The impact and experience of a culturally adapted brief intervention for harmful alcohol use in an emergency care setting (PPKAY: Punguza Pombe Kwa Afya Yako): A case series.

BACKGROUND

Harmful alcohol use is widespread in Tanzania, yet specialized resources to address this remain limited. This case series explores outcomes of three individuals who received a culturally-adapted brief intervention to reduce harmful alcohol use in an emergency department in Kilimanjaro, Tanzania.

METHODS

The PPKAY intervention is a 15-minute nurse-delivered motivational interview for adults with acute (< 24 h) injuries, with an Alcohol Use Disorder Identification Test (AUDIT) of 8 or above or self-reported drinking alcohol within 6 hours of injury. The primary outcome was participants' experience of the intervention. Secondary outcomes included number of binge drinking days in the prior month; depression, measured using the Patient Health Questionnaire-9 (PHQ-9); and alcohol-related consequences, measured by the Drinker Inventory of Consequences (DrInC). All outcomes were reported from baseline and at 3-month timepoints. Experience with the intervention was assessed with open-ended questions at a three-month post-intervention survey.

RESULTS

Participants reported fewer binge drinking days, improved self-efficacy in managing triggers, reduced alcohol-related consequences, remission of depression, and strengthened interpersonal relationships. These were corroborated by significantly lower AUDIT, PHQ-9, and DrInC scores. One participant was not able to meet his drinking reduction target, accompanied by an avoidance of discussing interpersonal consequences of alcohol.

CONCLUSIONS

Our findings underscore the importance of integrated and targeted early screening and intervention in resource-limited emergency care settings. The narratives emphasize how a brief negotiational intervention can equip individuals with practical strategies to minimize harmful alcohol consumption. Further research is recommended to validate these outcomes in larger cohorts and diverse settings.