Hazardous And Harmful Drinking Among Adults In Liuyang Rural Community:Epidemiological Survey And Intervention Trial

Objective:The objective of this study is to describe the epidemiological characteristics of drinking in Liuyang rural community; to investigate the effect of ASSSIT-linked brief intervention on hazardous and harmful drinkers in rural area; to find the appropriate intervention for rural residents.Method:Multistage clustered random sampling was adopted and8villages was selected as the frame of samples. The subject of this research is18-to60-year-old resident. Alcohol-drinking behavior was evaluated by AUDIT, and the hazardous and harmful drinkers identified by AUDIT was cluster-randomly assigned into experimental and control groups. The risk of alcohol use was evaluated by ASSIST, and then adopted related intervention according to the results. Per-protocol subjects’ analysis (PPS) and intention-to-treat analysis (ITT) were adopted for effectiveness of ASSIST-linked brief intervention, indicators including alcohol abstinence rate, transformation of alcohol use risk, total scores of ASSIST. Satisfaction and follow-up dropout was analysed for acceptability of motivational interviewing, the effectiveness indicators of MI is confidence of alcohol abstinence and readiness to behavioral change.Results:2706residents were included and2052individuals completed the investigation.The response rate is75.8%.40individuals dropped out in the trail, drop-out rate is19.7%.Among the2052individuals, the prevalence of regular alcohol use is23.2%(95%CI:21.3%-25.1%), the prevalence of hazardous and harmful alcohol use is11.5%(95%CI:9.9%-12.9%). There are statistical significant differences among the distribution of different alcohol use status in gender (χ2=469.421,P=0.000), educational status χ2=15.434,P=0.004), marital status (χ2=36.741,P=0.000), working status χ2=83.262, P=0.000), and regions (χ2=12.089,P=0.002). Compared to non-drinkers, hazardous and harmful drinkers were more male χ2=345.861,P=0.000), individuals with unstable marriage (χ2=19.573,P=0.000), individuals with jobs (χ2=56.727,P=0.000), residents in Gaoping (χ2=7.042,P=0.008).The results of ITT for ASSIST-linked brief intervention indicates that alcohol abstinence rate in experimental group is19.1%and control group11.8%, adjusted alcohol abstinence rate in experimental group is1.13times than rate in control group, but there is no statistical significance (P=0.794); the degree of risk reduction is better in experimental group (Z=4.325, P=0.000); the results of GLMMs indicates that there is interactive effect between Group and Time (F=22.807, P=0.000). when fixing Time, baseline ASSIST scores of experimental group is higher than scores of control group (t=4.482, P=0.000), follow-up ASSIST scores is lower than scores in control group (t=-5.330, P=0.000); when fixing Group, follow-up ASSSIT scores is lower than baseline scores inexperimental group (t=8.121, P=0.000), there were no significant differences between follow-up and baseline scores in control group. The results of PPS were consistent with ITT. The analysis of brief MI indicates that confidence scores of alcohol abstinence increased after MI (t=-2.924,P=0.004); the readiness scores of precontemplation decreased(t=5.470,P=0.000) and the readiness scores of contemplation increased(t=-5.494,P=0.000). Ordinal Regression show that gender is statistically significant factors of change of alcohol use risk when experimental factor controlled (OR=9.303)Conclusion:The prevalence of regular alcohol use in Liuyang rural community is23.2%(95%CI:21.3%-25.1%), and the prevalence of hazardous and harmful alcohol use is11.5%(95%CI:9.9%-12.9%). The distribution of alcohol use status is different in gender, educational status, marital status, working status, and regions. Compared to non-drinkers, hazardous and harmful drinkers were more male, individuals with unstable marriage, individuals with jobs, residents in Gaoping. ASSIST-linked brief intervention can effectively reduce the alcohol use risk of hazardous and harmful drinkers in rural area. Motivational interviewing can increase readiness to behavioral change, make hazardous and harmful drinkers realize current problems of alcohol use, and think about the method to overcome the problems. Gneder is a influenceing factor of effectiveness of ASSIST-linked brief intervention. Compared to male, female is more likely to change their risk behavior.