互联网干预对减少成年人饮酒量的效果。
The Effectiveness of an Internet Intervention Aimed at Reducing Alcohol Consumption in Adults.
机构信息
Institute and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf; GAIA AG, Hamburg, and Department of Psychology, City, University of London.
出版信息
Dtsch Arztebl Int. 2019 Feb 22;116(8):127-133. doi: 10.3238/arztebl.2019.0127.
BACKGROUND
In 2012, approximately 3.38 million people in Germany had an alcoholrelated disorder. Internet interventions can help lower alcohol consumption, albeit with mostly small effect sizes. It is still unclear whether the effectiveness of programs aimed at lowering alcohol consumption can be improved by individually adjusting program content for each participant. We studied the effectiveness of Vorvida, a new cognitive-behavioral internet intervention with individual adjustment of content.
METHODS
A randomized controlled trial was conducted on 608 adults with problematic alcohol consumption. The primary outcome was self-reported alcohol con - sumption in the past 30 days (as determined by the Quantity-Frequency-Index, QFI) and in the past 7 days (using the Timeline Follow-Back method, TFB). The secondary outcomes were drinking behavior (binge drinking/drunkenness) and satisfaction with Vorvida. Data were collected at three time points: at baseline (t0) and three and six months later (t1, t2). Trial registration: DRKS00006104.
RESULTS
The intention-to-treat (ITT) analysis revealed significant differences between groups at time t1 with respect to alcohol consumption (QFI: d = 0.28; TFB: d = 0.42), binge drinking (d = 0.87), and drunkenness (d = 0.39). Satisfaction with the intervention was high (27.4 [standard deviation, SD: 5.3] out of 32 points). All effects persisted, or were stronger, at time t2. Alcohol consumption, as measured by the QFI, declined over the interval from t0 to t2 in both groups: from 63.69 g/day (SD: 61.4) to 32.67 g/day (SD: 39.78) in the intervention group, and from 61.64 g/day (SD: 58.84) to 43.75 g/day (SD: 43.68) in the control group.
CONCLUSION
Vorvida was found to be effective in persons with risky, problematic alcohol consumption. Further studies should determine which elements of the program contribute most to effectiveness in routine clinical practice, and what long-term effects can be achieved.
背景
2012 年，德国约有 338 万人患有与酒精相关的疾病。互联网干预可以帮助降低饮酒量，尽管效果大多较小。目前尚不清楚针对降低饮酒量的方案的有效性是否可以通过为每个参与者单独调整方案内容来提高。我们研究了一种新的认知行为互联网干预措施 Vorvida 的效果，该措施可以针对内容进行个体调整。
方法
对 608 名有问题饮酒的成年人进行了一项随机对照试验。主要结局是过去 30 天（通过数量-频率指数，QFI）和过去 7 天（使用时间线随访法，TFB）的自我报告饮酒量。次要结局是饮酒行为（狂饮/醉酒）和对 Vorvida 的满意度。数据在三个时间点收集：基线时（t0）和三个月后（t1）和六个月后（t2）。试验注册：DRKS00006104。
结果
意向治疗（ITT）分析显示，在 t1 时，组间在酒精消耗（QFI：d = 0.28；TFB：d = 0.42）、狂饮（d = 0.87）和醉酒（d = 0.39）方面存在显著差异。对干预的满意度很高（27.4 [标准差，SD：32 分中的 5.3]）。所有效果在 t2 时仍然存在，或者更强。通过 QFI 测量的酒精消耗在 t0 到 t2 期间在两组中均下降：从干预组的 63.69 g/天（SD：61.4）降至 32.67 g/天（SD：39.78），从对照组的 61.64 g/天（SD：58.84）降至 43.75 g/天（SD：43.68）。
结论
Vorvida 对有风险、有问题的饮酒者有效。进一步的研究应该确定该方案的哪些元素对常规临床实践的有效性贡献最大，以及可以实现哪些长期效果。
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