Sundström Christopher, Gajecki Mikael, Johansson Magnus, Blankers Matthijs, Sinadinovic Kristina, Stenlund-Gens Erik, Berman Anne H
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.
Department of Public Health, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2016 Jul 6;11(7):e0157817. doi: 10.1371/journal.pone.0157817. eCollection 2016.
The Internet has increasingly been studied as mode of delivery for interventions targeting problematic alcohol use. Most interventions have been fully automated, but some research suggests that adding counselor guidance may improve alcohol consumption outcomes.
An eight-module Internet-based self-help program based on cognitive behavioral therapy (CBT) was tested among Internet help-seekers. Eighty participants with problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT; scores of ≥ 6 for women and ≥ 8 for men) were recruited online from an open access website and randomized into three different groups. All groups were offered the same self-help program, but participants in two of the three groups received Internet-based counselor guidance in addition to the self-help program. One of the guidance groups was given a choice between guidance via asynchronous text messages or synchronous text-based chat, while the other guidance group received counselor guidance via asynchronous text messages only.
In the choice group, 65% (13 of 20 participants) chose guidance via asynchronous text messages. At the 10-week post-treatment follow-up, an intention-to-treat (ITT) analysis showed that participants in the two guidance groups (choice and messages) reported significantly lower past week alcohol consumption compared to the group without guidance; 10.8 (SD = 12.1) versus 22.6 (SD = 18.4); p = 0.001; Cohen's d = 0.77. Participants in both guidance groups reported significantly lower scores on the AUDIT at follow-up compared to the group without guidance, with a mean score of 14.4 (SD = 5.2) versus 18.2 (SD = 5.9); p = 0.003; Cohen's d = 0.68. A higher proportion of participants in the guidance groups said that they would recommend the program compared to the group without guidance (81% for choice; 93% for messages versus 47% for self-help).
Self-help programs for problematic alcohol use can be more effective in reducing alcohol consumption over a 10-week period when counselor guidance is added.
Clinicaltrials.gov NCT02384304.
互联网越来越多地被作为针对酒精使用问题干预措施的一种交付方式进行研究。大多数干预措施都是完全自动化的，但一些研究表明，增加咨询师指导可能会改善饮酒结果。
在网络求助者中测试了一个基于认知行为疗法（CBT）的八模块网络自助项目。根据酒精使用障碍识别测试（AUDIT；女性得分≥6分，男性得分≥8分），从一个开放获取网站在线招募了80名有酒精使用问题的参与者，并随机分为三个不同的组。所有组都提供相同的自助项目，但三个组中的两个组除了自助项目外还接受基于网络的咨询师指导。其中一个指导组可以在通过异步短信或基于文本的同步聊天进行指导之间进行选择，而另一个指导组仅通过异步短信接受咨询师指导。
在选择组中，65%（20名参与者中的13名）选择了通过异步短信进行指导。在治疗后10周的随访中，意向性分析（ITT）显示，与无指导组相比，两个指导组（选择组和短信组）报告的过去一周饮酒量显著更低；分别为10.8（标准差=12.1）和22.6（标准差=18.4）；p=0.001；科恩d值=0.77。与无指导组相比，两个指导组的参与者在随访时报告的AUDIT得分显著更低，平均得分分别为14.4（标准差=5.2）和18.2（标准差=5.9）；p=0.003；科恩d值=0.68。与无指导组相比，指导组中有更高比例的参与者表示他们会推荐该项目（选择组为81%；短信组为93%，自助组为47%）。
当增加咨询师指导时，针对酒精使用问题的自助项目在10周内减少饮酒量方面可能更有效。
Clinicaltrials.gov NCT02384304。
