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35th AM (2025) - Poster Session
Rewards as Contingency Management for Unhealthy Al ...
Rewards as Contingency Management for Unhealthy Alcohol Use A Systematic Review and Meta-Analysis
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Pdf Summary
This systematic review and meta-analysis evaluated the effectiveness of contingency management (CM)—a behavioral intervention using tangible rewards—for reducing unhealthy alcohol use (UAU) across its spectrum, including both individuals with and without alcohol use disorder (AUD). The study synthesized data from 29 trials involving 2,615 adults with UAU, comparing CM to treatment-as-usual or non-contingent rewards and focusing on objective alcohol-related outcomes.<br /><br />Results showed that CM significantly increased the likelihood of alcohol-negative samples (odds ratio [OR] 3.07; 95% confidence interval [CI] 2.43–3.87) and alcohol-free days (OR 3.97; 95% CI 1.74–9.08). CM also led to reductions in self-reported alcohol consumption and concurrent use of nicotine and stimulants. However, CM did not significantly enhance continuous abstinence duration (standardized mean difference 0.88; 95% CI 0.34–2.10).<br /><br />The findings suggest that CM can effectively reduce alcohol use in adults across the UAU continuum, beyond just those diagnosed with AUD, indicating its broader applicability as a promising intervention. Despite these positive outcomes, limitations include missing data, study heterogeneity, and a high risk of bias in included trials.<br /><br />In conclusion, CM shows potential as an impactful strategy to curb unhealthy alcohol consumption, though further high-quality research is needed to confirm its effects on sustained abstinence and to optimize implementation across diverse populations.
Keywords
contingency management
unhealthy alcohol use
alcohol use disorder
behavioral intervention
meta-analysis
alcohol-negative samples
alcohol-free days
self-reported alcohol consumption
nicotine and stimulant use
tangible rewards
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