University of Zurich; Swiss Research Institute for Public Health and Addiction ISGF, Zurich, Switzerland.
National Institute for Health Development; Centre for Health Marketing, Tallinn, Estonia.
Addiction. 2022 Jan;117(1):108-117. doi: 10.1111/add.15633. Epub 2021 Jul 23.
Estonia has one of the highest alcohol-attributable mortality rates within the European Union. The aim of this study was to estimate the efficacy of an on-line self-help intervention to reduce problem drinking at the population level.
On-line open randomized controlled trial with an 8-week intervention and an active control group (intervention n = 303, control n = 286). Assessments took place at baseline and at 6 months follow-up.
On- and offline channels were used for population-based recruitment within a nation-wide prevention campaign in Estonia.
Inclusion criteria were age ≥ 18 years, heavy drinking [Alcohol Use Disorders Identification (AUDIT) test score ≥ 8], literacy in Estonian and at least weekly access to the internet; n = 589 participants were randomized (50% male, 1% other; mean age 37.86 years; 45% with higher level of education).
The intervention consisted of 10 modules based on principles of cognitive-behavioral therapy and motivational interviewing. The active control group received access to a website with a self-test including personalized normative feedback and information for standard alcohol treatment.
The primary outcome was AUDIT scores at 6 months follow-up adjusted for baseline scores.
Intention-to-treat analyses were applied. Missing data were addressed by using baseline observation carried forward (BOCF) and multiple imputation by chained equations (MI); 175 completed follow-up in the intervention group and 209 in the control group. AUDIT score at follow-up was significantly smaller in the intervention [BOCF mean = 13.91, standard deviation (SD) = 7.61, MI mean = 11.03, SD = 6.55] than control group (BOCF mean = 15.30, SD = 7.31; MI mean = 14.30, SD = 7.21), with a group difference of -1.38 [95% confidence interval (CI) = -2.58, -0.18], P = 0.02 for BOCF and -3.26 (95% CI = -2.01, -4.51), P < 0.001 for MI.
A randomized controlled trial has found that an on-line self-help intervention with minimal guidance was effective at reducing problem drinking in Estonia.
爱沙尼亚是欧盟内酒精相关死亡率最高的国家之一。本研究旨在评估在线自我帮助干预措施在人群中降低酗酒问题的效果。
为期 8 周的在线开放式随机对照试验，设有干预组（n=303）和对照组（n=286）。在基线和 6 个月随访时进行评估。
在爱沙尼亚全国预防运动中，利用线上和线下渠道在人群中进行了招募。
纳入标准为年龄≥18 岁，大量饮酒[酒精使用障碍识别测试（AUDIT）评分≥8]，爱沙尼亚语读写能力，每周至少上网一次；共有 589 名参与者被随机分配（50%为男性，1%为其他；平均年龄 37.86 岁；45%受过高等教育）。
干预措施包括基于认知行为疗法和动机访谈原则的 10 个模块。对照组获得了一个包含自我测试的网站访问权，该测试提供个性化的规范反馈和标准酒精治疗信息。
主要结局是 6 个月随访时的 AUDIT 评分，根据基线评分进行调整。
采用意向治疗分析。缺失数据通过基线观察延续（BOCF）和链状方程多重插补（MI）处理；干预组有 175 人完成随访，对照组有 209 人。干预组的 AUDIT 评分在随访时显著低于对照组[BOCF 均值=13.91，标准差（SD）=7.61，MI 均值=11.03，SD=6.55]（BOCF 均值=15.30，SD=7.31；MI 均值=14.30，SD=7.21），组间差异为-1.38[95%置信区间（CI）=-2.58，-0.18]，P=0.02（BOCF）和-3.26（95%CI=-2.01，-4.51），P<0.001（MI）。
一项随机对照试验发现，一种在线自我帮助干预措施，仅需最低限度的指导，就能有效地降低爱沙尼亚的酗酒问题。
