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Randomized Controlled Trial of Proactive Web-Based Alcohol Screening and Brief Intervention for University Students
Kypros Kypri, PhD;
Jonathan Hallett, BA;
Peter Howat, PhD;
Alexandra McManus, PhD;
Bruce Maycock, PhD;
Steven Bowe, MMedStat;
Nicholas J. Horton, ScD
Arch Intern Med. 2009;169(16):1508-1514.
Background University students drink more heavily than their nonstudent peers and are often unaware that their drinking is risky and exceeds normative levels. We tested the efficacy of a proactive Web-based alcohol screening and brief intervention program.
Methods A randomized controlled trial was conducted at an Australian university in 2007. Invitations were sent to 13 000 undergraduates (age range, 17-24 years) to complete a Web-based Alcohol Use Disorders Identification Test. Of 7237 students who responded, 2435 scored in the hazardous/harmful range ( 8) and were randomized, and 2050 (84%) completed at least 1 follow-up assessment. Intervention was 10 minutes of Web-based motivational assessment and personalized feedback. Controls received only screening. Follow-up assessments were conducted at 1 and 6 months with observers and participants blinded to allocation. Outcome measures were drinking frequency, typical occasion quantity, overall volume, number of personal problems, an academic problems score, prevalence of binge drinking, and prevalence of heavy drinking.
Results Mean (SD) baseline Alcohol Use Disorders Identification Test scores for control and intervention groups were 14.3 (5.1) and 14.2 (5.1), respectively. After 1 month, participants receiving intervention drank less often (rate ratio [RR], 0.89; 95% confidence interval [CI], 0.83-0.94), smaller quantities per occasion (RR, 0.93; 95% CI, 0.88-0.98), and less alcohol overall (RR, 0.83; 95% CI, 0.78-0.90) than did controls. Differences in alcohol-related harms were nonsignificant. At 6 months, intervention effects persisted for drinking frequency (RR, 0.91; 95% CI, 0.85-0.97) and overall volume (RR, 0.89; 95% CI, 0.82-0.96) but not for other variables.
Conclusion Proactive Web-based screening and intervention reduces drinking in undergraduates, and such a program could be implemented widely.
Trial Registration anzctr.org.au Identifier: ACTRN12608000104358
Author Affiliations: School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia (Dr Kypri and Mr Bowe); Injury Prevention Research Unit, University of Otago, Otago, New Zealand (Dr Kypri); Curtin Health Innovation Research Institute (Mr Hallett and Drs Howat, McManus, and Maycock) and Centre for Behavioural Research in Cancer Control (Mr Hallett and Drs Howat, McManus, and Maycock), Curtin University of Technology, Perth, Western Australia; and Department of Mathematics and Statistics, Smith College, Northampton, Massachusetts (Dr Horton).
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