J. Med. Internet Res. - Using ecological momentary assessment to test the effectiveness of a web-based brief alcohol intervention over time among heavy-drinking students: randomized controlled trial.

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Resumo

CKGROUND: Web-based brief alcohol interventions are effective in reducing alcohol use among students when measured at limited follow-up time points. To date, no studies have tested Web-based brief alcohol intervention effectiveness over time by using a large number of measurements.OBJECTIVE: Testing whether the What Do You Drink (WDYD) Web-based brief alcohol intervention can sustain a reduction in alcohol use among heavy-drinking students aged 18-24 years at 1-, 3-, and 6-month follow-up intervals.METHODS: A purely Web-based, 2-arm, parallel-group randomized controlled trial applying an ecological momentary assessment approach with 30 weekly measurements was conducted in the Netherlands (2010-2011). Participants were recruited offline and online. A total of 907 participants were randomized into the experimental condition (n=456) including the single-session and fully automated WDYD intervention, or into the control condition (n=451) including assessment only. Weekly alcohol consumption and frequency of binge drinking were the self-assessed outcome measures.RESULTS: Attrition rates of the 907 participants were 110 (12.1%), 130 (14.3%), and 162 (17.9%) at 1-, 3-, and 6-month follow-up intervals, respectively. Latent growth curve analyses according to the intention-to-treat principle revealed that participants in the experimental condition had significantly lower weekly alcohol consumption compared to participants in the control condition that was sustained at 3-month follow-up (intercept=-2.60, P<.001; slope=0.16, P=.08). Additional linear regression analyses indicated that this intercept difference resulted from significantly higher levels of alcohol units per week for participants in the control condition compared to those in the experimental condition at 1-month (beta=-2.56, SE 0.74, Cohen's d=0.20, P=.001), 3-month (beta=-1.76, SE 0.60, Cohen's d=0.13, P=.003), and 6-month (beta=-1.21, SE 0.58, Cohen's d=0.09, P=.04) follow-up intervals. Latent growth curve analyses further indicated that participants in the experimental condition had a significantly lower frequency of binge drinking compared to participants in the control condition that was sustained at 6-month follow-up (intercept=-0.14, P=.01; slope=0.004, P=.19). This intercept difference resulted from higher levels in this outcome for participants in the control condition relative to participants in the experimental condition at 1-month (beta=-1.15, SE 0.06, Cohen's d=0.16, P=.01), 3-month (beta=-0.12, SE 0.05, Cohen's d=0.09, P=.01), and 6-month (beta=-0.09, SE 0.05, Cohen's d=0.03, P=.045) follow-up intervals.CONCLUSIONS: The WDYD intervention was shown to be effective in preventing an increase in weekly alcohol consumption and frequency of binge drinking directly after the intervention. This effect was sustained 3 and 6 months after the intervention.TRIAL REGISTRATION: Netherlands Trial Register NTR2665; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2665 (Archived by WebCite at http://webcitation.org/6LuQVn12M).

Resumo Limpo

ckground webbas brief alcohol intervent effect reduc alcohol use among student measur limit followup time point date studi test webbas brief alcohol intervent effect time use larg number measurementsobject test whether drink wdyd webbas brief alcohol intervent can sustain reduct alcohol use among heavydrink student age year month followup intervalsmethod pure webbas arm parallelgroup random control trial appli ecolog momentari assess approach week measur conduct netherland particip recruit offlin onlin total particip random experiment condit n includ singlesess fulli autom wdyd intervent control condit n includ assess week alcohol consumpt frequenc bing drink selfassess outcom measuresresult attrit rate particip month followup interv respect latent growth curv analys accord intentiontotreat principl reveal particip experiment condit signific lower week alcohol consumpt compar particip control condit sustain month followup intercept p slope p addit linear regress analys indic intercept differ result signific higher level alcohol unit per week particip control condit compar experiment condit month beta se cohen d p month beta se cohen d p month beta se cohen d p followup interv latent growth curv analys indic particip experiment condit signific lower frequenc bing drink compar particip control condit sustain month followup intercept p slope p intercept differ result higher level outcom particip control condit relat particip experiment condit month beta se cohen d p month beta se cohen d p month beta se cohen d p followup intervalsconclus wdyd intervent shown effect prevent increas week alcohol consumpt frequenc bing drink direct intervent effect sustain month interventiontri registr netherland trial regist ntr httpwwwtrialregisternltrialregadminrctviewasptc archiv webcit httpwebcitationorgluqvnm

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