Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial
Abstract Background The ubiquity of Internet connectivity, and widespread unmet needs, requires investigations of digital interventions for people seeking help with their drinking. The objective of this study was to test the effectiveness of a digital alcohol intervention compared to existing online...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-022-02374-5 |
| _version_ | 1811250882582413312 |
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| author | Marcus Bendtsen Katarina Åsberg Jim McCambridge |
| author_facet | Marcus Bendtsen Katarina Åsberg Jim McCambridge |
| author_sort | Marcus Bendtsen |
| collection | DOAJ |
| description | Abstract Background The ubiquity of Internet connectivity, and widespread unmet needs, requires investigations of digital interventions for people seeking help with their drinking. The objective of this study was to test the effectiveness of a digital alcohol intervention compared to existing online resources for help seekers. Methods This parallel randomised controlled trial included 2129 risky drinkers with access to a mobile phone and aged 18 years or older. Randomised sub-studies investigated consent procedures and control group design. Simple computerised randomisation was used. Participants were aware of allocation after randomisation; research personnel were not. The digital intervention was designed around weekly monitoring of alcohol consumption followed by feedback and tools for behaviour change. Primary outcomes were total weekly consumption (TWC) and frequency of heavy episodic drinking (HED), measured 2 and 4 months post-randomisation. Results Between 25/04/2019 and 26/11/2020, 2129 participants were randomised (intervention: 1063, control: 1066). Negative binomial regression was used to contrast groups, with both Bayesian and maximum likelihood inference. The posterior median incidence rate ratio (IRR) of TWC was 0.89 (95% CI = 0.81;0.99, 98.2% probability of effect, P-value = 0.033) at 2 months among 1557 participants and 0.77 (95% CI = 0.69;0.86, > 99.9% probability of effect, P-value < 0.001) at 4 months among 1429 participants. For HED, the IRR was 0.83 (95% CI = 0.75;0.93, > 99.9% probability of effect, P-value = 0.0009) at 2 months among 1548 participants and 0.71 (95% CI = 0.63;0.79, probability of effect > 99.9%, P-value < 0.0001) at 4 months among 1424 participants. Analyses with imputed data were not markedly different. Conclusions A digital alcohol intervention produced self-reported behaviour change among online help seekers in the general population. The internal and external validity of this trial is strong, subject to carefully considered study limitations arguably inherent to trials of this nature. Limitations include higher than anticipated attrition to follow-up and lack of blinding. Trial registration The trial was prospectively registered ( ISRCTN48317451 ). |
| first_indexed | 2024-04-12T16:11:22Z |
| format | Article |
| id | doaj.art-eff2c45d714f4aa5bb169fd0f434827a |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-12T16:11:22Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-eff2c45d714f4aa5bb169fd0f434827a2022-12-22T03:25:54ZengBMCBMC Medicine1741-70152022-05-0120111310.1186/s12916-022-02374-5Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trialMarcus Bendtsen0Katarina Åsberg1Jim McCambridge2Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping UniversityDepartment of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping UniversityDepartment of Health Sciences, University of YorkAbstract Background The ubiquity of Internet connectivity, and widespread unmet needs, requires investigations of digital interventions for people seeking help with their drinking. The objective of this study was to test the effectiveness of a digital alcohol intervention compared to existing online resources for help seekers. Methods This parallel randomised controlled trial included 2129 risky drinkers with access to a mobile phone and aged 18 years or older. Randomised sub-studies investigated consent procedures and control group design. Simple computerised randomisation was used. Participants were aware of allocation after randomisation; research personnel were not. The digital intervention was designed around weekly monitoring of alcohol consumption followed by feedback and tools for behaviour change. Primary outcomes were total weekly consumption (TWC) and frequency of heavy episodic drinking (HED), measured 2 and 4 months post-randomisation. Results Between 25/04/2019 and 26/11/2020, 2129 participants were randomised (intervention: 1063, control: 1066). Negative binomial regression was used to contrast groups, with both Bayesian and maximum likelihood inference. The posterior median incidence rate ratio (IRR) of TWC was 0.89 (95% CI = 0.81;0.99, 98.2% probability of effect, P-value = 0.033) at 2 months among 1557 participants and 0.77 (95% CI = 0.69;0.86, > 99.9% probability of effect, P-value < 0.001) at 4 months among 1429 participants. For HED, the IRR was 0.83 (95% CI = 0.75;0.93, > 99.9% probability of effect, P-value = 0.0009) at 2 months among 1548 participants and 0.71 (95% CI = 0.63;0.79, probability of effect > 99.9%, P-value < 0.0001) at 4 months among 1424 participants. Analyses with imputed data were not markedly different. Conclusions A digital alcohol intervention produced self-reported behaviour change among online help seekers in the general population. The internal and external validity of this trial is strong, subject to carefully considered study limitations arguably inherent to trials of this nature. Limitations include higher than anticipated attrition to follow-up and lack of blinding. Trial registration The trial was prospectively registered ( ISRCTN48317451 ).https://doi.org/10.1186/s12916-022-02374-5Brief alcohol interventionDigital behaviour change interventionPublic healthTelemedicineRandomised controlled trial |
| spellingShingle | Marcus Bendtsen Katarina Åsberg Jim McCambridge Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial BMC Medicine Brief alcohol intervention Digital behaviour change intervention Public health Telemedicine Randomised controlled trial |
| title | Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial |
| title_full | Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial |
| title_fullStr | Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial |
| title_full_unstemmed | Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial |
| title_short | Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial |
| title_sort | effectiveness of a digital intervention versus alcohol information for online help seekers in sweden a randomised controlled trial |
| topic | Brief alcohol intervention Digital behaviour change intervention Public health Telemedicine Randomised controlled trial |
| url | https://doi.org/10.1186/s12916-022-02374-5 |
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