Prevention of Alcohol-related Incidents in the U.S. Air Force: Results From a Cluster Randomized Trial

• Published in: Military medicine 2023-07, Vol.188 (7-8), p.e1874-e1881
• Main Authors: Little, Melissa A, Klesges, Robert C, Mallawaarachchi, Indika, McMurry, Timothy, Pebley, Kinsey, McDevitt-Murphy, Meghan, Murphy, James, Wayne Talcott, G
• Format: Article
• Language: English
• Subjects: Alcohol use; Breath tests; Intervention; Military personnel
• ISSN: 0026-4075; 1930-613X; 1930-613X
• DOI: 10.1093/milmed/usab489

ABSTRACT Background Alcohol misuse poses significant public health concerns in the U.S. Military. An Alcohol Misconduct Prevention Program (AMPP), which includes a brief alcohol intervention (BAI) session, plus random breathalyzer program, has been shown to reduce alcohol-related incidents (ARIs) among Airmen undergoing training. Purpose The current study sought to examine whether a booster BAI administered at the end of Airmen’s training reduced ARIs out to a 1-year follow-up. Methods Participants were 26,231 U.S. Air Force Technical Trainees recruited between March 2016 and July 2018. Participants were cluster randomized by cohort to two conditions: AMPP + BAI Booster or AMPP + Bystander Intervention. The primary analysis was a comparison of the interventions’ efficacies in preventing Article 15 ARIs at a 1-year follow-up, conducted using a generalized estimating equations logistic regression model controlling for covariates. Results There was no significant difference by condition in Article 15 ARIs at the 1-year follow-up (P = .912). Conclusions Findings suggest that a booster may not be necessary to produce maximum effects beyond the initial AMPP intervention. It is also possible that alcohol behaviors changed as a result of the intervention but were not captured by our outcome measures. Future research should consider alternative outcomes or participant-tracking measures to determine whether a different or more intensive BAI booster is effective. The majority of Article 15 ARIs were for underage drinking; therefore, developing an intervention focused on this problem behavior could lead to large reductions in training costs in the military.