Effectiveness of a dental practice-based brief screening and intervention protocol for heavy drinking

Purpose: Screening, Brief Intervention, Referral, and Treatment (SBIRT) protocols for heavy drinkers, effective in medical settings, have not been examined in dental settings. This paper presents RCT effectiveness results for a new dental hygienist-delivered SBI incorporating motivational interviewing techniques and personalized normative feedback for heavy drinkers in dental settings. Methods: A RCT was conducted using N = 103 adult (age 21 – 55) patients from randomized Intervention (7) and Control (6) dental practices, meeting criteria of 1+ binge drinking episodes in the past 30 days. Data were gathered via telephone interviews at baseline, 3- and 6-months on alcohol outcomes (Total Drinks/Week) as well as Individual- and Practice-level covariates. Data from 40 Intervention (78% follow-up) and 42 Control (79% follow-up) subjects with complete data were analyzed with normal mixed models using SAS PROC MIXED, adjusting for individual and practice-level covariates. Results: A-priori contrasts compared total weekly consumption means across waves (baseline vs. 3-month; baseline vs. 6-month) within Intervention and Control groups. Analyses showed significant (p< .05) declines in weekly consumption at 3 months among heavier drinkers (13+ drinks/wk) in both groups. However, declines continued among Intervention subjects by 6 months (42.6% decline from baseline; ~ 8.5 drinks/week; d=1.33); whereas Control group drinking leveled off (20.8% decline from baseline; ~4.4 drinks/week; d= .52). Conclusions: Results provide preliminary support for the intervention. Declines in total drinks/week by 6 months were twice as large for heavy drinkers in Intervention than Control groups, reflecting a 4 drink per week greater decline among heavy-drinking Intervention subjects.