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Web‐based self‐help for problem drinkers: a pragmatic randomized trial
Author(s) -
Riper Heleen,
Kramer Jeannet,
Smit Filip,
Conijn Barbara,
Schippers Gerard,
Cuijpers Pim
Publication year - 2008
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2007.02063.x
Subject(s) - randomized controlled trial , psychological intervention , population , medicine , brief intervention , intervention (counseling) , randomization , physical therapy , clinical psychology , psychology , psychiatry , environmental health , surgery
Aims Self‐help interventions for adult problem drinkers in the general population have proved effective. The question is whether this also holds for self‐help interventions delivered over the internet. Design We conducted a pragmatic randomized trial with two parallel groups, using block randomization stratified for gender and with follow‐up at 6 months. Setting The intervention and trial were conducted online in the Netherlands in 2003–2004. Participants We selected 261 adult problem drinkers from the general population with a weekly alcohol consumption above 210 g of ethanol for men or 140 g for women, or consuming at least 60 g (men) or 40 g (women) at least 1 day a week over the past 3 months. Participants were randomized to either the experimental drinking less (DL) condition or to the control condition (PBA). Intervention DL is a web‐based, multi‐component, interactive self‐help intervention for problem drinkers without therapist guidance. The recommended treatment period is 6 weeks. The intervention is based on cognitive–behavioural and self‐control principles. The control group received access to an online psychoeducational brochure on alcohol use (PBA). Outcome measures We assessed the following outcome measures at 6‐month follow‐up: (i) the percentage of participants who had reduced their drinking levels to within the normative limits of the Dutch guideline for low‐risk drinking; and (ii) the reduction in mean weekly alcohol consumption. Findings At follow‐up, 17.2% of the intervention group participants had reduced their drinking successfully to within the guideline norms; in the control group this was 5.4% [odds ratio (OR) = 3.66; 95% confidence interval (CI) 1.3–10.8; P = 0.006; number needed to treat (NNT) = 8.5]. The intervention subjects decreased their mean weekly alcohol consumption significantly more than control subjects, with a difference of 12.0 standardized units (95% CI 5.9–18.1; P < 0.001; standardized mean difference 0.40). Conclusions To our knowledge this is one of the first randomized controlled trials on a web‐based self‐help intervention without therapist guidance for self‐referred problem drinkers among the adult general population. The intervention showed itself to be effective in reducing problem drinking in the community.