How Age and Race/Ethnicity Affect the Benefits of Mutual-Help Group Involvement for People With Alcohol Use Disorders: Findings From the PAL Study Cohorts.

BACKGROUND

Mutual-help groups (MHGs) are generally effective for alcohol use disorders (AUDs), but how demographic characteristics affect the benefits of MHG involvement is largely unknown. This longitudinal study of adults with AUD examined whether age and race/ethnicity moderated associations between MHG involvement and alcohol outcomes.

METHODS

Data were from the pooled Peer ALternatives for Addiction 2015 and 2021 Cohorts (N = 1152), which adopted parallel designs and measures. Eligibility criteria included lifetime AUD and past-30-day 12-step and/or second-wave MHG attendance. Participants were surveyed at baseline, 6 months, and 12 months; surveys assessed MHG involvement (5-item scale) and alcohol outcomes (i.e., abstinence, alcohol problems, heavy drinking). Generalized Estimating Equations (GEE) models tested effects for MHG involvement, demographics, and their interactions on outcomes at next survey.

RESULTS

In adjusted models, lagged MHG involvement consistently predicted better outcomes and showed significant interactions with both age (for alcohol problems and heavy drinking) and race/ethnicity (for alcohol problems). Follow-up analyses showed that MHG involvement was protective against alcohol problems for those aged 30-59 and 60+ (ORs = 0.35-0.37, ps < 0.05) but nonsignificant among those 18-29 (OR = 2.39, p = 0.10); similarly, MHG involvement was predictive of fewer drinking days for those 30-59 and 60+ (IRRs = 0.02-0.11, ps < 0.001) but nonsignificant among those 18-29 (IRR = 1.05, p = 0.90). Meanwhile, MHG involvement was protective against alcohol problems for Non-Hispanic White participants (OR = 0.34, p < 0.001) but nonsignificant among those of any other race/ethnicity (OR = 1.71, p = 0.20).

CONCLUSIONS

MHG involvement may confer diminished benefits for young adults and people of color. These subgroups may benefit from tailored meetings and/or alternative activities that foster peer support for recovery.