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.
