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Comparative Costs of Brief Intervention in US College Students and Air Force Personnel

This study presents the costs of brief interventions for risky drinkers in college students and US Air Force personnel, analyzing the differences in implementation costs and outcomes.

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Comparative Costs of Brief Intervention in US College Students and Air Force Personnel

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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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