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Lockhart J, Knapp MB, Feehan AK, Latimer S, Walter A, Craft BN, Quantz YP, Frugé H, Sylvester Terry M, Arceneaux EE, Kimball M. Implementation and Process Evaluation of Alcohol Free for 40: Community-Based Programming to Reduce Alcohol Consumption. Health Promot Pract 2024; 25:436-444. [PMID: 36600627 DOI: 10.1177/15248399221142633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Alcohol consumption is known to increase risk for chronic diseases and other negative health outcomes. Abstinence, even temporary, from alcohol consumption can have positive health impacts. In this article, we describe implementation and process evaluation of Ochsner Eat Fit's Alcohol Free for 40 (AFF40), an annual, 40-day voluntary alcohol abstinence challenge that takes place in six regions of Louisiana. Participants are challenged to abstain from alcohol consumption for 40 days to promote behavior change. To support participants' success, staff conduct pre and post metrics (physical and laboratory) and host community-based events to encourage replacement behaviors. Process evaluation included measures of reach, recruitment, dose, and fidelity through tracking of participant registrations, an exit survey, media analytics, and program activity logs. In 2021, 493 participants enrolled in AFF40, with 347 completing laboratory metrics and 298 completing physical metrics. Majority of exit survey respondents (74.5%) reported no alcohol consumption during the 40-day challenge and that they planned to participate in AFF40 2022 (90.9%). The Eat Fit team documented moderate engagement (48.7% of enrolled participants) in program events. Social and digital impressions and page views recorded 23,591 hits while print media resulted in over 750,000 impressions. AFF40 has shown to be highly engaging for participants and effective in supporting temporary abstinence from alcohol. Incorporating stronger methods and evaluation will enhance future program implementation and community impact. Lessons learned and implications for practice are transferable to other community-based efforts to reduce alcohol consumption.
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Affiliation(s)
| | - Megan B Knapp
- Xavier University of Louisiana, New Orleans, LA, USA
| | - Amy K Feehan
- Ochsner Clinic Foundation, New Orleans, LA, USA
- The University of Queensland and Ochsner Clinical School, New Orleans, LA, USA
| | | | - Anna Walter
- Ochsner LSU Health Shreveport-Academic Medical Center, Shreveport, LA, USA
| | | | - Yvette P Quantz
- Ochsner Lafayette General Medical Center, Lafayette, LA, USA
| | - Hope Frugé
- Ochsner LSU Health Shreveport-Monroe Medical Center, Monroe, LA, USA
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Fahoum K, Shen NT, Basu E, Lee J, Kaplan A, Salajegheh A, Rosenblatt R, Jesudian A, Lucero C, Fortune B, Safford M, Brown RS. Prognostic Factors in Alcohol-associated Liver Disease Patients Presenting With First Evidence of Ascites. J Clin Gastroenterol 2024; 58:200-206. [PMID: 37126326 DOI: 10.1097/mcg.0000000000001836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/02/2023] [Indexed: 05/02/2023]
Abstract
GOALS To identify factors associated with transplantation and death in alcohol-associated liver disease (ALD) patients presenting with first evidence of ascites. BACKGROUND Ascites development is a poor prognostic sign for patients with cirrhosis. Among ALD patients, the baseline factors at time of ascites development that are associated with eventual transplantation or death are currently unknown. STUDY Adult patients with ascites in the "Evaluating Alcohol Use in Alcohol-related Liver Disease Prospective Cohort Study" (NCT03267069 clinicaltrials.gov) were identified from 2016 to 2020. Demographic, clinical, and laboratory factors at initial ascites presentation were identified as potential predictors of transplant and death as competing risks. RESULTS A total of 96 patients were identified. Median (interquartile range) follow-up time was 2.00 years (0.87 to 3.85). By last follow-up, 34/96 patients had been transplanted (35.4%) and 11/96 had died (11.4%). Prognostic factors for transplant included age per decade [hazard ratio (HR): 0.52 (95% CI, 0.33 to 0.83)], employed status [HR: 0.35 (95% CI, 0.14 to 0.90)], and sodium [HR: 0.94 (95% CI, 0.90 to 0.99)], whereas prognostic factors for death were body mass index [HR: 1.11 (95% CI, 1.00 to 1.22)], Charlson index [HR: 2.14 [95% CI, 1.13 to 4.08]), Maddrey Discriminant Function >32 (HR: 5.88 (95% CI, 1.18, 29.39)], aspartate aminotransferase [HR: 0.99 (95% CI, 0.98 to 0.997)], and a prior 12-month abstinence period [HR: 5.53 (95% CI, 1.10 to 27.83)], adjusted for age, sex, and ALD subcategory. CONCLUSIONS Several factors at initial ascites presentation are associated with increased risk of transplantation or death and validation in larger cohorts will allow for improved risk stratification for ALD patients.
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Affiliation(s)
| | | | | | - Jihui Lee
- Departments of Population Health Sciences
| | | | | | | | | | | | | | - Monika Safford
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY
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Butters A, Kersbergen I, Holmes J, Field M. Temporary abstinence challenges: What do we need to know? Drug Alcohol Rev 2023; 42:1087-1091. [PMID: 36808783 PMCID: PMC10947026 DOI: 10.1111/dar.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/22/2023]
Abstract
Participation in temporary abstinence challenges (TAC) continues to increase with campaigns established in several countries. Temporarily abstaining from alcohol as part of such challenges is associated with ongoing benefits including reductions to alcohol consumption after the TAC. We identified three research priorities regarding TACs which are outlined in this paper. First, the role of temporary abstinence itself is unclear with post-TAC reductions in alcohol consumption still apparent among participants who do not remain fully abstinent throughout the challenge. It is necessary to establish to what degree temporary abstinence itself, rather than the combination of abstinence and the additional supports provided by TAC organisers (e.g., mobile applications, online support groups), contributes to changes in consumption after the TAC. Second, little is known about the psychological changes underlying these changes in alcohol consumption, with conflicting evidence as to whether increases in someone's belief in their ability to avoid drinking mediates the association between participation in a TAC and reductions in consumption afterwards. Other potential psychological and social mechanisms of change have been subjected to little, if any, scrutiny. Third, evidence of increased consumption post-TAC among a minority of participants indicates a need to establish for whom or in what circumstances participation in a TAC may result in unintended negative consequences. Focussing research in these areas would increase the confidence with which participation could be encouraged. It would also enable campaign messaging and additional supports to be prioritised and tailored to be as effective as possible in facilitating long-term change.
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Affiliation(s)
- Anna Butters
- Department of PsychologyUniversity of SheffieldSheffieldUK
| | - Inge Kersbergen
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - John Holmes
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Matt Field
- Department of PsychologyUniversity of SheffieldSheffieldUK
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Weijers G, Munsterman ID, Thijssen JM, Kuppeveld H, Drenth JPH, Tjwa ETTL, de Korte CL. Noninvasive Staging of Hepatic Steatosis Using Calibrated 2D US with Liver Biopsy as the Reference Standard. Radiology 2023; 306:e220104. [PMID: 36255308 DOI: 10.1148/radiol.220104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Accumulation of lipid in the liver (ie, hepatic steatosis) is the basis of nonalcoholic fatty liver disease (NAFLD). Asymptomatic steatosis can lead to nonalcoholic steatohepatitis and downstream complications. Purpose To assess the diagnostic performance of calibrated US (CAUS) as a method for detection and staging of hepatic steatosis in comparison with liver biopsy. Materials and Methods Two-dimensional US images in 223 consecutive patients who underwent US-guided liver biopsy from May 2012 to February 2016 were retrospectively analyzed by two observers using CAUS. CAUS semiautomatically estimates echo-level and texture parameters, with particular interest in the residual attenuation coefficient (RAC), which is the remaining steatosis-driven attenuation obtained after correction of the beam profile. Data were correlated with patient characteristics and histologically determined steatosis grades and fibrosis stages. The data were equally divided into training and test sets to independently train and test logistic regression models for detection (>5% fat) and staging (>33% and >66% fat) of hepatic steatosis by using area under the receiver operating characteristic curve (AUC) analysis. Results A total of 195 patients (mean age, 50 years ± 13 [SD]; 110 men) were included and divided into a training set (n = 97 [50%]) and a test set (n = 98 [50%]). The average CAUS interobserver correlation coefficient was 0.95 (R range, 0.87-0.99). The best correlation with steatosis was found for the RAC parameter (R = 0.78, P < .01), while no correlation was found for fibrosis (R = 0.14, P = .054). Steatosis detection using RAC showed an AUC of 0.97 (95% CI: 0.94, 1.00), and the multivariable AUC was found to be 0.97 (95% CI: 0.95, 1.00). The predictive performance for moderate and severe hepatic steatosis using RAC was 0.93 (95% CI: 0.88, 0.98) and 0.93 (95% CI: 0.87, 0.98), respectively. Conclusion The calibrated US parameter residual attenuation coefficient detects and stages steatosis accurately with limited interobserver variability, and performance is not hampered by the presence of fibrosis. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Grant in this issue.
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Affiliation(s)
- Gert Weijers
- From the Medical UltraSound Imaging Center (MUSIC), Department of Medical Imaging, Radboud Institute for Health Sciences (G.W., J.M.T., H.K., C.L.d.K.), and Department of Gastroenterology and Hepatology (I.D.M., J.P.H.D., E.T.T.L.T.), Radboud University Medical Center, Geert Grootepleinzuid 10, Nijmegen 6500 HB, the Netherlands
| | - Isabelle D Munsterman
- From the Medical UltraSound Imaging Center (MUSIC), Department of Medical Imaging, Radboud Institute for Health Sciences (G.W., J.M.T., H.K., C.L.d.K.), and Department of Gastroenterology and Hepatology (I.D.M., J.P.H.D., E.T.T.L.T.), Radboud University Medical Center, Geert Grootepleinzuid 10, Nijmegen 6500 HB, the Netherlands
| | - Johan M Thijssen
- From the Medical UltraSound Imaging Center (MUSIC), Department of Medical Imaging, Radboud Institute for Health Sciences (G.W., J.M.T., H.K., C.L.d.K.), and Department of Gastroenterology and Hepatology (I.D.M., J.P.H.D., E.T.T.L.T.), Radboud University Medical Center, Geert Grootepleinzuid 10, Nijmegen 6500 HB, the Netherlands
| | - Hans Kuppeveld
- From the Medical UltraSound Imaging Center (MUSIC), Department of Medical Imaging, Radboud Institute for Health Sciences (G.W., J.M.T., H.K., C.L.d.K.), and Department of Gastroenterology and Hepatology (I.D.M., J.P.H.D., E.T.T.L.T.), Radboud University Medical Center, Geert Grootepleinzuid 10, Nijmegen 6500 HB, the Netherlands
| | - Joost P H Drenth
- From the Medical UltraSound Imaging Center (MUSIC), Department of Medical Imaging, Radboud Institute for Health Sciences (G.W., J.M.T., H.K., C.L.d.K.), and Department of Gastroenterology and Hepatology (I.D.M., J.P.H.D., E.T.T.L.T.), Radboud University Medical Center, Geert Grootepleinzuid 10, Nijmegen 6500 HB, the Netherlands
| | - Eric T T L Tjwa
- From the Medical UltraSound Imaging Center (MUSIC), Department of Medical Imaging, Radboud Institute for Health Sciences (G.W., J.M.T., H.K., C.L.d.K.), and Department of Gastroenterology and Hepatology (I.D.M., J.P.H.D., E.T.T.L.T.), Radboud University Medical Center, Geert Grootepleinzuid 10, Nijmegen 6500 HB, the Netherlands
| | - Chris L de Korte
- From the Medical UltraSound Imaging Center (MUSIC), Department of Medical Imaging, Radboud Institute for Health Sciences (G.W., J.M.T., H.K., C.L.d.K.), and Department of Gastroenterology and Hepatology (I.D.M., J.P.H.D., E.T.T.L.T.), Radboud University Medical Center, Geert Grootepleinzuid 10, Nijmegen 6500 HB, the Netherlands
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de Ternay J, Leblanc P, Michel P, Benyamina A, Naassila M, Rolland B. One-month alcohol abstinence national campaigns: a scoping review of the harm reduction benefits. Harm Reduct J 2022; 19:24. [PMID: 35246148 PMCID: PMC8895623 DOI: 10.1186/s12954-022-00603-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/17/2022] [Indexed: 12/29/2022] Open
Abstract
Over the last decade, one-month alcohol abstinence campaigns (OMACs) have been implemented within the general population in an increasing number of countries. We identified the published studies reporting data on OMACs to explore the following aspects: profile of participants, rates and factors associated with the completion of the abstinence challenge, and outcomes and harm reduction benefits in participating in the challenges. We screened 322 records, including those found in the grey literature, and reviewed 6 studies and 7 Dry July Annual Reports. Compared to non-participating alcohol users, participants were more likely to be female, have a higher income, and a higher level of education. They were heavier drinkers and were more concerned by the consequences of alcohol on health and by their health in general. Participants who achieved the one-month abstinence challenge were lower drinkers and more likely to have registered on the campaign-related Internet communities. Both successful and unsuccessful participants frequently reported health benefits, including sleep improvement and weight loss. Successful participants were more likely to durably change their alcohol drinking habits. Overall, OMACs provide short- or mid-term harm reduction benefits for both successful and unsuccessful participants. Findings were limited by the paucity of studies, their observational nature, and heterogeneity in the features of the different national campaigns, which would probably gain in enhanced internationalization.
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Affiliation(s)
- Julia de Ternay
- Service d'Addictologie, Hôpital Édouard Herriot, Hospices Civils de Lyon, 5, Place d'Arsonval, Pavillon K, 69003, Lyon, France.
| | - Pierre Leblanc
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Hospices Civils de Lyon, Lyon, France
| | - Philippe Michel
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Hospices Civils de Lyon, Lyon, France
| | - Amine Benyamina
- Hôpital Paul Brousse, AHPH, Université Paris-Sud, Paris, France.,Unité Psychiatrie-Comorbidités-Addictions (PSYCOMADD), APHP, Université Paris-Sud, Paris, France
| | - Mickael Naassila
- Groupe de Recherche sur l'Alcool et les Pharmacodépendances (GRAP), INSERM U1247, Université de Picardie Jules Verne, Amiens, France
| | - Benjamin Rolland
- Service d'Addictologie, Hôpital Édouard Herriot, Hospices Civils de Lyon, 5, Place d'Arsonval, Pavillon K, 69003, Lyon, France.,Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France.,CRNL PSYR2, Inserm U1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Bron, France
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6
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Albertella L, Vd Hooven J, Bovens R, Wiers RW. Reward-related attentional capture predicts non-abstinence during a one-month abstinence challenge. Addict Behav 2021; 114:106745. [PMID: 33310691 DOI: 10.1016/j.addbeh.2020.106745] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND While it is generally recognised that cognitive attributes can predict behaviour change outcomes in the field of addiction this question is typically studied in treatment seeking samples (to predict treatment outcomes and relapse). However the concept of behaviour change applies to the entire spectrum of addiction-like behaviours and initiatives such as temporary abstinence challenges offer insight into an understudied but equally relevant point of the spectrum. Thus the current study examined whether reward-related attentional capture predicted non-abstinence during IkPas (the Dutch national dry January campaign translated: NoThanks!). METHOD Participants included 1130 adults who had complete baseline data and performed above chance level on the cognitive task. Of these 683 participants completed the post-IkPas assessment and were included in the primary analysis. A binary logistic regression examined whether reward-related attentional capture predicted drinking during IkPas controlling for alcohol use at baseline (among other potential confounders). RESULTS Participants who showed greater reward-related attentional capture before IkPas were more likely to not remain abstinent from drinking during IkPas (p = .014). Findings were replicated using multiple imputation to replace missing data (p = .013). CONCLUSION These findings provide important insights into the cognitive mechanisms that support successful behaviour change such as the ability to ignore task-irrelevant reward cues and may inform the development of tools that individuals could use to maximise their likelihood of achieving successful behaviour change.
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Affiliation(s)
- Lucy Albertella
- BrainPark Turner Institute for Brain and Mental Health Monash University, Victoria, Australia.
| | - Jessie Vd Hooven
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, the Netherlands
| | - Rob Bovens
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, the Netherlands
| | - Reinout W Wiers
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, the Netherlands; Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology and Center for Urban Mental Health University of Amsterdam, the Netherlands
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de Visser RO, Piper R. Short- and Longer-Term Benefits of Temporary Alcohol Abstinence During ‘Dry January’ Are Not Also Observed Among Adult Drinkers in the General Population: Prospective Cohort Study. Alcohol Alcohol 2020; 55:433-438. [DOI: 10.1093/alcalc/agaa025] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/15/2020] [Accepted: 03/18/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aims
The alcohol abstinence challenge ‘Dry January’ continues to grow, but there is a lack of knowledge of how Dry January participants compare to the general population. There is also a need to determine whether benefits experienced by Dry January participants are unique to that group or are also observed among other people.
Methods
We conducted a prospective cohort study using online questionnaires in early January, February and August 2019. We compared 1192 Dry January participants and 1549 adult drinkers who did not attempt to abstain from alcohol. Key outcomes were self-rated physical health, psychological well-being (Warwick–Edinburgh Mental Well-Being Scale), control over drinking (Drink Refusal Self-Efficacy Scale (DRSE)) and alcohol intake (Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) subscale). Baseline differences in demographic and alcohol consumption variables were included as covariates in between-group analyses.
Results
Dry January participants had higher SES, poorer well-being, higher AUDIT-C scores and less control over their drinking than the general population. Beneficial changes in health, WEMWBS, DRSE and AUDIT-C observed among people completing Dry January were not observed among other adult drinkers.
Conclusions
Dry January appears to attract people who are heavier drinkers than the general population and who are more concerned about their alcohol intake. Completion of Dry January is associated with short- and longer-term benefits to well-being that are not observed in the general population.
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de Visser RO, Nicholls J. Temporary abstinence during Dry January: predictors of success; impact on well-being and self-efficacy. Psychol Health 2020; 35:1293-1305. [DOI: 10.1080/08870446.2020.1743840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Pados E, Kovács A, Kiss D, Kassai S, Kapitány-Fövény M, Dávid F, Karsai S, Terebessy A, Demetrovics Z, Griffiths MD, Rácz J. Voices of Temporary Sobriety - A Diary Study of an Alcohol-Free Month in Hungary. Subst Use Misuse 2020; 55:839-850. [PMID: 31900020 DOI: 10.1080/10826084.2019.1705861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Temporary abstinence from alcohol as a challenge could support self-knowledge, self-care, and health consciousness in several ways. Objectives: The present study explored Dry November participants' personal experiences and coping strategies during a one-month abstinence period. The research is embedded in the Hungarian context of drinking habits, culture, society, and alcohol policy. Methods: This qualitative study comprised the thematic analysis of 23 participants' diaries, reported twice a week for 30 days (in November 2017), to identify and understand the common experiences of temporary sobriety. Results: Three main themes emerged from the analysis: challenge, community, and relationship toward alcohol and abstinence. Results showed that there are no categorical differences between successful and non-successful participants. Conclusions: The present research demonstrated that during the challenge, rather than simply saying 'no' to alcohol, participants utilized other refusal strategies to avoid social confrontation.
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Affiliation(s)
- Eszter Pados
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Asztrik Kovács
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Dániel Kiss
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Szilvia Kassai
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Máté Kapitány-Fövény
- Faculty of Health Sciences, Department of Addictology, Semmelweis University, Budapest, Hungary.,Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Ferenc Dávid
- Blue Point Drug Counselling and Outpatient Centre, Budapest, Hungary
| | - Szilvia Karsai
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - András Terebessy
- Faculty of Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, UK
| | - József Rácz
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Faculty of Health Sciences, Department of Addictology, Semmelweis University, Budapest, Hungary.,Blue Point Drug Counselling and Outpatient Centre, Budapest, Hungary
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