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Citation
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Augsburger M, Kaal E, Ülesoo T, Wenger A, Blankers M, Haug S, Ebert DD, Riper H, Keough M, Noormets H, Schaub MP, Kilp K. Addiction 2021; ePub(ePub): ePub. |
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Abstract
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BACKGROUND AND AIMS: Estonia has one of the highest alcohol-attributable mortality rates within the European Union. The aim of this study was to estimate the efficacy of an online self-help intervention to reduce problem drinking at the population level.
DESIGN: Online open randomized controlled trial with an 8-week intervention and an active control group (intervention n=303, control n=286). Assessments took place at baseline and at 6 months follow-up. SETTING: Online and offline channels were used for population-based recruitment within a nationwide prevention campaign in Estonia. PARTICIPANTS: Inclusion criteria were age ≥18, heavy drinking (Alcohol Use Disorders Identification [AUDIT] test score ≥ 8), literacy in Estonian, and at least weekly access to the internet. N=589 participants were randomized (50% male, 1% other; mean age 37.86 years; 45% with higher level of education). INTERVENTION AND COMPARATOR: The intervention consisted of ten modules based on principles of cognitive-behavioral therapy and motivational interviewing. The active control group received access to a website with a self-test including personalized normative feedback and information for standard alcohol treatment. MEASUREMENTS: The primary outcome was AUDIT scores at six months follow-up adjusted for baseline scores.
FINDINGS: Intention-to-treat analyses were applied. Missing data were addressed by using baseline observation carried forward (BOCF) and multiple imputation by chained equations (MI). N=175 completed follow-up in the intervention group and n=209 in the control group. AUDIT score at follow-up was significantly smaller in the intervention (BOCF mean=13.91 [standard deviation (SD)=7.61], MI mean=11.03 [SD=6.55]) than control group (BOCF mean=15.30 [SD=7.31]; MI mean=14.30 [SD=7.21]) with a group difference of -1.38 (95% confidence interval (CI) -2.58,-.18), P=.02 for BOCF and -3.26 (95% CI -2.01,-4.51), P<.001 for MI.
CONCLUSIONS: A randomized controlled trial has found that an online self-help intervention with minimal guidance was effective at reducing problem drinking in Estonia.
Language: en |