Computer-Generated Written Behavioral Contracts with Problem Drinkers in Primary Medical Care

Area of Science:

• Primary Care Medicine
• Behavioral Health
• Digital Health Interventions

Background:

• Problem drinking is prevalent in primary care but frequently undetected.
• Physician-led brief interventions show promise but face time constraints.
• Novel approaches are needed to integrate alcohol screening and intervention into routine practice.

Purpose of the Study:

• To evaluate the feasibility, acceptability, and preliminary efficacy of a computer-assisted behavioral contract intervention for problem drinking in primary care.
• To assess the impact of computer-based interventions on alcohol use measures compared to usual care.

Main Methods:

• A randomized pilot study was conducted across eight family medicine practices.
• Patients were screened using the Alcohol Use Disorders Identification Test (AUDIT).
• Eligible patients with positive AUDIT scores were randomized to a computer-assisted behavioral contract intervention or a control group.

Main Results:

• The computer-based intervention was found to be feasible and acceptable to both patients and physicians.
• Effect sizes for the intervention were comparable to physician-based approaches.
• While not statistically significant in this pilot, trends suggested reductions in alcohol use scores in the intervention group.

Conclusions:

• Computer-based interventions offer a practical and efficient method for addressing problem drinking in primary care settings.
• These digital tools can enhance the identification and management of patients with alcohol use concerns.
• Further research is warranted to confirm the efficacy of computer-assisted interventions in reducing problem drinking.