Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
BMJ. 2023 Aug 16;382:e073713. doi: 10.1136/bmj-2022-073713.
To estimate the effects of providing access to an alcohol intervention based on a smartphone.
Randomised controlled trial..
Four higher education institutions in Switzerland.
1770 students (≥18 years) who screened positive for unhealthy alcohol use (ie, a score on the alcohol use disorders identification test-consumption (AUDIT-C) of ≥4 for men and ≥3 for women) were randomly assigned by 1:1 allocation ratio in blocks of 10.
Providing access to a brief, smartphone based alcohol intervention.
The primary outcome studied was number of standard drinks per week at six months and the secondary outcome was number of heavy drinking days (past 30 days). Additional outcomes were maximum number of drinks consumed on one occasion, alcohol related consequences, and academic performance. Follow-up assessments occurred at months three, six, and 12. Data were analysed by intention to treat and by using generalised linear mixed models with random intercepts for the recruitment site and participants nested within the recruitment site, and with intervention ( control), time (three months six months; 12 months six months), and baseline outcome values as fixed effects.
Between 26 April 26 2021 and 30 May 2022, 1770 participants (intervention group (n=884); control group (n=886)) were included. Mean age was 22.4 years (standard deviation 3.07); 958 (54.1%) were women; and 1169 (66.0%) were undergraduate students, 533 (30.1%) were studying for a master's degree, 43 (2.4%) were studying for a doctorate, and 25 (1.4%) were students of other higher education programme. The baseline mean number of standard drinks per week was 8.59 (standard deviation 8.18); the baseline number of heavy drinking days was 3.53 (4.02). Of 1770 participants, follow-up rates were 1706 (96.4%) at three months, 1697 (95.9%) at six months, and 1660 (93.8%) at 12 months. Of 884 students randomly assigned to the intervention group, 738 (83.5%) downloaded the smartphone application. The intervention had a significant overall effect on the number of standard drinks per week (incidence rate ratio 0.90 (95% confidence interval 0.85 to 0.96)), heavy drinking days (0.89 (0.83 to 0.96)), and the maximum number of drinks consumed on one occasion (0.96 (0.93 to 1.00), P=0.029), indicating significantly lower drinking outcomes in the intervention group than in the control group during the follow-up period. The intervention did not affect alcohol related consequences or academic performance.
Providing access to the smartphone application throughout the 12 month follow-up was effective at limiting the average drinking volume of university students who had self-reported unhealthy alcohol use at baseline.
ISRCTN 10007691.
评估通过智能手机提供酒精干预措施的效果。
随机对照试验。
瑞士的四所高等教育机构。
共有 1770 名（年龄≥18 岁）筛查出存在不健康饮酒行为（即酒精使用障碍识别测试-饮酒量（AUDIT-C）男性得分≥4，女性得分≥3）的学生被随机分为 1:1 分配比，分为 10 个块。
提供基于智能手机的简短酒精干预措施。
六个月时每周标准饮酒量和重度饮酒天数（过去 30 天）。次要结局指标包括一次饮酒量的最大值、酒精相关后果和学业表现。随访评估在三个月、六个月和十二个月进行。数据分析采用意向治疗分析和广义线性混合模型，使用随机截距对招募地点和嵌套在招募地点内的参与者进行分析，并将干预（对照组）、时间（三个月 六个月；十二个月 六个月）和基线结局值作为固定效应。
在 2021 年 4 月 26 日至 2022 年 5 月 30 日期间，共纳入 1770 名参与者（干预组（n=884）；对照组（n=886））。平均年龄为 22.4 岁（标准差 3.07）；958 名（54.1%）为女性；1169 名（66.0%）为本科生，533 名（30.1%）为攻读硕士学位，43 名（2.4%）为攻读博士学位，25 名（1.4%）为其他高等教育项目的学生。基线每周标准饮酒量的平均值为 8.59（标准差 8.18）；基线重度饮酒天数为 3.53（4.02）。在 1770 名参与者中，三个月时的随访率为 1706 名（96.4%），六个月时为 1697 名（95.9%），十二个月时为 1660 名（93.8%）。在随机分配到干预组的 884 名学生中，有 738 名（83.5%）下载了智能手机应用程序。干预措施对每周标准饮酒量（发病率比 0.90（95%置信区间 0.85 至 0.96））、重度饮酒天数（0.89（0.83 至 0.96））和单次饮酒量最大值（0.96（0.93 至 1.00））均有显著的总体影响，P=0.029），表明在随访期间，干预组的饮酒结果明显低于对照组。干预措施对酒精相关后果或学业表现没有影响。
在 12 个月的随访期间，提供智能手机应用程序的使用权限可以有效限制自我报告基线时存在不健康饮酒行为的大学生的平均饮酒量。
ISRCTN 10007691。
