A Multiple Baseline Study of a Brief Alcohol Reduction and Family Engagement Intervention for Fathers in Kenya.

Objective: To evaluate a lay provider-delivered, brief intervention to reduce problem drinking and related family consequences among men in Kenya. The 5-session intervention combines behavioral activation (BA) and motivational interviewing (MI). It integrates family-related material explicitly and addresses central cultural factors through gender transformative strategies. Method: A nonconcurrent multiple-baseline design was used. We initiated treatment with 9 men ages 30 to 48 who were fathers and screened positive for problem drinking; the median Alcohol Use Identification Test score was 17 (harmful range). Participants were randomized to staggered start dates. We measured the primary outcome of weekly alcohol consumption 4 weeks before treatment, during treatment, and 4 weeks posttreatment using the Timeline Followback measure. Secondary outcomes were assessed using a pre–post assessment (1-month) of men's depression symptoms, drinking- and family-related problem behavior, involvement with child, time with family, family functioning, relationship quality (child and partner), and harsh treatment of child and partner. Men, partners, and children (ages 8–17) reported on family outcomes. Results: Eight men completed treatment. Mixed-effects hurdle model analysis showed that alcohol use, both number of days drinking and amount consumed, significantly decreased during and after treatment. Odds of not drinking were 5.1 times higher posttreatment (95% CI [3.3, 7.9]). When men did drink posttreatment, they drank 50% less (95% CI [0.39, 0.65]). Wilcoxon signed-ranks test demonstrated pre–post improvements in depression symptoms and family related outcomes. Conclusion: Results provide preliminary evidence that a BA-MI intervention developed for lay providers may reduce alcohol use and improve family outcomes among men in Kenya. What is the public health significance of this article?: There are few interventions that aim to reduce men's alcohol use and the problems it causes in families. This is especially true in low-resource settings, including Kenya, that do not have adequate mental health services. In this study, a brief intervention delivered by nonprofessionals reduced alcohol use among fathers in Kenya and led to promising changes in family relationships. [ABSTRACT FROM AUTHOR]

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