Electronic Self-Help Interventions for Adults with Unhealthy Alcohol Use Moderately Reduce Drinking
Internet and other electronic-based self-help interventions (e-interventions) for unhealthy alcohol use have the potential to reach a broader population than interventions based in health-care settings. To assess the effectiveness of these interventions, researchers conducted a meta-analysis of randomized controlled trials of electronic (internet or CD-ROM) self-help interventions in people with “problem drinking*” aged 18 years and older. All interventions were no-contact (i.e., the subjects had no contact with a therapist, face-to-face or otherwise). Studies focused on college students were excluded. The main outcome was alcohol consumption, which had to be assessed by well-validated measures to be included in the meta-analysis.
- Nine randomized controlled trials with 1553 total participants were identified: 5 involved single-session feedback interventions, and 4 involved more extended interventions. All trials were conducted in developed, industrialized countries.
- A moderate effect size of 0.44 for decreased alcohol consumption was found for participants receiving e-intervention compared with controls.†
- Single-session e-interventions were less effective than extended e-interventions (effect size 0.27 and 0.61, respectively; p=0.04).
*Search terms to identify studies of problem drinking included alcohol abuse, alcoholism, problem drinking, hazardous drinking, and harmful drinking.
†Control conditions were waiting list (3 studies), alcohol leaflet (4 studies), or assessment only (2 studies).
Comments:This meta-analysis found a moderate effect of e-interventions on drinking among those with unhealthy alcohol use. This approach could have a large public-health impact due to its broad reach. Further research is needed to determine if e-interventions are more effective when paired with therapist contact, whether they are appropriate or effective for subgroups of people with more severe unhealthy alcohol use (e.g., dependence), and whether they are applicable in developing countries. Kevin L. Kraemer, MD, MSc
Riper H, Spek V, Boon B, et al. Effectiveness of e-self-help interventions for curbing adult problem drinking: a meta-analysis. J Med Internet Res. 2011;13(2):e42.