J. Med. Internet Res. - Effectiveness of a web-based brief alcohol intervention and added value of normative feedback in reducing underage drinking: a randomized controlled trial.


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CKGROUND: Current insights indicate that Web-based delivery may enhance the implementation of brief alcohol interventions. Previous research showed that electronically delivered brief alcohol interventions decreased alcohol use in college students and adult problem drinkers. To date, no study has investigated the effectiveness of Web-based brief alcohol interventions in reducing alcohol use in younger populations.OBJECTIVE: The present study tested 2 main hypotheses, that is, whether an online multicomponent brief alcohol intervention was effective in reducing alcohol use among 15- to 20-year-old binge drinkers and whether inclusion of normative feedback would increase the effectiveness of this intervention. In additional analyses, we examined possible moderation effects of participant's sex, which we had not a priori hypothesized.METHOD: A total of 575 online panel members (aged 15 to 20 years) who were screened as binge drinkers were randomly assigned to (1) a Web-based brief alcohol intervention without normative feedback, (2) a Web-based brief alcohol intervention with normative feedback, or (3) a control group (no intervention). Alcohol use and moderate drinking were assessed at baseline, 1 month, and 3 months after the intervention. Separate analyses were conducted for participants in the original sample (n = 575) and those who completed both posttests (n = 278). Missing values in the original sample were imputed by using the multiple imputation procedure of PASW Statistics 18.RESULTS: Main effects of the intervention were found only in the multiple imputed dataset for the original sample suggesting that the intervention without normative feedback reduced weekly drinking in the total group both 1 and 3 months after the intervention (n =575, at the 1-month follow-up, beta = -.24, P = .05; at the 3-month follow-up, beta = -.25, P = .04). Furthermore, the intervention with normative feedback reduced weekly drinking only at 1 month after the intervention (n=575, beta = -.24, P = .008). There was also a marginally significant trend of the intervention without normative feedback on responsible drinking at the 3-month follow-up (n =575, beta = .40, P =.07) implying a small increase in moderate drinking at the 3-month follow-up. Additional analyses on both datasets testing our post hoc hypothesis about a possible differential intervention effect for males and females revealed that this was the case for the impact of the intervention without normative feedback on weekly drinking and moderate drinking at the 1-month follow-up (weekly drinking for n = 278, beta = -.80, P = .01, and for n = 575, beta = -.69, P = .009; moderate drinking for n = 278, odds ratio [OR] = 3.76, confidence interval [CI] 1.05 - 13.49, P = .04, and for n = 575, OR = 3.00, CI = 0.89 - 10.12, P = .08) and at the 3-month follow-up (weekly drinking for n = 278, beta = -.58, P = .05, and for n = 575, beta = -.75, P = .004; moderate drinking for n = 278, OR = 4.34, CI = 1.18 - 15.95, P = .04, and for n = 575, OR = 3.65, CI = 1.44 - 9.25, P = .006). Furthermore, both datasets showed an interaction effect between the intervention with normative feedback and participant's sex on weekly alcohol use at the 1-month follow-up (for n = 278, beta = -.74, P =.02, and for n = 575, beta = -.64, P =.01) and for moderate drinking at the 3-month follow-up (for n = 278, OR = 3.10, CI = 0.81 - 11.85, P = .07, and for n = 575, OR = 3.00, CI = 1.23 - 7.27, P = .01). Post hoc probing indicated that males who received the intervention showed less weekly drinking and were more likely to drink moderately at 1 month and at 3 months following the intervention. For females, the interventions yielded no effects: the intervention without normative feedback even showed a small unfavorable effect at the 1-month follow-up.CONCLUSION: The present study demonstrated that exposure to a Web-based brief alcohol intervention generated a decrease in weekly drinking among 15- to 20-year-old binge drinkers but did not encourage moderate drinking in the total sample. Additional analyses revealed that intervention effects were most prominent in males resulting in less weekly alcohol use and higher levels of moderate drinking among 15- to 20-year-old males over a period of 1 to 3 months.TRIAL REGISTRATION: ISRCTN50512934; http://www.controlled-trials.com/ISRCTN50512934/ (Archived by WebCite at http://www.webcitation.org/5usICa3Tx).

Resumo Limpo

ckground current insight indic webbas deliveri may enhanc implement brief alcohol intervent previous research show electron deliv brief alcohol intervent decreas alcohol use colleg student adult problem drinker date studi investig effect webbas brief alcohol intervent reduc alcohol use younger populationsobject present studi test main hypothes whether onlin multicompon brief alcohol intervent effect reduc alcohol use among yearold bing drinker whether inclus normat feedback increas effect intervent addit analys examin possibl moder effect particip sex priori hypothesizedmethod total onlin panel member age year screen bing drinker random assign webbas brief alcohol intervent without normat feedback webbas brief alcohol intervent normat feedback control group intervent alcohol use moder drink assess baselin month month intervent separ analys conduct particip origin sampl n complet posttest n miss valu origin sampl imput use multipl imput procedur pasw statist result main effect intervent found multipl imput dataset origin sampl suggest intervent without normat feedback reduc week drink total group month intervent n month followup beta p month followup beta p furthermor intervent normat feedback reduc week drink month intervent n beta p also margin signific trend intervent without normat feedback respons drink month followup n beta p impli small increas moder drink month followup addit analys dataset test post hoc hypothesi possibl differenti intervent effect male femal reveal case impact intervent without normat feedback week drink moder drink month followup week drink n beta p n beta p moder drink n odd ratio confid interv ci p n ci p month followup week drink n beta p n beta p moder drink n ci p n ci p furthermor dataset show interact effect intervent normat feedback particip sex week alcohol use month followup n beta p n beta p moder drink month followup n ci p n ci p post hoc probe indic male receiv intervent show less week drink like drink moder month month follow intervent femal intervent yield effect intervent without normat feedback even show small unfavor effect month followupconclus present studi demonstr exposur webbas brief alcohol intervent generat decreas week drink among yearold bing drinker encourag moder drink total sampl addit analys reveal intervent effect promin male result less week alcohol use higher level moder drink among yearold male period monthstrial registr isrctn httpwwwcontrolledtrialscomisrctn archiv webcit httpwwwwebcitationorgusicatx

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