Cunningham John Alastair
Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.
J Med Internet Res. 2012 Aug 1;14(4):e107. doi: 10.2196/jmir.2090.
Alcohol problems are a serious public health concern, and few problem drinkers ever seek treatment. The Internet is one means of promoting access to care, but more research is needed to test the best types of interventions to employ. Evaluation of Internet-based interventions that contain a variety of research-validated cognitive-behavioral tools, which have been shown to be helpful to those with more severe alcohol concerns, should be a priority.
To evaluate whether providing access to an extended Internet intervention for alcohol problems offers additional benefits in promoting reductions in alcohol consumption compared with a brief Internet intervention. The hypothesis for the current trial was that respondents who were provided with access to an extended Internet intervention (the Alcohol Help Center [AHC]) would display significantly improved drinking outcomes at 6-month follow-up, compared with respondents who were provided with access to a brief Internet intervention (the Check Your Drinking [CYD] screener).
A single-blinded randomized controlled trial with a 6-month follow-up. A general population sample of problem drinkers was recruited through newspaper advertisements in a large metropolitan city. Baseline and follow-up data were collected by postal mail.
A volunteer sample of problem drinkers of legal drinking age with home access to the Internet were recruited for the trial. Of 239 potential respondents recruited in 2010, 170 met inclusion criteria (average age 45 years; 101/170, 59.4% male; average Alcohol Use Disorders Identification Test [AUDIT] score of 22). Follow-up rates were 90.0% (153/170) with no adverse effects of the interventions reported. A repeated-measures multivariate analysis of variance of the outcome measures using an intent-to-treat approach found a significantly greater reduction in amount of drinking among participants provided access to the AHC than among participants provided access to the CYD (P = .046).
The provision of the AHC gave additional benefit in the short term to problem drinkers over that seen from the research-validated CYD, indicating the benefits of promoting access to these interventions as one means of helping people with problem drinking concerns.
ClinicalTrials.gov NCT01114919; http://clinicaltrials.gov/ct2/show/NCT01114919 (Archived by WebCite at http://www.webcitation.org/68t1dCkRZ).
酒精问题是一个严重的公共卫生问题，很少有问题饮酒者寻求治疗。互联网是促进获得治疗的一种手段，但需要更多研究来测试最佳的干预类型。评估基于互联网的干预措施，这些措施包含各种经研究验证的认知行为工具，已被证明对那些有更严重酒精问题的人有帮助，应是一个优先事项。
评估与简短的互联网干预相比，提供扩展的酒精问题互联网干预在促进减少酒精消费方面是否有额外益处。当前试验的假设是，与获得简短互联网干预（“检查你的饮酒情况”[CYD]筛查工具）的受访者相比，获得扩展互联网干预（酒精帮助中心[AHC]）的受访者在6个月随访时饮酒结果会有显著改善。
一项为期6个月随访的单盲随机对照试验。通过在一个大城市的报纸广告招募有问题饮酒者的一般人群样本。通过邮政邮件收集基线和随访数据。
招募了有法定饮酒年龄且家中可上网的问题饮酒者志愿者样本进行试验。在2010年招募的239名潜在受访者中，170名符合纳入标准（平均年龄45岁；101/170，59.4%为男性；平均酒精使用障碍识别测试[AUDIT]分数为22）。随访率为90.0%（153/170），未报告干预措施有不良反应。采用意向性分析方法对结果测量进行重复测量多变量方差分析发现，获得AHC的参与者饮酒量的减少显著大于获得CYD的参与者（P = 0.046）。
与经研究验证的CYD相比，提供AHC在短期内给问题饮酒者带来了额外益处，表明推广获得这些干预措施作为帮助有饮酒问题者的一种手段是有益的。
ClinicalTrials.gov NCT01114919；http://clinicaltrials.gov/ct2/show/NCT01114919（由WebCite存档于http://www.webcitation.org/68t1dCkRZ）。
