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<p>Problem drinking accounts for 9.6% of disability-adjusted life years worldwide,
and disproportionally affects men with disabling physical, psychological, and behavioral
consequences. These can lead to a cascade of negative effects on men’s families, with
documented ties to intimate partner violence (IPV) and child maltreatment. These problems
are often exacerbated where poverty rates are high, including low and middle-income
countries (LMICs). To begin to address intersecting risks, two studies were completed.
Study 1 aimed to develop an alcohol reduction and family engagement intervention for
fathers with problem drinking in Kenya using a mixed-method, multi-step process, as
well as evaluate its feasibility and acceptability among fathers and lay counselors
using process data from the pilot trial. Study 2 aimed to pilot and examine the initial
impact of the intervention on alcohol use and related problems in the family using
a non-concurrent multiple baseline single case series design. Study 1 resulted in
a 5-session family-focused intervention rooted in behavioral activation (BA), motivational
interviewing (MI), and gender transformative strategies (GTS) modified for context-specific
goal and streamlined for lay providers. Results indicated the treatment was feasible
and acceptable to fathers with high attendance, high satisfaction, acceptance of implementation
strategies, and perceived program helpfulness. Counselors with no prior formal training
in mental health were able to recruited and trained as counselors and demonstrated
reached high rates of intervention fidelity implemented with good quality and high
general counselor competency. In Study 2, quantitative and qualitative findings demonstrated
promising findings. Fathers who completed treatment (n=8) showed significant reductions
in alcohol use during treatment and follow-up periods in comparison to the time prior
to treatment. Improvements were also seen in alcohol-related conflict, drinking-related
problems, father involvement, and missed family time due to drinking from the perspective
of multiple reporters, as well as in secondary outcomes of individual mental health,
couple relationship quality, and father-child relationship quality. Indicators of
family violence did not show significant improvements, but trended in the expected
direction. Results suggest that the developed treatment may be helpful for reducing
men’s alcohol use and family outcomes.</p>
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