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Online Alcohol Assessment and Feedback for Hazardous and Harmful Drinkers: Findings From the AMADEUS-2 Randomized Controlled Trial of Routine Practice in Swedish Universities.

Bendtsen P, Bendtsen M, Karlsson N, White IR, McCambridge J - J. Med. Internet Res. (2015)

Bottom Line: Previous research on the effectiveness of online alcohol interventions for college students has shown mixed results.Small benefits have been found in some studies and because online interventions are inexpensive and possible to implement on a large scale, there is a need for further study.Also, differences in effect sizes between universities were seen with participants from a major university (n=365) reducing their weekly alcohol consumption by 14% (95% CI -23% to -4%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Faculty, Department of Medical Specialist and Department of Medicine and Health Sciences, Linköping University, Motala, Linköping, Sweden. preben.bendtsen@liu.se.

ABSTRACT

Background: Previous research on the effectiveness of online alcohol interventions for college students has shown mixed results. Small benefits have been found in some studies and because online interventions are inexpensive and possible to implement on a large scale, there is a need for further study.

Objective: This study evaluated the effectiveness of national provision of a brief online alcohol intervention for students in Sweden.

Methods: Risky drinkers at 9 colleges and universities in Sweden were invited by mail and identified using a single screening question. These students (N=1605) gave consent and were randomized into a 2-arm parallel group randomized controlled trial consisting of immediate or delayed access to a fully automated online assessment and intervention with personalized feedback.

Results: After 2 months, there was no strong evidence of effectiveness with no statistically significant differences in the planned analyses, although there were some indication of possible benefit in sensitivity analyses suggesting an intervention effect of a 10% reduction (95% CI -30% to 10%) in total weekly alcohol consumption. Also, differences in effect sizes between universities were seen with participants from a major university (n=365) reducing their weekly alcohol consumption by 14% (95% CI -23% to -4%). However, lower recruitment than planned and differential attrition in the intervention and control group (49% vs 68%) complicated interpretation of the outcome data.

Conclusions: Any effects of current national provision are likely to be small and further research and development work is needed to enhance effectiveness.

Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN): 02335307; http://www.isrctn.com/ISRCTN02335307 (Archived by WebCite at http://www.webcitation.org/6ZdPUh0R4).

No MeSH data available.


Screenshot of AMADEUS: assessment of heavy episodic drinking.
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figure1: Screenshot of AMADEUS: assessment of heavy episodic drinking.

Mentions: Immediately after randomization, the intervention group only were asked to complete an assessment. Four questions were asked about sex, age, domestic situation, and faculty of study. Alcohol consumption was calculated as total number of standard drinks for each of the 7 days in a typical week during the last 3 months (this intervention component was also later used as the primary outcome in the trial and note was unavailable for the control group to minimize reactivity); other questions explored frequency of HED, the largest amount of alcohol intake in standard drinks on a single occasion during the last 3 months, negative experiences perceived to be related to alcohol, and motivation to reduce alcohol consumption (Figures 1-3). Participants then received feedback consisting of 3 statements summarizing their weekly consumption, their frequency of HED, and their highest blood alcohol concentration during the last 4 weeks, comparing drinking patterns against the safe drinking limits established by the Swedish Institute for Public Health [25]. Also, a graphic illustration of their level of risk was given using green, yellow, and red colors to indicate risk status. After this followed comprehensive normative feedback with information describing participants’ alcohol use compared to their peers in Swedish universities (adjusted for sex and age group) and, if applicable, personalized advice on reducing unhealthy levels or patterns of consumption. The feedback was shown on the screen and could also be printed out by the student. A PDF version of the feedback was also emailed to the students immediately after closing this page. A demonstration version in English of the assessment and feedback intervention can be viewed online [26].


Online Alcohol Assessment and Feedback for Hazardous and Harmful Drinkers: Findings From the AMADEUS-2 Randomized Controlled Trial of Routine Practice in Swedish Universities.

Bendtsen P, Bendtsen M, Karlsson N, White IR, McCambridge J - J. Med. Internet Res. (2015)

Screenshot of AMADEUS: assessment of heavy episodic drinking.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526986&req=5

figure1: Screenshot of AMADEUS: assessment of heavy episodic drinking.
Mentions: Immediately after randomization, the intervention group only were asked to complete an assessment. Four questions were asked about sex, age, domestic situation, and faculty of study. Alcohol consumption was calculated as total number of standard drinks for each of the 7 days in a typical week during the last 3 months (this intervention component was also later used as the primary outcome in the trial and note was unavailable for the control group to minimize reactivity); other questions explored frequency of HED, the largest amount of alcohol intake in standard drinks on a single occasion during the last 3 months, negative experiences perceived to be related to alcohol, and motivation to reduce alcohol consumption (Figures 1-3). Participants then received feedback consisting of 3 statements summarizing their weekly consumption, their frequency of HED, and their highest blood alcohol concentration during the last 4 weeks, comparing drinking patterns against the safe drinking limits established by the Swedish Institute for Public Health [25]. Also, a graphic illustration of their level of risk was given using green, yellow, and red colors to indicate risk status. After this followed comprehensive normative feedback with information describing participants’ alcohol use compared to their peers in Swedish universities (adjusted for sex and age group) and, if applicable, personalized advice on reducing unhealthy levels or patterns of consumption. The feedback was shown on the screen and could also be printed out by the student. A PDF version of the feedback was also emailed to the students immediately after closing this page. A demonstration version in English of the assessment and feedback intervention can be viewed online [26].

Bottom Line: Previous research on the effectiveness of online alcohol interventions for college students has shown mixed results.Small benefits have been found in some studies and because online interventions are inexpensive and possible to implement on a large scale, there is a need for further study.Also, differences in effect sizes between universities were seen with participants from a major university (n=365) reducing their weekly alcohol consumption by 14% (95% CI -23% to -4%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Faculty, Department of Medical Specialist and Department of Medicine and Health Sciences, Linköping University, Motala, Linköping, Sweden. preben.bendtsen@liu.se.

ABSTRACT

Background: Previous research on the effectiveness of online alcohol interventions for college students has shown mixed results. Small benefits have been found in some studies and because online interventions are inexpensive and possible to implement on a large scale, there is a need for further study.

Objective: This study evaluated the effectiveness of national provision of a brief online alcohol intervention for students in Sweden.

Methods: Risky drinkers at 9 colleges and universities in Sweden were invited by mail and identified using a single screening question. These students (N=1605) gave consent and were randomized into a 2-arm parallel group randomized controlled trial consisting of immediate or delayed access to a fully automated online assessment and intervention with personalized feedback.

Results: After 2 months, there was no strong evidence of effectiveness with no statistically significant differences in the planned analyses, although there were some indication of possible benefit in sensitivity analyses suggesting an intervention effect of a 10% reduction (95% CI -30% to 10%) in total weekly alcohol consumption. Also, differences in effect sizes between universities were seen with participants from a major university (n=365) reducing their weekly alcohol consumption by 14% (95% CI -23% to -4%). However, lower recruitment than planned and differential attrition in the intervention and control group (49% vs 68%) complicated interpretation of the outcome data.

Conclusions: Any effects of current national provision are likely to be small and further research and development work is needed to enhance effectiveness.

Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN): 02335307; http://www.isrctn.com/ISRCTN02335307 (Archived by WebCite at http://www.webcitation.org/6ZdPUh0R4).

No MeSH data available.