Fletcher Kathryn, Moran-Pryor Alex, Robert-Hendren Dominique
Hello Sunday Morning, Sydney, Australia.
Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.
JMIR Form Res. 2023 Oct 24;7:e48245. doi: 10.2196/48245.
Alcohol-related injuries and diseases are a leading cause of morbidity and mortality worldwide. Early intervention is essential given the chronic, relapsing nature of alcohol use disorders. There is significant potential for widely accessible web-based screening tools to help individuals determine where they stand in terms of alcohol use and provide support recommendations. Screening and brief interventions (SBIs) provide individuals with a stigma-free opportunity to learn and think about the potential risks of drinking and prompt help-seeking behavior by incorporating behavior change techniques. Furthermore, as excessive alcohol use and mental health problems often occur concurrently, SBIs for both conditions simultaneously can potentially address a critical gap in alcohol and mental health treatment.
We investigated the feasibility, acceptability, and clinical outcomes of participants completing the Alcohol and Wellbeing Self-assessment (A&WS), a web-based SBI.
The A&WS is freely available on the Hello Sunday Morning website as part of an uncontrolled observational prospective study. Feasibility was assessed based on the number of respondents who commenced and subsequently completed the A&WS. Acceptability was measured via participant feedback to determine overall satisfaction, perceived helpfulness, and likelihood of recommending the A&WS to others. Clinical outcomes were measured in two ways: (1) self-reported changes in alcohol consumption (Alcohol Use Disorders Identification Test score) or psychological distress (Kessler Psychological Distress Scale score) over time and (2) help seeking-both self-reported and immediate web-based help seeking. Preliminary baseline data collected for the first 9 months (March 2022 to December 2022) of the study were reported, including the 3-month follow-up outcomes.
A total of 17,628 participants commenced the A&WS, and of these, 14,419 (81.8%) completed it. Of those 14,419 who completed the A&WS, 1323 (9.18%) agreed to participate in the follow-up research. Acceptability was high, with 78.46% (1038/1323) reporting high satisfaction levels overall; 95.62% (1265/1323) found the A&WS easy to use and would recommend the tool to others. The 1-, 2-, and 3-month follow-ups were completed by 28.57% (378/1323), 21.09% (279/1323), and 17.61% (233/1323) of the participants, respectively. Significant reductions in the Alcohol Use Disorders Identification Test Consumption subscale (P<.001) and Kessler Psychological Distress Scale scores (P<.001) were observed over the 3-month follow-up period.
Our results suggest that the A&WS is a highly feasible and acceptable digital SBI that may support individuals in making changes to their alcohol consumption and improve their psychological well-being. In the absence of a control group, positive clinical outcomes cannot be attributed to the A&WS, which should now be subjected to a randomized controlled trial. This scalable, freely available tool has the potential to reach a large number of adults who might not otherwise access help while complementing the alcohol and mental health treatment ecosystem.
酒精相关的伤害和疾病是全球发病和死亡的主要原因。鉴于酒精使用障碍具有慢性、复发性的特点，早期干预至关重要。广泛可用的基于网络的筛查工具具有巨大潜力，可帮助个人确定自己在酒精使用方面的状况，并提供支持建议。筛查与简短干预（SBI）为个人提供了一个无耻辱感的机会，让他们了解并思考饮酒的潜在风险，并通过纳入行为改变技巧来促使其寻求帮助的行为。此外，由于过度饮酒和心理健康问题常常同时出现，针对这两种情况同时进行的SBI有可能填补酒精和心理健康治疗方面的一个关键空白。
我们调查了参与者完成基于网络的SBI——酒精与幸福感自我评估（A&WS）的可行性、可接受性和临床结果。
A&WS可在“周日早安”网站上免费获取，作为一项非对照观察性前瞻性研究的一部分。根据开始并随后完成A&WS的受访者数量评估可行性。通过参与者反馈来衡量可接受性，以确定总体满意度、感知的帮助程度以及向他人推荐A&WS的可能性。临床结果通过两种方式衡量：（1）随时间自我报告的酒精消费量变化（酒精使用障碍识别测试分数）或心理困扰（凯斯勒心理困扰量表分数）；（2）寻求帮助——包括自我报告的和即时基于网络的寻求帮助。报告了研究前9个月（2022年3月至2022年12月）收集的初步基线数据，包括3个月的随访结果。
共有17628名参与者开始使用A&WS，其中14419名（81.8%）完成了该评估。在完成A&WS的14419名参与者中，1323名（9.18%）同意参与后续研究。可接受性较高，78.46%（1038/1323）报告总体满意度较高；95.62%（1265/1323）认为A&WS易于使用，并会向他人推荐该工具。分别有28.57%（378/1323）、21.09%（279/1323）和17.61%（233/1323）的参与者完成了1个月、2个月和3个月的随访。在3个月的随访期内，观察到酒精使用障碍识别测试消费量子量表（P<0.001）和凯斯勒心理困扰量表分数（P<0.001）有显著降低。
我们的结果表明，A&WS是一种高度可行且可接受的数字SBI，可能支持个人改变其酒精消费行为并改善其心理健康。在没有对照组的情况下，积极的临床结果不能归因于A&WS，现在应该对其进行随机对照试验。这种可扩展的、免费可用的工具有可能惠及大量原本可能无法获得帮助的成年人，同时补充酒精和心理健康治疗生态系统。
