Primary Outcome from a Cluster-randomized Trial of Three Formats for Delivering Community Reinforcement and Family Training (CRAFT) to the Significant Others of Problem Drinkers

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2022 May 10

PMID 35538465

Authors

Rikke Hellum

Randi Bilberg

Kjeld Andersen

Gallus Bischof

Morten Hesse

Anette Sogaard Nielsen

Affiliations

Soon will be listed here.

Abstract

Background: Community Reinforcement and Family Training (CRAFT) is an intervention designed to help the concerned significant others (CSOs) of people with alcohol problems who are reluctant to seek treatment. It aims to improve the well-being of CSOs and teach them how to change their behavior in order to positively influence the "identified patient" (IP) to seek treatment.

Methods: The aim of the present pragmatic cluster-randomized trial was to compare the effectiveness of three formats for delivering CRAFT in real life settings: group sessions, individual sessions, and written material only (control group). Eighteen public treatment centers for alcohol use disorders were randomly assigned to deliver CRAFT in one of the three formats as part of their daily clinical routine. CSOs were recruited via pamphlets, general practitioners, and advertisements on social media. Trained clinicians delivered CRAFT in individual and group format, and self-administered CRAFT was limited to handing out a self-help book. The primary outcome was treatment engagement of the IP after three months.

Results: A total of 249 CSOs were found to be eligible and randomly assigned to receive CRAFT delivered in group, individual, or self-administered format. The three-month follow-up rate was 60%. At three months follow-up, 29% (n = 32) of the CSOs who received group/individual CRAFT reported that their IP had engaged in treatment. The corresponding rate for the CSOs who received self-administered CRAFT was lower (15%; n = 5) but did not differ significantly from the other group of CSOs (Odds ratio (OR) = 2.27 (95% CI: 0.80, 6.41)).

Conclusion: We hypothesized that CSOs receiving CRAFT in a group format would improve the most, but although our findings pointed in this direction, the differences were not statistically significant.

Trial Registration: Clinical trials.gov ID: NCT03281057 . Registration date:13/09/2017.

Citing Articles

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Siljeholm O, Eckerstrom J, Molander O, Sundbye J, Hammarberg A BMC Psychiatry. 2024; 24(1):464.

PMID: 38907237 PMC: 11191224. DOI: 10.1186/s12888-024-05913-x.

Potential factors affecting the impact of community reinforcement and family training. Secondary analysis of an RCT.

Hellum R, Bilberg R, Mejldal A, Nielsen A BMC Public Health. 2024; 24(1):213.

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An online self-directed program combining Community Reinforcement Approach and Family Training and parenting training for concerned significant others sharing a child with a person with problematic alcohol consumption: a randomized controlled trial.

Siljeholm O, Lindner P, Johansson M, Hammarberg A Addict Sci Clin Pract. 2022; 17(1):49.

PMID: 36064466 PMC: 9446578. DOI: 10.1186/s13722-022-00332-3.

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