Hansen Anders Blædel Gottlieb, Becker Ulrik, Nielsen Anette Søgaard, Grønbæk Morten, Tolstrup Janne Schurmann, Thygesen Lau Caspar
National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark.
J Med Internet Res. 2012 Jul 30;14(4):e98. doi: 10.2196/jmir.1883.
Internet-based interventions for heavy drinkers show promising results, but existing research is characterized by few studies in nonstudent adult populations and few comparisons with appropriate control groups.
To test whether a fully automated Internet-based brief personalized feedback intervention and a fully automated Internet-based personalized brief advice intervention in a non-treatment-seeking population of heavy drinkers would result in a reduced alcohol intake.
We conducted a 3-arm parallel randomized controlled trial in a general population-based sample of heavy drinkers. The 54,157 participants (median age of 58 years) were screened for heavy drinking. Of the 3418 participants who had a weekly alcohol consumption above 14 drinks for women and 21 drinks for men, 1380 (619 women) consented to take part in the trial and were randomly assigned to an Internet-based brief personalized feedback intervention group (normative feedback, n = 476), an Internet-based personalized brief advice intervention group (n = 450), or a nonintervention control group (n = 454). Follow-up after 6 and 12 months included 871 and 1064 participants, respectively, of all groups combined. The outcome measure was self-reported weekly alcohol consumption. We analyzed the data according to the intention-to-treat principle. To examine changes over time and to account for the multiple time measurements, we used a multilevel linear mixed model. To take attrition into account, we used multiple imputation to address missing data.
The intervention effect of the Internet-based brief personalized feedback intervention, determined as the mean additional difference in changes in alcohol consumption in the Internet-based brief personalized feedback intervention compared with the control group, was -1.8 drinks/week after 6 months and -1.4 drinks/week after 12 months; these effects were nonsignificant (95% confidence interval -4.0 to 0.3 at 6 months, -3.4 to 0.6 at 12 months). The intervention effect of the Internet-based personalized brief advice intervention was -0.5 drinks/week after 6 months and -1.2 drinks/week after 12 months; these effects were nonsignificant (95% confidence interval -2.7 to 1.6 at 6 months, -3.3 to 0.9 at 12 months).
In this randomized controlled trial we found no evidence that an Internet-based brief personalized feedback intervention was effective in reducing drinking in an adult population of heavy drinkers.
ClinicalTrials.gov NCT00751985; http://clinicaltrials.gov/ct2/show/NCT00751985 (Archived by WebCite at http://www.webcitation.org/68WCRLyaP).
针对重度饮酒者的基于互联网的干预措施显示出了有前景的结果,但现有研究的特点是针对非学生成年人群体的研究较少,且与适当对照组的比较也较少。
测试在未寻求治疗的重度饮酒者群体中,基于互联网的完全自动化简短个性化反馈干预和基于互联网的完全自动化个性化简短建议干预是否会导致酒精摄入量减少。
我们在一个基于普通人群的重度饮酒者样本中进行了一项三臂平行随机对照试验。对54157名参与者(中位年龄58岁)进行了重度饮酒筛查。在3418名每周饮酒量女性超过14杯、男性超过21杯的参与者中,1380人(619名女性)同意参加试验,并被随机分配到基于互联网的简短个性化反馈干预组(规范反馈,n = 476)、基于互联网的个性化简短建议干预组(n = 450)或非干预对照组(n = 454)。6个月和12个月后的随访分别包括所有组的871名和1064名参与者。结局指标是自我报告的每周酒精摄入量。我们根据意向性分析原则分析数据。为了检查随时间的变化并考虑多次测量,我们使用了多级线性混合模型。为了考虑失访情况,我们使用多重填补法处理缺失数据。
基于互联网的简短个性化反馈干预的干预效果,定义为与对照组相比,基于互联网的简短个性化反馈干预中酒精消费变化的平均额外差异,在6个月后为-1.8杯/周,在12个月后为-1.4杯/周;这些效果不显著(6个月时95%置信区间为-4.0至0.3,12个月时为-3.4至0.6)。基于互联网的个性化简短建议干预的干预效果在6个月后为-0.5杯/周,在12个月后为-1.2杯/周;这些效果不显著(6个月时95%置信区间为-2.7至1.6,12个月时为-3.3至0.9)。
在这项随机对照试验中,我们没有发现证据表明基于互联网的简短个性化反馈干预对成年重度饮酒者群体减少饮酒有效。
ClinicalTrials.gov NCT007519,85;http://clinicaltrials.gov/ct2/show/NCT00751985(由WebCite存档于http://www.webcitation.org/68WCRLyaP)。