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Pragmatic randomized controlled trial of providing access to a brief personalized alcohol feedback intervention in university students.

ABSTRACT: There is a growing body of evidence indicating that web-based personalized feedback interventions can reduce the amount of alcohol consumed in problem drinking college students. This study sought to evaluate whether providing voluntary access to such an intervention would have an impact on drinking.College students responded to an email inviting them to participate in a short drinking survey. Those meeting criteria for risky drinking (and agreeing to participate in a follow-up) were randomized to an intervention condition where they were offered to participate in a web-based personalized feedback intervention or to a control condition (intervention not offered). Participants were followed-up at six weeks.A total of 425 participants were randomized to condition and 68% (n = 290) completed the six-week follow-up. No significant difference in drinking between conditions was observed.Web-based personalized feedback interventions that are offered to students on a voluntary basis may not have a measurable impact on problem drinking.ClinicalTrials.gov: NCT01521078.

SUBMITTER: Cunningham JA

PROVIDER: S-EPMC3684505 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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Pragmatic randomized controlled trial of providing access to a brief personalized alcohol feedback intervention in university students.

Cunningham John A JA Hendershot Christian S CS Murphy Michelle M Neighbors Clayton C

Addiction science & clinical practice 20121010

<h4>Background</h4>There is a growing body of evidence indicating that web-based personalized feedback interventions can reduce the amount of alcohol consumed in problem drinking college students. This study sought to evaluate whether providing voluntary access to such an intervention would have an impact on drinking.<h4>Methods</h4>College students responded to an email inviting them to participate in a short drinking survey. Those meeting criteria for risky drinking (and agreeing to participat ...[more]

PMID: 23185985

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Project description:Brief interventions via the internet have been shown to reduce university students' alcohol intake. This study tested two smartphone applications (apps) targeting drinking choices on party occasions, with the goal of reducing problematic alcohol intake among Swedish university students.Students were recruited via e-mails sent to student union members at two universities. Those who gave informed consent, had a smartphone, and showed risky alcohol consumption according to the Alcohol Use Disorders Identification Test (AUDIT) were randomized into three groups. Group 1 had access to the Swedish government alcohol monopoly's app, Promillekoll, offering real-time estimated blood alcohol concentration (eBAC) calculation; Group 2 had access to a web-based app, PartyPlanner, developed by the research group, offering real-time eBAC calculation with planning and follow-up functions; and Group 3 participants were controls. Follow-up was conducted at 7 weeks.Among 28574 students offered participation, 4823 agreed to join; 415 were excluded due to incomplete data, and 1932 fulfilled eligibility criteria for randomization. Attrition was 22.7-39.3 percent, higher among heavier drinkers and highest in Group 2. Self-reported app use was higher in Group 1 (74%) compared to Group 2 (41%). Per-protocol analyses revealed only one significant time-by-group interaction, where Group 1 participants increased the frequency of their drinking occasions compared to controls (p?=?0.001). Secondary analyses by gender showed a significant difference among men in Group 1 for frequency of drinking occasions per week (p?=?0.001), but not among women. Among all participants, 29 percent showed high-risk drinking, over the recommended weekly drinking levels of 9 (women) and 14 (men) standard glasses.Smartphone apps can make brief interventions available to large numbers of university students. The apps studied using eBAC calculation did not, however, seem to affect alcohol consumption among university students and one app may have led to a negative effect among men. Future research should: 1) explore ways to increase user retention, 2) include apps facilitating technical manipulation for evaluation of added components, 3) explore the effects of adapting app content to possible gender differences, and 4) offer additional interventions to high-risk users.clinicaltrials.gov: NCT01958398.

Project description:ObjectiveIncreasing numbers of young people attending university has raised concerns about the capacity of student mental health services to support them. We conducted a randomised controlled trial (RCT) to explore whether provision of an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students-MSS), compared with university mental health support as usual (SAU), reduced psychological distress during the examination period. Here, we conduct an economic evaluation of MSS+SAU compared with SAU.Design and settingEconomic evaluation conducted alongside a pragmatic, parallel, single-blinded RCT comparing provision of MSS+SAU to SAU.Participants616 university students randomised.Primary and secondary outcome measuresThe primary economic evaluation assessed the cost per quality-adjusted life year (QALY) gained from the perspective of the university counselling service. Costs relate to staff time required to deliver counselling service offerings. QALYs were derived from the Clinical Outcomes in Routine Evaluation Dimension 6 Dimension (CORE-6D) preference based tool, which uses responses to six items of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM; primary clinical outcome measure). Primary follow-up duration was 5 and 7 months for the two recruitment cohorts.ResultsIt was estimated to cost £1584 (2022 prices) to deliver an MSS course to 30 students, £52.82 per student. Both costs (adjusted mean difference: £48, 95% CI £40-£56) and QALYs (adjusted mean difference: 0.014, 95% CI 0.008 to 0.021) were significantly higher in the MSS arm compared with SAU. The incremental cost-effectiveness ratio (ICER) was £3355, with a very high (99.99%) probability of being cost-effective at a willingness-to-pay threshold of £20 000 per QALY.ConclusionsMSS leads to significantly improved outcomes at a moderate additional cost. The ICER of £3355 per QALY suggests that MSS is cost-effective when compared with the UK's National Institute for Health and Care Excellence thresholds of £20 000 per QALY.Trial registration numberAustralian and New Zealand Clinical Trials Registry, ACTRN12615001160527.

Project description:BackgroundYoung adult veterans from the wars in Iraq and Afghanistan represent a population at-risk for heavy and problematic alcohol use. Unfortunately, few seek treatment for alcohol concerns and those that do seek care may drop out from lengthy multicomponent treatments. Additionally, veterans who live in rural areas and those who are not engaged in the Veterans Affairs Healthcare System are often overlooked, difficult to engage in treatment, and may not be actively seeking treatment for heavy patterns of use that may develop into an alcohol use disorder. The objective of this proposed randomized controlled trial is to develop and pilot test a brief, stand-alone Internet-based alcohol intervention with young adult veterans to help them reduce their drinking and prevent the development of problematic alcohol use.Methods/designRecruitment and intervention is delivered entirely over the Internet to address barriers to seeking care among this at-risk group. The online intervention consists of an assessment followed by a single module of personalized normative feedback (PNF), which provides individuals with accurate information to reduce misperceptions regarding the frequency and acceptability of risky peer behavior. PNF has established efficacy as included within multicomponent interventions targeting military populations or as a stand-alone intervention with young adult college students, but has not yet been empirically supported for the at-risk veteran population. This paper describes the development of the PNF intervention content and details the protocol for the intervention study, which will utilize a sample of 600 young adult veterans to examine the efficacy of the brief PNF intervention targeted toward reducing perceived norms, intentions to drink, actual drinking behavior, and consequences. Specific subpopulations of this veteran population, including those with mental health concerns and those differentiated by level of drinking problems, reasons for drinking, and connection to peers, will be examined to support generalizability of the intervention.DiscussionThis intervention has the potential to improve veteran health care by utilizing a novel approach to increase access to care, assist with drinking reductions, and prevent alcohol-related problems. Trial registration ClinicalTrials.gov Identifier NCT02187887.

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Pragmatic randomized controlled trial of providing access to a brief personalized alcohol feedback intervention in university students.

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Pragmatic randomized controlled trial of providing access to a brief personalized alcohol feedback intervention in university students.

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