Berman Anne H, Gajecki Mikael, Fredriksson Morgan, Sinadinovic Kristina, Andersson Claes
Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
JMIR Res Protoc. 2015 Dec 22;4(4):e139. doi: 10.2196/resprot.4894.
About 50% of university students overconsume alcohol, and drinking habits in later adulthood are to some extent established during higher educational studies. Several studies have demonstrated that Internet-based interventions have positive effects on drinking habits among university students. Our recent study evaluated two mobile phone apps targeting drinking choices at party occasions via personalized feedback on estimated blood alcohol concentration (eBAC) for students with hazardous drinking. No changes in drinking parameters were found over a seven-week period apart from an increase in number of drinking occasions among men for one of the apps tested. Up to 30% of the study participants drank at potentially harmful levels: higher than the national recommended number of standard drinks per week (a maximum of 9 for women and 14 for men) in Sweden.
(1) To evaluate improved versions of the two mobile phone apps tested in our prior trial, in a new, 3-armed randomized controlled trial among university students with at least hazardous drinking habits according to the Alcohol Use Disorders Identifications Test (AUDIT; Study 1). (2) After 6 weeks, to target study participants showing alcohol consumption higher than the national recommended levels for standard drinks per week by offering them participation in a second, 2-armed randomized trial evaluating an additional mobile phone app with skill enhancement tasks (Study 2). (3) To follow participants at 6, 12 and 18 weeks after recruitment to Study 1 and at 6 and 12 weeks after recruitment to Study 2.
Two randomized controlled trials are conducted. Study 1: Students are recruited at four Swedish universities, via direct e-mail and advertisements on Facebook and student union web sites. Those who provide informed consent, have a mobile phone, and show at least hazardous alcohol consumption according to the AUDIT (≥6 for women; ≥8 points for men) are randomized into three groups. Group 1 has access to the Swedish government alcohol monopoly's app, Promillekoll, offering real-time estimated eBAC calculation; Group 2 has access to a Web-based app, PartyPlanner, developed by the research group, offering real-time eBAC calculation with planning and follow-up functions; and Group 3 participants are controls. Follow-up is conducted at 6, 12 and 18 weeks. Study 2. Participants who at the first 6-week follow-up show drinking levels higher than 9 (W) or 14 (M) standard drinks (12 g alcohol) per week, are offered participation in Study 2. Those who consent are randomized to either access to a skills training app, TeleCoach or to a wait-list control group.
Latent Markov models for Study 1 and mixed models analyses for Study 2 will be performed. Study 2 data will be analyzed for publication during the spring of 2016; Study 1 data will be analyzed for publication during the fall of 2016.
If mobile phone interventions for reducing hazardous alcohol use are found to be effective, the prospects for positively influencing substance use-related health among university students can considerably improve.
ClinicalTrials.gov http://clinicaltrials.gov/ct2/show/NCT02064998 (Archived by WebCite at http://www.webcitation.org/6dy0AlVRP).
约50%的大学生过度饮酒,成年后的饮酒习惯在一定程度上是在高等教育阶段形成的。多项研究表明,基于互联网的干预措施对大学生的饮酒习惯有积极影响。我们最近的一项研究评估了两款手机应用程序,通过针对有危险饮酒行为的学生提供个性化的估计血液酒精浓度(eBAC)反馈,来帮助他们在聚会场合做出饮酒选择。在为期七周的时间里,除了测试的其中一款应用程序使男性饮酒次数有所增加外,未发现饮酒参数有任何变化。高达30%的研究参与者饮酒量可能有害:高于瑞典国家建议的每周标准饮酒量(女性最多9杯,男性最多14杯)。
(1)在一项新的三臂随机对照试验中,针对根据酒精使用障碍识别测试(AUDIT)至少有危险饮酒习惯的大学生,评估我们之前试验中测试的两款手机应用程序的改进版本(研究1)。(2)6周后,针对那些每周酒精摄入量高于国家建议标准饮酒量的研究参与者,让他们参与第二项双臂随机试验,评估一款具有技能提升任务的额外手机应用程序(研究2)。(3)在招募到研究1的参与者后的第6、12和18周以及招募到研究2的参与者后的第6和12周对他们进行跟踪。
进行两项随机对照试验。研究1:通过直接电子邮件以及在脸书和学生会网站上做广告,在四所瑞典大学招募学生。那些提供知情同意书、拥有手机且根据AUDIT显示至少有危险饮酒行为(女性≥6分;男性≥8分)的学生被随机分为三组。第1组可以使用瑞典政府酒精专卖机构的应用程序Promillekoll,该程序可提供实时估计eBAC计算;第2组可以使用研究小组开发的基于网络的应用程序PartyPlanner,该程序提供具有规划和跟踪功能的实时eBAC计算;第3组参与者为对照组。在第6、12和18周进行随访。研究2:在首次6周随访中显示每周饮酒量高于9(女性)或14(男性)标准饮酒量(12克酒精)的参与者,被邀请参与研究2。那些同意的人被随机分配到可以使用技能培训应用程序TeleCoach组或等待名单对照组。
将对研究1进行潜在马尔可夫模型分析,对研究2进行混合模型分析。研究2的数据将在2016年春季进行分析以便发表;研究1的数据将在2016年秋季进行分析以便发表。
如果发现手机干预措施对减少危险饮酒有效,那么积极影响大学生与物质使用相关健康状况的前景将大大改善。
ClinicalTrials.gov http://clinicaltrials.gov/ct2/show/NCT02064998(由WebCite存档于http://www.webcitation.org/6dy0AlVRP)