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Abstract

Abstract Background Risky alcohol consumption is prevalent among conflict-affected populations in low-and middle-income countries. However, studies on the effectiveness of screening brief intervention (SBI) for risky alcohol use among hospital outpatients in such settings remain limited. This study assessed the effectiveness of SBI in mitigating risky post-war alcohol consumption among public hospital outpatients. Methods We conducted randomized controlled trial with 6-and 12-month follow-ups to examine the effects of SBI on reducing hazardous/harmful alcohol use among hospital outpatients. Eligible participants were adults (≥ 18 years) of both sexes with AUDIT scores between 8 and 19 for men 7 to 19 for women. AUDIT questionnaire was used as an assessment instrument. After screening hazardous/harmful drinkers were randomized into intervention (brief counseling and alcohol leaflets) and control (no intervention). Data were analyzed with Stata v15. Descriptive statistics summarized baseline characteristics. Independent t-tests, Mann-Whitney U tests, and repeated-measures ANOVA applied to compare AUDIT scores and examine time effects. Results Control group had higher mean age (mean = 43.28, SD = 17.22) than the intervention group (mean = 40.65, SD = 2.78), though the difference was non-significant (p = 0.5428). Females comprised 38.5% of the intervention group versus 20.7% of controls; and 82.8% of controls were married compared with 57.7% of the intervention group. At 6- and 12-month follow-ups, significant differences in mean ( p = 0.003 , 95% CI: 1.17 to 5.38) and median (z = 5.405, p < 0.001 ) AUDIT scores were observed, indicating lower alcohol consumption levels among participants in intervention group. Repeated-measures ANOVA further revealed a significant main effect of time on AUDIT scores (F(2, 50) = 73.41; p < 0.001 ), suggesting substantial changes in alcohol use patterns across measurement occasions. Conclusion SBI significantly reduced unhealthy alcohol consumption among public hospital outpatients in a conflict-affected settings. Trial registration (01/28/2025): NCT06918106