Treatment dismantling pilot study to identify the active ingredients in personalized feedback interventions for hazardous alcohol use: randomized controlled trial

John A Cunningham, Michelle Murphy, Christian S Hendershot, John A Cunningham, Michelle Murphy, Christian S Hendershot

Abstract

Background: There is a considerable body of evidence supporting the effectiveness of personalized feedback interventions for hazardous alcohol use-whether delivered face-to-face, by postal mail, or over the Internet (probably now the primary mode of delivery). The Check Your Drinking Screener (CYD; see www.CheckYourDrinking.net) is one such intervention.

Objectives: The current treatment dismantling study assessed which components of personalized feedback interventions were effective in motivating change in drinking. Specifically, the major objective of this project was to conduct a randomized controlled trial (RCT) comparing the impact of the normative feedback and other personalized feedback components of the CYD intervention in the general population.

Methods: Participants were recruited to take part in an RCT and received either the complete CYD final report, just the normative feedback sections of the CYD, just the personalized feedback components of the CYD, or were assigned to a no-intervention control group. Participants were followed-up at 3 months to assess changes in alcohol consumption.

Results: A total of 741 hazardous drinking participants were recruited for the trial, of which 73 percent provided follow-up data. Analyses using an intent-to-treat approach found some evidence for the impact of the personalized feedback components of the CYD in reducing alcohol consumption on the variables, number of drinks in a week and AUDIT-C (p = .028 and .047 respectively; no impact on highest number of drinks on one occasion; p = .594). However, there was no significant evidence of the impact of the normative feedback components (all p > .3).

Conclusions: Personalized feedback elements alone could provide an active intervention for hazardous drinkers, particularly in situations where normative feedback information was not available.

Trials registration: ClinicalTrials.gov NCT01608763.

References

    1. McCambridge J, Cunningham JA. The early history of ideas on brief interventions for alcohol. Addiction. 2014;109:538–546. doi: 10.1111/add.12458.
    1. Cunningham JA, Hodgins DC. Brief interventions for at-risk drinking. In: Herie M, Skinner MHW, editors. Fundamentals of Addiction: A Practical Guide for Counsellors. 4. Toronto, Canada: Centre for Addiction and Mental Health; 2014. pp. 193–204.
    1. Moyer A, Finney JW, Swearingen CE, Vergun P. Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction. 2002;97:279–292. doi: 10.1046/j.1360-0443.2002.00018.x.
    1. Babor TF, De La Fuente MF, Saunders JB, Grant M. AUDIT— The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care. Geneva, Switzerland: World Health Organization; 1989.
    1. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption— II. Addiction. 1993;88:791–804. doi: 10.1111/j.1360-0443.1993.tb02093.x.
    1. Lewis MA, Neighbors C. Social norms approaches using descriptive drinking norms education: a review of the research on personalized normative feedback. J Am Coll Health. 2006;54(4):213–218. doi: 10.3200/JACH.54.4.213-218.
    1. Kazdin AE. Mediators and mechanisms of change in psychotherapy research. Annu Rev Clin Psychol. 2007;3:1–27. doi: 10.1146/annurev.clinpsy.3.022806.091432.
    1. Miller WR, Sovereign RG, Krege B. Motivational interviewing with problem drinkers: II. The drinker's check-up as a preventive intervention. Behav Psychother. 1988;16:251–268. doi: 10.1017/S0141347300014129.
    1. Cunningham JA, Wild TC, Cordingley J, van Mierlo T, Humphreys K. A randomized controlled trial of an internet-based intervention for alcohol abusers. Addiction. 2009;104(12):2023–2032. doi: 10.1111/j.1360-0443.2009.02726.x.
    1. Doumas DM, Hannah E. Preventing high-risk drinking in youth in the workplace: a web-based normative feedback program. J Subst Abuse Treat. 2008;34(3):263–271. doi: 10.1016/j.jsat.2007.04.006.
    1. Doumas DM, Haustveit T. Reducing heavy drinking in intercollegiate athletes: Evaluation of a web-based personalized feedback program. Sport Psychol. 2008;22:213–229.
    1. Doumas DM, McKinley LL, Book P. Evaluation of two web-based alcohol interventions for mandated college students. J Subst Abuse Treat. 2009;36(1):65–74. doi: 10.1016/j.jsat.2008.05.009.
    1. Cunningham JA, Humpheys K, Kypri K, van Mierlo T: Formative evaluation and three-month follow-up of an online personalized assessment feedback intervention for problem drinkers.J Med Internet Res 2006, 8(2):e5.
    1. Butt P, Beirness D, Gliksman L, Paradis C, Stockwell T. Alcohol and Health in Canada: A Summary of Evidence and Guidelines for Low-Risk Drinking. Canadian Centre on Substance Abuse: Ottawa; 2011.
    1. Dawson DA, Grant BF, Stinson FS, Zhou Y. Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population. Alcohol Clin Exp Res. 2005;29(5):844–854. doi: 10.1097/01.ALC.0000164374.32229.A2.
    1. Cunningham JA, Hodgins DC, Toneatto T, Murphy M: A randomized controlled trial of a personalized feedback intervention for problem gamblers.PLoS One 2012, 7(2):e31586.
    1. Cunningham JA, Humphreys K, Koski-Jannes A. Providing personalized assessment feedback for problem drinking on the internet: a pilot project. J Stud Alcohol. 2000;61(6):794–798.
    1. Cunningham JA, Wong HTA. Assessing the immediate impact of normative drinking information using an immediate post-test randomized controlled design: implications for normative feedback interventions? Addict Behav. 2013;38(6):2252–2256. doi: 10.1016/j.addbeh.2013.02.005.

Source: PubMed

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