Targeting individuals with problematic alcohol use via Web-based cognitive-behavioral self-help modules, personalized screening feedback or assessment only: a randomized controlled trial

Eur Addict Res. 2014;20(6):305-18. doi: 10.1159/000362406. Epub 2014 Oct 4.

Abstract

Background/aims: Most problematic alcohol users never seek professional help to reduce their use, and Web-based interventions might fulfill users' unmet needs for professional support.

Methods: This randomized controlled trial compared two open Web-based interventions, one extended self-help program and one brief screening and feedback intervention, with an assessment-only control group. Participants were 633 Internet help seekers with at least hazardous alcohol use (Alcohol Use Disorders Identification Test, AUDIT ≥6 for women and ≥8 for men).

Results: All groups reduced their alcohol use at 3-month follow-up (p < 0.001), remaining stable at the 6- and 12-month follow-ups (n.s.) according to AUDIT-C and AUDIT scores (intention-to-treat, ITT, analysis). Per protocol (PP) analysis, including only participants who accessed the interventions and also reported accessing additional outside interventions during the trial, showed that about 75% of extended self-help participants moved from probable dependence, harmful or hazardous use to lower alcohol use levels at 3- and 6- and 12-month follow-ups, compared to about 40-60% of brief intervention users and controls who accessed extra help (p < 0.05).

Conclusion: ITT analysis suggested parity over time for all interventions, including assessment only, in reducing problematic alcohol use. In contrast, PP analysis suggested that cognitive-behavioral extended self-help in combination with other interventions was more effective in changing alcohol use than brief intervention or assessment only.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alcoholism / diagnosis
  • Alcoholism / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Diagnosis, Computer-Assisted / methods
  • Feedback*
  • Female
  • Humans
  • Internet*
  • Male
  • Mass Screening
  • Middle Aged
  • Self Care
  • Therapy, Computer-Assisted / methods*
  • Treatment Outcome
  • Young Adult