{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:54:37Z","timestamp":1793321677187,"version":"4.5.0"},"reference-count":82,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unhealthy alcohol use (UAU) describes a continuum of drinking behaviors ranging from risky consumption to severe alcohol use disorder (AUD). Despite its high prevalence, most individuals across this spectrum remain untreated. Contingency management (CM), a behavioral intervention utilizing reward\u2010based incentives, effectively promotes behavior change in various substance use disorders but remains insufficiently studied across the full UAU spectrum. This systematic review and meta\u2010analysis assesses the efficacy and clinical utility of CM for reducing alcohol use among individuals with UAU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We comprehensively searched MEDLINE, EMBASE, PsycINFO, Scopus, and Cochrane Central through February 2025 for randomized and non\u2010randomized trials comparing CM to treatment\u2010as\u2010usual or non\u2010contingent rewards in adults with UAU. Eligible studies reported at least one objective measure of alcohol use. The primary outcome was a reduction in alcohol consumption. Meta\u2010analyses were performed using the Generic Inverse Variance method (RevMan 5.4), with statistical significance set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05. Heterogeneity was evaluated using Cochran's\n                      <jats:italic>Q<\/jats:italic>\n                      and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics, and the risk of bias was assessed with Cochrane Risk of Bias 2 and ROBINS\u2010I tools.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010nine studies (21 randomized controlled trials and 8 non\u2010randomized studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092615; mean age\u2009=\u200941.0\u2009years; 30.3% female) were included. CM significantly increased alcohol\u2010negative samples (OR\u2009=\u20093.07, 95% CI: 2.43\u20133.87) and alcohol\u2010free days (OR\u2009=\u20093.97, 95% CI: 1.74\u20139.08). CM was also effective in reducing self\u2010reported alcohol consumption and concurrent nicotine and stimulant use. However, it did not significantly improve continuous abstinence duration (SMD\u2009=\u20090.88, 95% CI: \u22120.34 to 2.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis demonstrates that CM effectively reduces alcohol use among adults with UAU. Given its adaptability and scalability, CM represents a promising intervention, addressing an important gap in evidence\u2010based approaches for early intervention, harm reduction, and broader treatment of alcohol\u2010related problems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70198","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T07:40:23Z","timestamp":1763624423000},"page":"2660-2674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Contingency management for unhealthy alcohol use: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7612-8009","authenticated-orcid":false,"given":"Mateus Rodrigues","family":"Alessi","sequence":"first","affiliation":[{"name":"Positivo University  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia Mara dos Santos","family":"Barbetta","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Gomes","family":"Andreata","sequence":"additional","affiliation":[{"name":"University S\u00e3o Leopoldo Mandic  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Carolina Teixeira","family":"Leal","sequence":"additional","affiliation":[{"name":"Est\u00e1cio de S\u00e1\/IDOMED University  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruan Pablo Duarte","family":"Freitas","sequence":"additional","affiliation":[{"name":"Faculdade Zarns  Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel P.","family":"Costa","sequence":"additional","affiliation":[{"name":"Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Nero","sequence":"additional","affiliation":[{"name":"Medical Library, Cleveland Clinic Floyd D. 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