Alcohol use is rapidly increasing in low- and middle-income countries, where it is inexpensive, readily available, poorly regulated, and there are few resources devoted to promoting safe alcohol use. Like many other limited resource settings, there are no treatment facilities or addiction practitioners in the Kilimanjaro region of Tanzania. For many in this setting, they only seek care after an emergency like an acute injury. From our preliminary work, we have seen that 30% of injury patients presenting for care in the Emergency Department report excess alcohol use and are at risk of a repeat injury. A Brief Intervention based on a motivational interviewing framework has been shown to reduce alcohol use and alcohol-related harms. We have translated and adapted a Brief Intervention for alcohol to the Tanzanian context and Swahili language called “Punguza Pombe Kwa Afya Yako (PPKAY)/ Reduce Alcohol for Your Health.” This project will evaluate this intervention in injury patients presenting for care at the Kilimanjaro Christian Medical Center in Moshi, Tanzania. By using innovative adaptive clinical trial methods, we will expedite the development of the most effective way to integrate this intervention into clinical care. By the end of this project, we will have identified the most effective brief intervention components and be able to characterize the intervention’s effect overall. Additionally, we will standardize adaptive trial methods to revolutionize the science of clinical trials for behavioral sciences in low-resource settings.

Start Date: 02/11/2020
End Date: 01/31/2025
Grant: R01AA027512

Conference Presentations:

1. The prevalence of depression and its association with “alcohol use behaviors and consequences”; a community survey from Moshi, Tanzania. Timothy Antipas, Winifrida Mwita, Kim Madundo, Nemes Kimaro, Daniel Masunga,  Joao Vitor de Souza, Joao Ricardo Nickenig Vissoci, Blandina Mmbaga, Catherine Staton. 50th Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society.
2. Reducing Alcohol Use for Emergency Department Patients: A Pragmatic Trial in Moshi, Tanzania. Catherine A. Staton, Linda Minja, Joao Vitor Perez de Souza, John A. Gallis, Pollyana Coelho Pessoa Santos, Mia Buono, Francis Sakita, Judith Boshe, Ashley J. Phillips, Joao Ricardo Nickenig Vissoci, Blandina T. Mmbaga. African Conference on Emergency Medicine, 2024.
3. Reducing Alcohol Use for Emergency Department Patients: A Pragmatic Trial in Moshi, Tanzania. Catherine A. Staton, Linda Minja, Joao Vitor Perez de Souza, John A. Gallis, Pollyana Coelho Pessoa Santos, Mia Buono, Francis Sakita, Judith Boshe, Ashley J. Phillips, Joao Ricardo Nickenig Vissoci, Blandina T. Mmbaga. SAEM Annual Meeting, 2024.
4. Brief Negotiational Intervention for Alcohol Use Disorder: Mental Health Outcomes of Randomized Trial in Tanzania. Joao Vitor Perez de Souza, Linda Minja, Ashley J Phillips, Joao Ricardo Nickenig Vissoci, Blandina T Mmbaga, Catherine A Staton. SAEM Annual Meeting, 2024.
5. Effectiveness of a Brief Negotiational Intervention to Reduce Harmful and Hazardous Alcohol Use in the Emergency Department: A Pragmatic Randomized Adaptive Clinical Trial in Moshi, Tanzania. Catherine A. Staton, Linda Minja, Joao Vitor Perez de Souza, John A. Gallis, Pollyana Coelho Pessoa Santos, Mia Buono, Francis Sakita, Judith Boshe, Ashley Joyce Phillips, Joao Ricardo Nickenig Vissoci, Blandina T. Mmbaga. Inebria, Brief INtervention Conference for WHO for alcohol/Drugs, 2023.