1. Psychosocial interventions for reducing alcohol consumption in sub‐Saharan African settings: a systematic review and meta‐analysis
- Author
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Sileo, Katelyn M, Miller, Amanda P, Wagman, Jennifer A, and Kiene, Susan M
- Subjects
Health Services and Systems ,Public Health ,Health Sciences ,Clinical Research ,Alcoholism ,Alcohol Use and Health ,Prevention ,Substance Misuse ,Clinical Trials and Supportive Activities ,Stroke ,Mental health ,Cancer ,Oral and gastrointestinal ,Cardiovascular ,Good Health and Well Being ,Africa South of the Sahara ,Alcohol Abstinence ,Alcohol Drinking ,Alcoholism ,Humans ,Psychosocial Intervention ,Alcohol ,interventions ,meta-analysis ,psychosocial ,sub-Saharan Africa ,systematic review ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Substance Abuse ,Public health ,Clinical and health psychology - Abstract
BackgroundHarmful alcohol use is a leading cause of morbidity and mortality in sub-Saharan Africa (sSA); however, the effects of non-pharmacological alcohol interventions in this region are unknown.DesignA systematic review and meta-analysis of the available literature through 14 March 2019 was undertaken. Two authors extracted and reconciled relevant data and assessed risk of bias. Meta-analyses were conducted. The review protocol is registered on International Prospective Register of Systematic Reviews (PROSPERO) (CRD42019094509).SettingStudies conducted in sSA were eligible for inclusion.ParticipantsIndividuals participating in interventions aimed at reducing alcohol use.InterventionsRandomized and non-randomized controlled trials testing non-pharmacological interventions (psychosocial and structural) on alcohol consumption in sSA.MeasurementsEligible outcomes included the Alcohol Use Disorders Identification Test (AUDIT) scores; alcohol abstinence; measures of drinking quantity and frequency; and biomarkers of alcohol consumption.FindingsNineteen intervention trials (18 reports) testing psychosocial interventions (no structural interventions included), judged of moderate quality, were included in meta-analyses. A beneficial effect was identified for psychosocial interventions on alcohol abstinence at 3-6 months [odds ratio (OR) = 2.05, 95% confidence interval (CI) = 1.20-3.48, k = 5, n = 2312, I2 = 79%] and 12-60 months (OR = 1.91, 95% CI = 1.40-2.61, k = 6, n = 2737, I2 = 63%) follow-up. There were no statistically significant effects found for AUDIT score [2-3 months: mean differences (MD) = -1.13, 95% CI = -2.60 to 0.34, k = 6, n = 992, I2 = 85%; 6 months: MD = -0.83, 95% CI = -1.92 to 0.26, k = 6, n = 1081, I2 = 69%; 12 months: MD = -0.15, 95% CI = -1.66 to 1.36, k = 4; n = 677; I2 = 75%], drinks per drinking day (3 months: MD = -0.22, 95% CI = -2.51 to 2.07, k = 2, n = 359, I2 = 82%; 6-36 months: MD = -0.09, 95% CI = -0.49 to 0.30, k = 3, n = 1450, I2 = 60%) or percentage of drinking days (3 months: MD = -4.60, 95% = -21.14 to 11.94; k = 2; n = 361; I2 = 90%; 6-9 months: MD = 1.96, 95% CI = -6.54 to 10.46; k = 2; n = 818; I2 = 88%).ConclusionPsychosocial interventions show promise at increasing self-reported alcohol abstinence in sSA, but clinical, methodological and statistical heterogeneity across meta-analytical outcomes suggests that results should be interpreted with caution.
- Published
- 2021