Title

Screening and Brief Intervention for Patients with Tobacco and At-risk Alcohol Use in a Dental Setting

Date of Completion

January 2011

Keywords

Health Sciences, Public Health|Psychology, Behavioral Sciences

Degree

Ph.D.

Abstract

As a secondary prevention effort, there has been a sizeable growth in research related to the Screening and B rief Intervention (SBI) concept as it applies to medical patients who are at risk of health problems because of their use of alcohol, tobacco and other drugs. As a public health initiative, the aim of SBI is to improve a community's health by reducing the prevalence of adverse consequences of substance misuse by linking early intervention and referral to specialized treatment. Despite the relevance of SBI to the prevention of dental pathology, particularly with tobacco and at-risk alcohol use, there has been less attention to the determination of its effectiveness in dental settings. Further, most SBI research and dissemination efforts have focused on the treatment of single risk factors despite the fact that use of these substances tends to co-occur. There is also debate about the optimal timing of the interventions, whether to intervene simultaneously or sequentially, and whether improvement in one behavior tends to be offset by deterioration of the other. This dissertation was designed to test the efficacy of SBI practices aimed at dental patients who were both smokers and at-risk drinkers. Participants (N=288) were randomized into four experimental conditions to (1) test the efficacy of comparative interventions for tobacco and at-risk alcohol users when delivered separately and in combined forms, and (2) to compare the effects of sequential vs. simultaneous interventions. The results indicated that individuals in each of three active brief intervention (BI) groups (Alcohol BI, Tobacco BI, Combined Alcohol and Tobacco BI) significantly reduced their self-reported drinks per week and cigarettes per day compared with those in the wait-list control group. There was no advantage to the combined versus single-substance focused interventions as individuals changed both behaviors regardless of the treatment intervention received. No significant differences in self-reported drinks per week or cigarettes per day were found between those receiving simultaneous versus the sequential interventions, nor were there differences between those receiving Tobacco BI first versus Alcohol BI first at baseline. The findings have implications for the design of BIs aimed at multiple substance use. ^