Linke Stuart, Murray Elizabeth, Butler Ceri, Wallace Paul
Islington Mental Health Psychology Services, Camden and Islington Mental Health and Social Care Trust, London, UK.
J Med Internet Res. 2007 May 8;9(2):e10. doi: 10.2196/jmir.9.2.e10.
Heavy drinking is responsible for major health and social problems. Brief interventions have been shown to be effective, but there have been difficulties in reaching those who might benefit from them. Pilot studies have indicated that a Web-based intervention is likely to be acceptable to heavy drinkers and may produce some health benefits. However, there are few data on how many people might use such a program, the patterns of use, and potential benefits.
The aim was to examine the demographic characteristics of users of a free, Web-based, 6-week intervention for heavy drinkers and to describe the methods by which users identified the site, the pattern of site use and attrition, the characteristics associated with completing the program, and the self-reported impact on alcohol-related outcomes.
Cohort study. Visitors to the Web site were offered screening with the Fast Alcohol Screening Test, and those scoring above the cutoff for risky drinking were invited to register with the program. Demographic information was collected routinely at registration, and questionnaires were completed at the end of weeks 1 and 6. The outcome measures assessed dependency (Short Alcohol Dependency Data Questionnaire), harms (modified Alcohol Problems Questionnaire), and mental health (Clinical Outcomes in Routine Evaluation-Outcome Measure).
The records of 10,000 users were analyzed. The mean age was 37.4 years, 51.1% were female, 37.5% were single, and 42.4% lived with children. The majority were White British, lived in the United Kingdom, and reported occupations from the higher socioeconomic strata. Over 70% connected to the Down Your Drink (Down Your Drink) site from another Internet-based resource, whereas only 5.8% heard about the site from a health or other professional. Much of the Web site use (40%) was outside normal working hours. Attrition from the program was high, with only 16.5% of registrants completing the whole 6 weeks. For those who completed the program, and the final outcome measures, measures of dependency, alcohol-related problems, and mental health symptoms were all reduced at week 6.
The Web-based intervention was highly used, and those who stayed with the program showed significant reductions in self-reported indicators of dependency, alcohol-related problems, and mental health symptoms; however, this association cannot be assumed to be causal. Programs of this type may have the potential to reach large numbers of heavy drinkers who might not otherwise seek help. There are significant methodological challenges and further research is needed to fully evaluate such interventions.
大量饮酒会导致严重的健康和社会问题。简短干预已被证明是有效的，但要让可能从中受益的人接受干预却存在困难。试点研究表明，基于网络的干预可能为大量饮酒者所接受，并可能带来一些健康益处。然而，关于有多少人可能使用这样的项目、使用模式以及潜在益处的数据却很少。
旨在研究针对大量饮酒者的为期6周的免费网络干预项目使用者的人口统计学特征，并描述使用者识别该网站的方式、网站使用和流失模式、与完成项目相关的特征以及自我报告的对与酒精相关结果的影响。
队列研究。网站访问者会接受快速酒精筛查测试，得分高于危险饮酒临界值的人会被邀请注册该项目。在注册时常规收集人口统计学信息，并在第1周和第6周结束时完成问卷调查。结果测量评估依赖性（简短酒精依赖数据问卷）、危害（改良酒精问题问卷）和心理健康（常规评估临床结果-结果测量）。
分析了10000名使用者的记录。平均年龄为37.4岁，51.1%为女性，37.5%为单身，42.4%与孩子同住。大多数是英国白人，居住在英国，报告的职业来自社会经济较高阶层。超过70%的人通过另一个基于互联网的资源连接到“减少饮酒量”（Down Your Drink）网站，而只有5.8%的人从健康或其他专业人员那里听说过该网站。网站的大量使用（40%）发生在正常工作时间之外。该项目的流失率很高，只有16.5%的注册者完成了整个6周的项目。对于完成项目的人以及最终结果测量，在第6周时，依赖性、与酒精相关问题和心理健康症状的测量指标均有所降低。
基于网络的干预被大量使用，坚持完成项目的人在自我报告的依赖性、与酒精相关问题和心理健康症状指标上有显著降低；然而，不能认为这种关联是因果关系。这类项目有可能惠及大量原本可能不会寻求帮助的大量饮酒者。存在重大的方法学挑战，需要进一步研究以全面评估此类干预措施。
