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Presented by Alexander J. Cowell

Brief Intervention Costs in Two Populations in the United States: College Students and US Air Force Personnel. Presented by Alexander J. Cowell. Presented at INEBRIA, Gateshead, UK October 9, 2009. Acknowledgments. PI for both is Dr. Janice Brown Air Force

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Presented by Alexander J. Cowell

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  1. Brief Intervention Costs in Two Populations in the United States: College Students and US Air Force Personnel Presented by Alexander J. Cowell Presented at INEBRIA, Gateshead, UK October 9, 2009

  2. Acknowledgments • PI for both is Dr. Janice Brown • Air Force • Many colleagues and collaborators at RTI and US Air Force • Yuta Masuda and Brendan Wedehase • Funding from Department of Defense W81XWH-04-1-0072 • College • Yuta Masuda and Brendan Wedehase • Many colleagues and collaborators at RTI and study site • National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health R01 AA014374-02

  3. Background • Intervene with risky drinkers • Both populations have problem drinkers • Young adults aged 18 to 25 are the age group with the highest rates of heavy alcohol use • Air Force population: In 2005, 10.3% of Air Force personnel in the sample reported heavy drinking over the past 30 days (Bray and Hourani, 2007) • College population: In 2001, 44% of college students in the sample reported binge drinking (Wechsler et al., 2002) • Little known about cost of MI for these groups

  4. Air Force 4 bases 3 study arms Treatment as Usual (TAU) A full day of alcohol education and information sessions 6-10 hour session Group MI (GMI) MI in a group of 3 – 5 2-2.5 hour session Individual MI (IMI) Usual MI 0.5-1.5 hour session College 1 university campus 4 study arms Assessment Only No treatment Feedback Feedback report based on participant drinking habits MI Only MI with Feedback Methods: Treatment Groups

  5. Methods: Main Study • Eligibility • Preliminary screening • Air Force: referral • College: at recruitment • AUDIT or other screening • Exclude dependents • Include risky drinkers • Outcomes • Survey • Number of drinking days in past 30 days • Number of heavy episodic drinking days in past 30 days • Average drinks per drinking day

  6. Methods: Economic Evaluation • Cost Perspective • Air Force and client • College • Cost = P * Q • Price • From various records • Quantity • Detailed records of activities • Log kept by interventionists

  7. RESULTS Air Force

  8. Startup Costs (€2009)

  9. Time per Intervention (minutes)

  10. Cost per Client of Providing the Intervention (€2009)

  11. Cost per Client of Client’s Time and Expenses (€2009)

  12. Total Cost (€2009)

  13. RESULTS College

  14. Trainee Time

  15. Startup Costs (€2009)

  16. Time per Intervention (minutes)

  17. Cost per Intervention (€2009)

  18. Cost per Intervention Sensitivity Analysis (€2009)

  19. Comparing the Two Studies

  20. Comparison of Start-up Costs

  21. Comparison of MI Cost • Average length of MI • Air Force MI: 80 minutes • College MI: 33 minutes

  22. Discussion and Conclusion • Similar start-up costs • Different implementation costs • Next Step: Cost-Effectiveness • Evidence for both studies of improvement in outcome • Air Force • Outcome study has low n and high attrition • If value of client time is included, TAU is not likely to be cost-effective • College • Outcome study has high n and low attrition • Sensitivity of conclusions to assumptions made in “feedback only” arm may well affect cost-effectiveness conclusions

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