AIM To test the effectiveness of a motivational interviewing (MI) intervention using the mobile phone among adults with alcohol use problems. DESIGN A randomized clinical trial of mobile MI and standard in-person MI with 1- and 6-month follow-up, including a one-month waitlist control followed by mobile MI. SETTING A primary health center in rural Kenya. PARTICIPANTS Three hundred adults screening positive for alcohol use problems were randomized and received immediate mobile MI (n=89), in-person MI (n=65), or delayed mobile MI (n=76) for waitlist controls one month after no treatment, with 70 unable to be reached for intervention. INTERVENTION AND COMPARATOR One MI session was provided either immediately by mobile phone, in-person at the health center, or delayed by one month and then provided by mobile phone. MEASUREMENTS Alcohol use problems were repeatedly assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the shorter AUDIT-C. The primary outcome was difference in alcohol score one month after no intervention for waitlist control vs. one month after MI for mobile MI. The secondary outcomes were difference in alcohol score for in-person MI vs. mobile MI one and six months after MI. FINDINGS For our primary outcome, average AUDIT-C scores were nearly three points higher (Difference=2.88, 95% CI: 2.11, 3.66) for waitlist controls after one month of no intervention vs. mobile MI one month after intervention. Results for secondary outcomes supported the null hypothesis of no difference between in-person and mobile MI at one month (Bayes Factor=.22) but were inconclusive at six months (Bayes Factor=.41). CONCLUSION Mobile phone-based motivational interviewing may be an effective treatment for alcohol use problems among adults visiting primary care in Kenya. Providing mobile motivational interviewing may help clinicians in rural areas reach patients needing treatment for alcohol use problems.

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肯尼亚关于酒精使用问题的手机动机访谈的随机临床试验

目的 测试在有酒精使用问题的成年人中使用手机进行动机性访谈 (MI) 干预的有效性。设计 一项关于移动 MI 和标准面对面 MI 的随机临床试验，随访 1 个月和 6 个月，包括一个月的等待名单对照，然后是移动 MI。在肯尼亚农村设立初级卫生中心。参与者 酒精使用问题筛查呈阳性的 300 名成人随机接受即时移动 MI (n=89)、面对面 MI (n=65) 或延迟移动 MI (n=76) 以进行等待名单对照，一个月后不接受治疗，无法联系到 70 进行干预。干预和比较器 一次 MI 会话通过手机立即提供，在健康中心亲自提供，或延迟一个月然后通过手机提供。测量 使用酒精使用障碍识别测试 (AUDIT) 和较短的 AUDIT-C 反复评估酒精使用问题。主要结果是等待名单控制无干预后 1 个月与移动 MI 后 1 个月酒精评分的差异。次要结果是在 MI 后 1 个月和 6 个月，面对面 MI 与移动 MI 的酒精评分差异。结果 对于我们的主要结果，无干预一个月后的候补名单对照与干预一个月后的移动 MI 的平均 AUDIT-C 得分高出近三分（差异 = 2.88，95% CI：2.11，3.66）。次要结果的结果支持一个月时面对面和移动 MI 之间没有差异的零假设（贝叶斯因子 = .22），但在六个月时不确定（贝叶斯因子 = .41）。结论 基于手机的动机性访谈可能是解决肯尼亚初级保健机构成年人饮酒问题的有效方法。提供移动动机访谈可以帮助农村地区的临床医生接触需要治疗酒精使用问题的患者。