Kirkman Jessica Jane Louise, Leo Briony, Moore Jamie Christopher
Hello Sunday Morning, Surry Hills, Australia.
J Med Internet Res. 2018 May 17;20(5):e196. doi: 10.2196/jmir.9605.
Alcohol misuse is a major social and public health issue in Australia, with an estimated cost to the community of Aus $30 billion per annum. Until recently, a major barrier in addressing this significant public health issue is the fact that the majority of individuals with alcohol use disorders and alcohol misuse are not receiving treatment.
This study aimed to assess whether alcohol consumption changes are associated with participation in Hello Sunday Morning's blog platform, an online forum discussing experiences in abstaining from alcohol.
The study reports on Hello Sunday Morning participants who signed up for a 3-month period of abstinence from November 2009 to November 2016. The sample comprised 1917 participants (female: 1227/1917, 64.01%; male: 690/1917, 35.99%). Main outcome measures were Alcohol Use Disorders Identification Test (AUDIT) scores, mood, program engagement metrics, and slip-ups.
Individuals who reported hazardous (preprogram AUDIT mean 11.92, SD 2.25) and harmful consumption levels (preprogram AUDIT mean 17.52, SD 1.08) and who engaged in the Hello Sunday Morning program reported a significant decrease in alcohol consumption, moving to lower risk consumption levels (hazardous, mean 7.59, SD 5.70 and harmful, mean 10.38, SD 7.43), 4 months following program commencement (P<.001). Those who reported high-risk or dependent consumption levels experienced the biggest reduction (preprogram mean 25.38, SD 4.20), moving to risky consumption (mean 15.83, SD 11.11), 4 months following program commencement (P<.001). These reductions in risk were maintained by participants in each group, 7 months following program commencement. Furthermore, those who engaged in the program more (as defined by more sign-ins, blogs posted, check-ins completed, and engagement with the community through likes and following) had lower alcohol consumption. Finally, those who experienced more slip-ups had lower alcohol consumption.
Participation in an online forum can support long-term behavior change in individuals wishing to change their drinking behavior. Importantly, reductions in AUDIT scores appeared larger for those drinking at high-risk and hazardous levels before program commencement. This has promising implications for future models of alcohol reduction treatment, as online forums are an anonymous, accessible, and cost-effective alternative or adjunct to treatment-as-usual. Further research is needed into the specific mechanisms of change within a Web-based supportive community, as well as the role of specific mood states in predicting risky drinking behavior.
酒精滥用是澳大利亚一个重大的社会和公共卫生问题，据估计每年给社区造成的成本为300亿澳元。直到最近，解决这一重大公共卫生问题的一个主要障碍是，大多数患有酒精使用障碍和酒精滥用的人没有接受治疗。
本研究旨在评估饮酒量的变化是否与参与“周日早安”博客平台有关，该平台是一个讨论戒酒经历的在线论坛。
该研究报告了2009年11月至2016年11月期间报名参加为期3个月戒酒计划的“周日早安”参与者。样本包括1917名参与者（女性：1227/1917，64.01%；男性：690/1917，35.99%）。主要结局指标为酒精使用障碍识别测试（AUDIT）分数、情绪、项目参与指标和失误情况。
报告有危险饮酒（计划前AUDIT平均分为11.92，标准差为2.25）和有害饮酒水平（计划前AUDIT平均分为17.52，标准差为1.08）且参与了“周日早安”计划的个体，在计划开始4个月后报告酒精摄入量显著减少，降至较低风险的饮酒水平（危险饮酒，平均分为7.59，标准差为5.70；有害饮酒，平均分为10.38，标准差为7.43）（P<0.001）。那些报告有高风险或依赖饮酒水平的个体减少幅度最大（计划前平均分为25.38，标准差为4.20），在计划开始4个月后降至风险饮酒水平（平均分为15.83，标准差为11.11）（P<0.001）。每组参与者在计划开始7个月后都保持了这些风险降低水平。此外，参与该计划更多的人（通过更多的登录、发布博客、完成签到以及通过点赞和关注与社区互动来定义）饮酒量更低。最后，经历失误更多的人饮酒量更低。
参与在线论坛可以支持希望改变饮酒行为的个体实现长期行为改变。重要的是，对于计划开始前处于高风险和危险饮酒水平的人来说，AUDIT分数的降低似乎更大。这对未来的酒精减少治疗模式具有积极意义，因为在线论坛是一种匿名、可及且具有成本效益的替代方案或常规治疗的辅助手段。需要进一步研究基于网络的支持性社区内的具体改变机制，以及特定情绪状态在预测危险饮酒行为中的作用。
