.CrossRef
15.
Linke S, Murray E, Butler C, Wallace P: Internet-based interactive health intervention for the promotion of sensible drinking: patterns of use and potential impact on members of the general public. J Med Internet Res. 2007, 9: e10-10.2196/jmir.9.2.e10.PubMedCentralCrossRefPubMed
16.
Cunningham JA, Humphreys K, Koski-Jannes A: Providing personalized assessment feedback for problem drinking on the Internet: a pilot project. J Stud Alcohol. 2000, 61: 794-798.CrossRefPubMed
17.
Saitz R, Helmuth ED, Aromaa SE, Guard A, Belanger M, Rosenbloom DL: Web-based screening and brief intervention for the spectrum of alcohol problems. Prev Med. 2004, 39: 969-975. 10.1016/j.ypmed.2004.04.011.CrossRefPubMed
18.
Gerbert B, Bronstone A, Pantilat S, McPhee S, Allerton M, Moe J: When asked, patients tell: disclosure of sensitive health-risk behaviors. Med Care. 1999, 37: 104-111. 10.1097/00005650-199901000-00014.CrossRefPubMed
19.
Straits-Troster K, Kudler H, Jones E, Calhoun P: Executive Summary Report on Focus Groups: Clinical Needs Assessment of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) Veterans and Families. 2007, VISN 6 Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC
20.
Simon-Arndt CM, Hurtado SL, Patriarca-Troyk LA: Acceptance of Web-based personalized feedback: user ratings of an alcohol misuse prevention program targeting U.S. Marines. Health Commun. 2006, 20: 13-22. 10.1207/s15327027hc2001_2.CrossRefPubMed
21.
Curry SJ: eHealth research and healthcare delivery beyond intervention effectiveness. Am J Prev Med. 2007, 32: S127-130. 10.1016/j.amepre.2007.01.026.CrossRefPubMed
22.
Bewick BM, Trusler K, Mulhern B, Barkham M, Hill AJ: The feasibility and effectiveness of a web-based personalised feedback and social norms alcohol intervention in UK university students: a randomised control trial. Addict Behav. 2008, 33: 1192-1198. 10.1016/j.addbeh.2008.05.002.CrossRefPubMed
23.
Copeland J, Martin G: Web-based interventions for substance use disorders: a qualitative review. J Subst Abuse Treat. 2004, 26: 109-116. 10.1016/S0740-5472(03)00165-X.CrossRefPubMed
24.
Elliott JC, Carey KB, Bolles JR: Computer-based interventions for college drinking: a qualitative review. Addict Behav. 2008, 33: 994-1005. 10.1016/j.addbeh.2008.03.006.PubMedCentralCrossRefPubMed
25.
Carey KB, Henson JM, Carey MP, Maisto SA: Computer versus in-person intervention for students violating campus alcohol policy. J Consult Clin Psychol. 2009, 77: 74-87.PubMedCentralCrossRefPubMed
26.
Rooke S, Thorsteinsson E, Karpin A, Copeland J, Allsop D: Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction. 2010, 105: 1381-1390. 10.1111/j.1360-0443.2010.02975.x.CrossRefPubMed
27.
Khadjesari Z, Murray E, Hewitt C, Hartley S, Godfrey C: Can stand-alone computer-based interventions reduce alcohol consumption? A systematic review. Addiction. 2011, 106: 267-282. 10.1111/j.1360-0443.2010.03214.x.CrossRefPubMed
28.
Kypri K, Langley JD, Saunders JB, Cashell-Smith ML, Herbison P: Randomized controlled trial of web-based alcohol screening and brief intervention in primary care. Arch Intern Med. 2008, 168: 530-536. 10.1001/archinternmed.2007.109.CrossRefPubMed
29.
Kypri K, Hallett J, Howat P, McManus A, Maycock B, Bowe S, Horton NJ: Randomized controlled trial of proactive web-based alcohol screening and brief intervention for university students. Arch Intern Med. 2009, 169: 1508-1514. 10.1001/archinternmed.2009.249.CrossRefPubMed
30.
Babor TF, de la Fuente JR, Saunders J, Grant M: AUDIT. Alcohol Use Disorders Identification Test: guidelines for use in primary health care. 1989, World Health Organization, Geneva
31.
Kypri K, Saunders JB, Williams SM, McGee RO, Langley JD, Cashell-Smith ML, Gallagher SJ: Web-based screening and brief intervention for hazardous drinking: a double-blind randomized controlled trial. Addiction. 2004, 99: 1410-1417. 10.1111/j.1360-0443.2004.00847.x.CrossRefPubMed
32.
Miller WR, Rollnick S: Motivational Interviewing: Preparing People to Change Addictive Behavior. 1991, Guilford Press, New York
33.
Hallett J, Maycock B, Kypri K, Howat P, McManus A: Development of a Web-based alcohol intervention for university students: processes and challenges. Drug Alcohol Rev. 2009, 28: 31-39. 10.1111/j.1465-3362.2008.00008.x.CrossRefPubMed
34.
Bradley KA, Williams EC, Achtmeyer CE, Hawkins EJ, Harris AH, Frey MS, Craig T, Kivlahan DR: Measuring performance of brief alcohol counseling in medical settings:a review of the options and lessons from the Veterans Affairs (VA) health care system. Subst Abus. 2007, 28: 133-149. 10.1300/J465v28n04_05.CrossRefPubMed
35.
Wright SM, Craig T, Campbell S, Schaefer J, Humble C: Patient satisfaction of female and male users of Veterans Health Administration services. J Gen Intern Med. 2006, 21 (Suppl 3): S26-32.PubMedCentralCrossRefPubMed
36.
Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A: The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000, 15: 1021-1027. 10.1002/1099-1166(200011)15:11<1021::AID-GPS234>3.0.CO;2-6.CrossRefPubMed
37.
38.
39.
Gask L, Ludman E, Schaefer J: Qualitative study of an intervention for depression among patients with diabetes: how can we optimize patient-professional interaction?. Chronic Illn. 2006, 2: 231-242.PubMed
40.
King N: Template analysis. Qualitative Methods and Analysis in Organizational Research: A Practical Guide. Edited by: Symon G, Cassell C. 1998, Sage, Thousand Oaks, CA, 118-134.
41.
Saitz R, Palfai TP, Freedner N, Winter MR, Macdonald A, Lu J, Ozonoff A, Rosenbloom DL, Dejong W: Screening and brief intervention online for college students: the ihealth study. Alcohol Alcohol. 2007, 42: 28-36.CrossRefPubMed
42.
43.
Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR: AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007, 31: 1208-1217. 10.1111/j.1530-0277.2007.00403.x.CrossRefPubMed
44.
45.
46.
47.
Maurage P, Joassin F, Speth A, Modave J, Philippot P, Campanella S: Cerebral effects of binge drinking: respective influences of global alcohol intake and consumption pattern. Clin Neurophysiol. 2012, 123: 892-901. 10.1016/j.clinph.2011.09.018.CrossRefPubMed
48.
Dawson DA, Grant BF, Li TK: Quantifying the risks associated with exceeding recommended drinking limits. Alcohol Clin Exp Res. 2005, 29: 902-908. 10.1097/01.ALC.0000164544.45746.A7.CrossRefPubMed
49.
Saha TD, Stinson FS, Grant BF: The role of alcohol consumption in future classifications of alcohol use disorders. Drug Alcohol Depend. 2007, 89: 82-92. 10.1016/j.drugalcdep.2006.12.003.PubMedCentralCrossRefPubMed
50.
Cunningham JA, Humphreys K, Kypri K, van Mierlo T: Formative evaluation and three-month follow-up of an online personalized assessment feedback intervention for problem drinkers. J Med Internet Res. 2006, 8: e5-10.2196/jmir.8.2.e5.PubMedCentralCrossRefPubMed
Metadata
Title
Feedback from recently returned veterans on an anonymous web-based brief alcohol intervention
Authors
Gwen T Lapham
Eric J Hawkins
Laura J Chavez
Carol E Achtmeyer
Emily C Williams
Rachel M Thomas
Evette J Ludman
Kypros Kypri
Stephen C Hunt
Katharine A Bradley
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2012
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/1940-0640-7-17

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