Internet-based brief personalized feedback intervention in a non-treatment-seeking population of adult heavy drinkers: a randomized controlled trial

Anders Blædel Gottlieb Hansen, Ulrik Becker, Anette Søgaard Nielsen, Morten Grønbæk, Janne Schurmann Tolstrup, Lau Caspar Thygesen, Anders Blædel Gottlieb Hansen, Ulrik Becker, Anette Søgaard Nielsen, Morten Grønbæk, Janne Schurmann Tolstrup, Lau Caspar Thygesen

Abstract

Background: Internet-based interventions for heavy drinkers show promising results, but existing research is characterized by few studies in nonstudent adult populations and few comparisons with appropriate control groups.

Objective: To test whether a fully automated Internet-based brief personalized feedback intervention and a fully automated Internet-based personalized brief advice intervention in a non-treatment-seeking population of heavy drinkers would result in a reduced alcohol intake.

Methods: We conducted a 3-arm parallel randomized controlled trial in a general population-based sample of heavy drinkers. The 54,157 participants (median age of 58 years) were screened for heavy drinking. Of the 3418 participants who had a weekly alcohol consumption above 14 drinks for women and 21 drinks for men, 1380 (619 women) consented to take part in the trial and were randomly assigned to an Internet-based brief personalized feedback intervention group (normative feedback, n = 476), an Internet-based personalized brief advice intervention group (n = 450), or a nonintervention control group (n = 454). Follow-up after 6 and 12 months included 871 and 1064 participants, respectively, of all groups combined. The outcome measure was self-reported weekly alcohol consumption. We analyzed the data according to the intention-to-treat principle. To examine changes over time and to account for the multiple time measurements, we used a multilevel linear mixed model. To take attrition into account, we used multiple imputation to address missing data.

Results: The intervention effect of the Internet-based brief personalized feedback intervention, determined as the mean additional difference in changes in alcohol consumption in the Internet-based brief personalized feedback intervention compared with the control group, was -1.8 drinks/week after 6 months and -1.4 drinks/week after 12 months; these effects were nonsignificant (95% confidence interval -4.0 to 0.3 at 6 months, -3.4 to 0.6 at 12 months). The intervention effect of the Internet-based personalized brief advice intervention was -0.5 drinks/week after 6 months and -1.2 drinks/week after 12 months; these effects were nonsignificant (95% confidence interval -2.7 to 1.6 at 6 months, -3.3 to 0.9 at 12 months).

Conclusions: In this randomized controlled trial we found no evidence that an Internet-based brief personalized feedback intervention was effective in reducing drinking in an adult population of heavy drinkers.

Trial registration: ClinicalTrials.gov NCT00751985; https://ichgcp.net/clinical-trials-registry/NCT00751985 (Archived by WebCite at http://www.webcitation.org/68WCRLyaP).

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Screenshot of the Internet-based brief personalized feedback intervention.
Figure 2
Figure 2
Screenshot of the Internet-based personalized brief advice intervention.
Figure 3
Figure 3
Screenshot of the control group condition.
Figure 4
Figure 4
Flow of participants through the study. PBA = Internet-based personalized brief advice intervention, PFI = Internet-based brief personalized feedback intervention. aFollow-up took place by means of two emails. bNo response and declined are subsets of lost to follow-up. c Follow-up took place by means of two emails and two letters.
Figure 5
Figure 5
Alcohol consumption at baseline and at 6- and 12-month follow-ups for women based on multiple imputation. Error bars indicate 95% confidence interval. Drinks/week = mean number of standard drinks in a typical week, PBA = Internet-based personalized brief advice intervention, PFI = Internet-based brief personalized feedback intervention.
Figure 6
Figure 6
Alcohol consumption at baseline and at 6- and 12-month follow-ups for men based on multiple imputation. Error bars indicate 95% confidence interval. Drinks/week = mean number of standard drinks in a typical week, PBA = Internet-based personalized brief advice intervention, PFI = Internet-based brief personalized feedback intervention.
Figure 7
Figure 7
Alcohol consumption at baseline and at 6- and 12-month follow-ups for women based on completers-only analysis. n = 390 after 6 months and 466 after 12 months. Error bars indicate 95% confidence interval. Drinks/week = mean number of standard drinks in a typical week, PBA = Internet-based personalized brief advice intervention, PFI = Internet-based brief personalized feedback intervention.
Figure 8
Figure 8
Alcohol consumption at baseline and at 6- and 12-month follow-ups for men based on completers-only analysis. n = 481 after 6 months and 598 after 12 months. Error bars indicate 95% confidence interval. Drinks/week = mean number of standard drinks in a typical week, PBA = Internet-based personalized brief advice intervention, PFI = Internet-based brief personalized feedback intervention. *P value for difference between PFI and control group (Kruskal-Wallis test).

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