Bendtsen Marcus, Åsberg Katarina, McCambridge Jim
Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.
Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.
Drug Alcohol Depend. 2023 Oct 1;251:110957. doi: 10.1016/j.drugalcdep.2023.110957. Epub 2023 Sep 4.
Digital alcohol interventions have been shown to exert effects in helping individuals reduce their drinking. However, little is known about the mechanisms which mediate such effects. The objective of this study was to estimate natural direct and indirect effects of a digital alcohol intervention.
This secondary analysis of mediated effects used data from a randomised controlled trial which included individuals with unhealthy alcohol use with access to a mobile phone aged 18 years or older in Sweden. The comparator was basic alcohol and health information. The digital intervention was centrally designed around weekly monitoring of consumption followed by feedback and tools to support behaviour change. Mediated effects were estimated using measures from 1-, 2-, and 4-months post-randomisation. Primary outcomes were total weekly consumption (TWC) and frequency of heavy episodic drinking (HED). A counterfactual framework was used to estimate three hypothesised mediators: importance, knowledge of how to change (know-how), and confidence.
Between 25/04/2019 and 26/11/2020, 2129 participants were randomised. The intervention improved know-how and confidence, which in turn mediated the effects on TWC and HED at 2- and 4-months. Analyses with imputed data were not markedly different.
A digital alcohol intervention was found to exert effects in reducing consumption by means of improving individuals' knowledge of how to reduce their consumption and confidence in their ability to reduce. The use of face-valid single item measures is a study limitation notwithstanding observed findings, as is attrition and lack of blinding of participants.
数字酒精干预已被证明在帮助个人减少饮酒方面有效果。然而，对于介导这种效果的机制知之甚少。本研究的目的是评估数字酒精干预的自然直接和间接效应。
这项中介效应的二次分析使用了一项随机对照试验的数据，该试验纳入了瑞典年龄在18岁及以上、有不健康饮酒习惯且能使用手机的个体。对照为基本的酒精与健康信息。数字干预围绕每周饮酒量监测进行集中设计，随后提供反馈及支持行为改变的工具。使用随机分组后1个月、2个月和4个月的测量指标评估中介效应。主要结局为每周饮酒总量（TWC）和重度饮酒发作频率（HED）。采用反事实框架来估计三个假设的中介因素：重要性、如何改变的知识（操作知识）和信心。
在2019年4月25日至2020年11月26日期间，2129名参与者被随机分组。干预改善了操作知识和信心，进而在2个月和4个月时介导了对TWC和HED的影响。使用插补数据进行的分析结果无明显差异。
发现数字酒精干预通过提高个人关于如何减少饮酒量的知识以及对自身减少饮酒能力的信心来减少饮酒量。尽管有观察到的结果，但使用表面有效的单项测量指标是本研究的一个局限，损耗和参与者未设盲也是如此。
