Internet-Based Interactive Health Intervention for the Promotion of Sensible Drinking: Patterns of Use and Potential Impact on Members of the General Public

Abstract

Background Heavy drinking is responsible for major health and social problems. Brief interventions have been shown to be effective, but there have been difficulties in reaching those who might benefit from them. Pilot studies have indicated that a Web-based intervention is likely to be acceptable to heavy drinkers and may produce some health benefits. However, there are few data on how many people might use such a program, the patterns of use, and potential benefits.Objectives The aim was to examine the demographic characteristics of users of a free, Web-based, 6-week intervention for heavy drinkers and to describe the methods by which users identified the site, the pattern of site use and attrition, the characteristics associated with completing the program, and the self-reported impact on alcohol-related outcomes.Methods Cohort study. Visitors to the Web site were offered screening with the Fast Alcohol Screening Test, and those scoring above the cutoff for risky drinking were invited to register with the program. Demographic information was collected routinely at registration, and questionnaires were completed at the end of weeks 1 and 6. The outcome measures assessed dependency (Short Alcohol Dependency Data Questionnaire), harms (modified Alcohol Problems Questionnaire), and mental health (Clinical Outcomes in Routine Evaluation–Outcome Measure).Results The records of 10000 users were analyzed. The mean age was 37.4 years, 51.1% were female, 37.5% were single, and 42.4% lived with children. The majority were White British, lived in the United Kingdom, and reported occupations from the higher socioeconomic strata. Over 70% connected to the Down Your Drink (Down Your Drink) site from another Internet-based resource, whereas only 5.8% heard about the site from a health or other professional. Much of the Web site use (40%) was outside normal working hours. Attrition from the program was high, with only 16.5% of registrants completing the whole 6 weeks. For those who completed the program, and the final outcome measures, measures of dependency, alcohol-related problems, and mental health symptoms were all reduced at week 6.Conclusions The Web-based intervention was highly used, and those who stayed with the program showed significant reductions in self-reported indicators of dependency, alcohol-related problems, and mental health symptoms; however, this association cannot be assumed to be causal. Programs of this type may have the potential to reach large numbers of heavy drinkers who might not otherwise seek help. There are significant methodological challenges and further research is needed to fully evaluate such interventions.

Online self-guided interventions for the treatment of problem gambling

“…The low barriers to entering an online intervention (simple registration and completing of initial assessment) inflate attrition rates by including individuals exploring options but not ready to enter programs, or deciding programs are not suitable at time of registration. An evaluation of an online program for problem drinking found that of 10,000 users over a 27-month period, approximately one-third of users dropped out after the first week and usage declined each week with only 17% of users completing the six-week program (Linke, Murray, Butler, & Wallace, 2007). Reasons for dropping out appeared to vary, with some participants finding programs too timeconsuming or too challenging, or disengaging after early successful behavioural change (Linke et al, 2007;Strecher, Shiffman, & West, 2005).…”

“…An evaluation of an online program for problem drinking found that of 10,000 users over a 27-month period, approximately one-third of users dropped out after the first week and usage declined each week with only 17% of users completing the six-week program (Linke, Murray, Butler, & Wallace, 2007). Reasons for dropping out appeared to vary, with some participants finding programs too timeconsuming or too challenging, or disengaging after early successful behavioural change (Linke et al, 2007;Strecher, Shiffman, & West, 2005). Client feedback from a Norwegian online therapy program for problem gambling found that a proportion had reached goals and reported diminished urges despite early attrition (Eidem, 2010).…”

Digital Divide: Variation in Internet and Cellular Phone Use among Women Attending an Urban Sexually Transmitted Infections Clinic

“…[2][3][4][5][6] While this strategy has the potential for low-cost widespread dissemination, access to ICT among certain groups such as urban women at high risk for HIV infection is variable. Characterizing ICT use is the first step in determining whether delivering interventions via these modalities is feasible.…”

Internet Health Information Seeking Behavior and Antiretroviral Adherence in Persons Living with HIV/AIDS

“…Internetbased health interventions have been proven to be successful in conditions such as diabetes, heart failure, obesity, and substance abuse, among others. [1][2][3][4][5][6][7] In addition to medical applications delivered via the Internet, the Internet is becoming a major source of consumer health information. Surveys indicate that 64% of all Internet users in the United States engage in Internet health information seeking behavior (IHISB) and that 4% of all Internet searches are health related.…”

“…2 Section of General Internal Medicine, Portland VA Medical Center, Portland, Oregon. 3 Division of General Internal Medicine & Geriatrics, 5 Departments of Medicine and Public Health & Preventive Medicine, Oregon Health Science University, Portland, Oregon.…”