Which outcomes matter most for alcohol brief intervention trials in Latin America? A regional Delphi

What is it about?

The ORBITAL core outcome set for alcohol brief interventions (ABIs) was developed through a global consensus process, but only three of the 150 participants were from Latin America, raising questions about whether its recommendations adequately reflect priorities and contexts in the region. This study addressed that gap by conducting a two-round Delphi procedure with 465 participants from 18 Latin American countries, including researchers, health professionals, healthcare service users, journal editors, policymakers, members of non-governmental organisations and core outcome set developers. Participants rated 101 candidate variables by their relevance to ABI efficacy and effectiveness, with responses collected in Spanish and Portuguese. Round 1 identified 47 variables meeting the 70% consensus threshold, and Round 2 expanded this to 63 variables. To account for differing levels of expertise across participant types, the analysis was stratified by subgroup, with consensus defined separately within each.

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Why is it important?

Latin America carries a substantial burden of alcohol-related harm, yet the evidence base for alcohol brief interventions in the region remains thin, and trials are hampered by the same outcome heterogeneity problems that affect the global literature. This study demonstrates that while there is considerable overlap with the ORBITAL core outcome set, Latin American stakeholders identify contextual priorities that a purely global consensus process does not fully capture. The inclusion of service users, policymakers and NGO representatives alongside researchers reflects a genuinely participatory approach to outcome prioritisation. The findings directly inform the design of ABI trials in Latin America, supporting the development of a regionally contextualised core outcome set that can build a comparable and culturally appropriate evidence base for the region, notably as ABI are often used in treatment settings, more so than globally.