Effectiveness of a nurse-led telephonic brief intervention to reduce risky alcohol use among women in primary care in Brazil: a randomized controlled trial.

BACKGROUND

Despite the increase in alcohol use among women worldwide, evidence on scalable, gender-responsive interventions remains limited, particularly in primary-care settings. This study evaluated the effectiveness of a nurse-delivered, telephonic brief intervention (BI) for reducing risky and harmful alcohol use among women.

METHODS

This randomized controlled trial included 151 women recruited from four primary-care facilities in São Paulo, Brazil, who scored 8-19 on the Alcohol Use Disorders Identification Test (AUDIT). Participants were randomly assigned to an intervention group (IG), which received a nurse-delivered telephone BI, or a control group (CG), which received feedback only. The primary outcome was the change in AUDIT scores assessed longitudinally from baseline through 24 months of follow-up.

RESULTS

In women receiving the telephonic BI, AUDIT scores significantly reduced during the first 6 months postintervention. Although this benefit was attenuated over longer-term follow-up, AUDIT scores in the control group followed an increasing trajectory over time. Race and household income were significantly associated with AUDIT scores; this suggests that socioeconomic factors may influence patterns of alcohol-related risk and intervention outcomes.

CONCLUSIONS

A nurse-delivered telephonic BI produced meaningful short- to medium-term reductions in risky and harmful alcohol use among women in the primary-care setting. The attenuation of effects beyond 6 months suggests that a single brief intervention may be insufficient to sustain behavioral change over the long term and supports the evaluation of booster sessions or other low-intensity follow-up strategies. As a low-cost and scalable approach that can be integrated into routine primary care, telephonic BI may expand access to alcohol-related preventive care for women, particularly in resource-constrained settings.

CLINICAL TRIAL NUMBER: RBR-6msv2kv.