Pragmatic randomized controlled trial of a web-based intervention for alcohol use among Brazilian college students: Motivation as a moderating effect

Bedendo, André; Ferri, Cleusa P.; Souza, Altay Alves Lino de; Andrade, André Luiz Monezi; Noto, Ana Regina

doi:10.1016/j.drugalcdep.2019.02.021

Cited by 26 publications

(33 citation statements)

References 45 publications

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“…This finding is complementary to our parallel trial result showing a moderation effect by this variable . In this previous report the full PNF effects compared to an assessment‐only control group were larger among students who were motivated to receive the intervention, but adverse (increasing AUDIT score) among participants less motivated . In the same direction, our present findings suggest that it may be more appropriate to provide less information (not the full PNF) to those less motivated.…”

Section: Discussionsupporting

confidence: 74%

“…The between‐group differences observed in this study were mainly driven by a subgroup of participants less motivated to receive the intervention. This finding is complementary to our parallel trial result showing a moderation effect by this variable . In this previous report the full PNF effects compared to an assessment‐only control group were larger among students who were motivated to receive the intervention, but adverse (increasing AUDIT score) among participants less motivated .…”

Section: Discussionsupporting

confidence: 61%

“…This study was part of a larger parallel‐group pragmatic randomized controlled trial with a 1 : 1 : 1 : 1 allocation ratio designed to evaluate the effectiveness of the PNF compared to a non‐intervention control group, and the present dismantling study (Trial registration: NCT02058355). A previous report showed that the PNF full intervention was effective in reducing the typical number of drinks, but not other outcomes, compared to the control group (assessment only). It also showed that the intervention effects were moderated by participant motivation to know more about their current alcohol use.…”

Section: Methodsmentioning

confidence: 91%

“…We further defined two subgroups, ‘less motivated’ (score ≤ 3) or ‘motivated’ (score ≥ 3), according to a series of decision tree analyses using the CHAID algorithm on SPSS version 23 software. More details are described elsewhere .…”

Section: Methodsmentioning

confidence: 99%

“…Primary analysis considered all available cases at any follow‐up (observed cases, n = 5476). We also conducted subgroup analyses considering student's motivation to receive the feedback [less motivated ( n = 1146) versus motivated ( n = 4330)], as this variable has been previously identified as a moderator of PNF effectiveness . This subgroup analysis should be regarded as exploratory and post‐hoc , as it was not specified in the original trial registration.…”

Section: Methodsmentioning

confidence: 99%

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Components evaluation of a web‐based personalized normative feedback intervention for alcohol use among college students: a pragmatic randomized controlled trial with a dismantling design

Bedendo

McCambridge

Gaume³

et al. 2020

Addiction

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Aims To evaluate the effects of the two main components of a personalized normative feedback (PNF) [normative feedback only (NFO); and consequences feedback only (CFO)] compared with the full intervention (PNF) in reducing alcohol use and consequences. Design Three-arm pragmatic randomized controlled trial with dismantling design and 1-, 3-and 6-month follow-ups. Setting Web-based among Brazilian college students. Participants College students (aged 18-30 years) who reported alcohol use in the last 3 months (n = 5476). Interventions (1) Full PNF (a) drinking profile; (b) normative comparisons; (c) practical costs; (d) alcohol consequences; (e) strategies to decrease risks; (2) NFO components (a), (b) and (e); or (3) CFO components (c), (d) and (e). Measurements The primary outcome was change in Alcohol Use Disorders Identi-fication Test (AUDIT) score; secondary outcomes were the number of alcohol consequences, drinking frequency and typical/maximum number of drinks. We used mixed models with multiple imputation and a pattern-mixture model to account for attrition. Subgroup analyses considered participant motivation to know more about their drinking (less motivated versus motivated). Findings Dismantled components reduced rather than increased AUDIT score compared to full PNF, with significant effects for NFO at 1 month [b = -0.23, 95% confidence interval (CI) = -0.46; -0.002] and for CFO at 3 months (b = -0.33, 95% CI = -0.62; -0.03). Compared with PNF, NFO reduced the number of alcohol consequences at 1 month (b = -0.16, 95% CI = -0.25; -0.06) and drinking frequency at 3 months (b = -0.42, 95% CI = -0.79; -0.05), but increased the number of typical drinks at 6 months (b = 0.38, 95% CI = 0.04; 0.72). CFO reduced drinking frequency at 3 months (b = -0.37, 95% CI = -0.73; -0.01). Attrition models confirmed all results, except for the NFO effect on typical drinks and drinking frequency. Subgroup analyses indicated superiority of dismantled components among the students less motivated in knowing more about their drinking. Conclusions There was no evidence that either the normative or the consequences components of a web-based personalized normative feedback intervention to reduce alcohol use and its consequences contributed to intervention effects. There was some evidence of adverse effects of personalized normative feedback, and these results were driven by 20% of participants who were less motivated in knowing more about their drinking.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 61%

Section: Methodsmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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