J. Med. Internet Res. - Providing web-based feedback and social norms information to reduce student alcohol intake: a multisite investigation.

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Resumo

CKGROUND: Unhealthy alcohol use among university students is cause for concern, yet the level of help seeking behavior for alcohol use is low within the student population. Electronic brief interventions delivered via the Internet present an alternative to traditional treatments and could enable the delivery of interventions on a population basis. Further evidence is needed of the effectiveness of Internet-delivered interventions and of their generalizability across educational institutions.OBJECTIVE: Our objective was to evaluate the effectiveness across 4 UK universities of a Web-based intervention for student alcohol use.METHODS: In total, 1112 participants took part. Participants were stratified by educational institution, gender, age group, year of study, and self-reported weekly consumption of alcohol and randomly assigned to either the control arm or to the immediate or delayed intervention arms. Intervention participants gained access to the intervention between weeks 1 to 7 or weeks 8 to 15, respectively. The intervention provided electronic personalized feedback and social norms information on drinking behavior accessed by logging on to a website. Participants registered interest by completing a brief screening questionnaire and were then asked to complete 4 further assessments across the 24 weeks of the study. Assessments included a retrospective weekly drinking diary, the Alcohol Use Disorders Identification Test (AUDIT), and a readiness-to-change algorithm. The outcome variable was the number of units of alcohol consumed in the last week. The effect of treatment arm and time on units consumed last week and average units consumed per drinking occasion were investigated using repeated measures multivariate analysis of covariance (MANCOVA). In addition, the data were modeled using a longitudinal regression with time points clustered within students.RESULTS: MANCOVA revealed a main effect of time on units of alcohol consumed over the last week. A longitudinal regression model showed an effect of assessment across time predicting that participants who completed at least 2 assessments reduced their drinking. The model predicted an additional effect of being assigned to an intervention arm, an effect that increased across time. Regression analysis predicted that being male or being assigned to an intervention arm increased the odds of not completing all assessments. The number of units of alcohol consumed over the last week at registration, age, university educational institution, and readiness to change were not predictive of completion.CONCLUSIONS: Delivering an electronic personalized feedback intervention to students via the Internet can be effective in reducing weekly alcohol consumption. The effect does not appear to differ by educational institution. Our model suggested that monitoring alone is likely to reduce weekly consumption over 24 weeks but that consumption could be further reduced by providing access to a Web-based intervention. Further research is needed to understand the apparent therapeutic effect of monitoring and how this can be utilized to enhance the effectiveness of brief Web-based interventions.

Resumo Limpo

ckground unhealthi alcohol use among univers student caus concern yet level help seek behavior alcohol use low within student popul electron brief intervent deliv via internet present altern tradit treatment enabl deliveri intervent popul basi evid need effect internetdeliv intervent generaliz across educ institutionsobject object evalu effect across uk univers webbas intervent student alcohol usemethod total particip took part particip stratifi educ institut gender age group year studi selfreport week consumpt alcohol random assign either control arm immedi delay intervent arm intervent particip gain access intervent week week respect intervent provid electron person feedback social norm inform drink behavior access log websit particip regist interest complet brief screen questionnair ask complet assess across week studi assess includ retrospect week drink diari alcohol use disord identif test audit readinesstochang algorithm outcom variabl number unit alcohol consum last week effect treatment arm time unit consum last week averag unit consum per drink occas investig use repeat measur multivari analysi covari mancova addit data model use longitudin regress time point cluster within studentsresult mancova reveal main effect time unit alcohol consum last week longitudin regress model show effect assess across time predict particip complet least assess reduc drink model predict addit effect assign intervent arm effect increas across time regress analysi predict male assign intervent arm increas odd complet assess number unit alcohol consum last week registr age univers educ institut readi chang predict completionconclus deliv electron person feedback intervent student via internet can effect reduc week alcohol consumpt effect appear differ educ institut model suggest monitor alon like reduc week consumpt week consumpt reduc provid access webbas intervent research need understand appar therapeut effect monitor can util enhanc effect brief webbas intervent

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