Computer-delivered interventions for reducing alcohol consumption: meta-analysis and meta-regression using behaviour change techniques and theory

Abstract

The current aim was to examine the effectiveness of behaviour change techniques (BCTs), theory and other characteristics in increasing the effectiveness of computer-delivered interventions (CDIs) to reduce alcohol consumption. Included were randomised studies with a primary aim of reducing alcohol consumption, which compared self-directed CDIs to assessment-only control groups. CDIs were coded for the use of 42 BCTs from an alcohol-specific taxonomy, the use of theory according to a theory coding scheme and general characteristics such as length of the CDI. Effectiveness of CDIs was assessed using random-effects meta-analysis and the association between the moderators and effect size was assessed using univariate and multivariate meta-regression. Ninety-three CDIs were included in at least one analysis and produced small, significant effects on five outcomes (d+ = 0.07-0.15). Larger effects occurred with some personal contact, provision of normative information or feedback on performance, prompting commitment or goal review, the social norms approach and in samples with more women. Smaller effects occurred when information on the consequences of alcohol consumption was provided. These findings can be used to inform both intervention- and theory-development. Intervention developers should focus on, including specific, effective techniques, rather than many techniques or more-elaborate approaches.

A randomized controlled trial of a brief online intervention to reduce alcohol consumption in new university students: Combining self‐affirmation, theory of planned behaviour messages, and implementation intentions

“…The effects of the messages on both the quantity of alcohol consumed and the frequency of binge drinking were mediated by TPB variables with significant indirect effects through intention and self-efficacy which, according to the TPB, are proximal determinants of behaviour. The effect sizes for the TPB-based messages on the quantity of alcohol consumed (d = 0.20) and the frequency of binge drinking (d = 0.17), although small, are larger than the average effect sizes reported by interventions targeting alcohol consumption in first-year university students (d + s = 0.13, 0.07; Scott-Sheldon et al, 2014) and for online alcohol interventions (d + s = 0.15, 0.07;Black, Mullan, & Sharpe, 2016). Furthermore, the finding that the effects of the messages were mediated by cognitions about binge drinking (i.e., intention and self-efficacy) provides strong support for the TPB (Norman & Conner, 2015).…”

“…The effect sizes for the TPB‐based messages on the quantity of alcohol consumed ( d = 0.20) and the frequency of binge drinking ( d = 0.17), although small, are larger than the average effect sizes reported by interventions targeting alcohol consumption in first‐year university students ( d + s = 0.13, 0.07; Scott‐Sheldon et al ., ) and for online alcohol interventions ( d + s = 0.15, 0.07; Black, Mullan, & Sharpe, ). Furthermore, the finding that the effects of the messages were mediated by cognitions about binge drinking (i.e., intention and self‐efficacy) provides strong support for the TPB (Norman & Conner, ).…”

Health behaviour: Current issues and challenges

“…Rhodes et al (2017) highlighted a cluster of behavioural techniques (e.g., goal setting, feedback on performance, self-monitoring) that were associated with larger effects in physical activity interventions in adults. Similarly, in their review of online alcohol interventions, Black et al (2016) reported that interventions that included prompting commitment or reviewing goals had larger effects on alcohol consumption whereas those interventions that provided information on the consequences of alcohol consumption had smaller effects. The identification of key behaviour change techniques has the potential to improve intervention design and effectiveness.…”

Binge drinking: Health impact, prevalence, correlates and interventions

“…Black, Mullan, and Sharpe (2016) conducted a meta-analysis to investigate the effectiveness of computer-delivered interventions for reducing alcohol use and included 47 studies using binge drinking outcomes. Overall, the included interventions had small effect sizes on binge drinking frequency (d = 0.07).…”