Alcohol Consumption Reduction Among a Web-Based Supportive Community Using the Hello Sunday Morning Blog Platform: Observational Study

Abstract

BackgroundAlcohol misuse is a major social and public health issue in Australia, with an estimated cost to the community of Aus $30 billion per annum. Until recently, a major barrier in addressing this significant public health issue is the fact that the majority of individuals with alcohol use disorders and alcohol misuse are not receiving treatment.ObjectiveThis study aimed to assess whether alcohol consumption changes are associated with participation in Hello Sunday Morning’s blog platform, an online forum discussing experiences in abstaining from alcohol.MethodsThe study reports on Hello Sunday Morning participants who signed up for a 3-month period of abstinence from November 2009 to November 2016. The sample comprised 1917 participants (female: 1227/1917, 64.01%; male: 690/1917, 35.99%). Main outcome measures were Alcohol Use Disorders Identification Test (AUDIT) scores, mood, program engagement metrics, and slip-ups.ResultsIndividuals who reported hazardous (preprogram AUDIT mean 11.92, SD 2.25) and harmful consumption levels (preprogram AUDIT mean 17.52, SD 1.08) and who engaged in the Hello Sunday Morning program reported a significant decrease in alcohol consumption, moving to lower risk consumption levels (hazardous, mean 7.59, SD 5.70 and harmful, mean 10.38, SD 7.43), 4 months following program commencement (P<.001). Those who reported high-risk or dependent consumption levels experienced the biggest reduction (preprogram mean 25.38, SD 4.20), moving to risky consumption (mean 15.83, SD 11.11), 4 months following program commencement (P<.001). These reductions in risk were maintained by participants in each group, 7 months following program commencement. Furthermore, those who engaged in the program more (as defined by more sign-ins, blogs posted, check-ins completed, and engagement with the community through likes and following) had lower alcohol consumption. Finally, those who experienced more slip-ups had lower alcohol consumption.ConclusionsParticipation in an online forum can support long-term behavior change in individuals wishing to change their drinking behavior. Importantly, reductions in AUDIT scores appeared larger for those drinking at high-risk and hazardous levels before program commencement. This has promising implications for future models of alcohol reduction treatment, as online forums are an anonymous, accessible, and cost-effective alternative or adjunct to treatment-as-usual. Further research is needed into the specific mechanisms of change within a Web-based supportive community, as well as the role of specific mood states in predicting risky drinking behavior.

A Digital Intervention Addressing Alcohol Use Problems (the “Daybreak” Program): Quasi-Experimental Randomized Controlled Trial

“…Thus, many of our participants (69%) were classified as probably dependent on the AUDIT whereas the respective figure reported by Riper et al was 22%, but they also reported that 34% were heavy drinkers (defined as >35/50 standard drinks for females or males) [13]. Also notable was the high prevalence of women in our trial, representing 71% of participants compared with typical values of about 50% [12,13] and even compared to the previous assessment of Hello Sunday Morning clients (64%) [19]. There are concerns that eHealth alcohol interventions may not be as effective with women as men [13].…”

“…The Daybreak program lies within the more extensive group. Previously, the extent of engagement with the Hello Sunday Morning program (eg, in terms of blog posts, blog shares, following other participants) has been shown to correlate with improved outcomes (ie, reduced AUDIT scores) [19]. Despite the low overall level of engagement (see Table 2), these measures still predicted a range of improved outcomes (eg, in AUDIT–C score, in EUROHIS-QOL score with blog comments about alcohol use, and in blog shares at one month).…”

“…Hello Sunday Morning , established in 2010, asked participants to set a public alcohol consumption goal (eg, abstinence or reduction) for a set period of time (eg, three, six or twelve months [16,17]). Previous reports have provided descriptive analysis of participants [16], and an observational study reported a significant improvement in scores on the alcohol use disorders identification test (AUDIT) [18], down from a mean of 20.3 (SD 6.7) at baseline to a mean of 8.9 (SD 8.9) at seven months [19]. In August 2018, the original version of Hello Sunday Morning closed, having registered more than 100,000 people, and was superseded by the Daybreak program that was accessible via mobile app and desktop.…”

Outcomes of two randomized controlled trials, employing participants recruited through Mechanical Turk, of Internet interventions targeting unhealthy alcohol use

“…In study 2, we sought to determine whether it was possible to conduct a trial evaluating the impact of Internet intervention websites that we did not have direct control over. After examining several free-of-charge online interventions for suitability for an American audience (i.e., MTurk workers) we chose Hello Sunday Morning (HSM) [25], comparing it to Check Your Drinking (CYD; public access version) as the active control and to a no intervention control condition. The objectives of study 2 were to test whether it was possible to conduct the trial in such a way that the participants demonstrated that they had accessed the intervention, and to examine whether there was any evidence of impact of the intervention.…”

Qualitative Analysis of the Content Found in Online Discussion Boards for Urethral Stricture Disease and Urethroplasty

“…6 Additionally, engagement with web-based interventions can impact patient decisions such as alcohol abstinence and are being tested for encouraging a heart healthy lifestyle. 9,10 The men with USD in our study often expressed that hearing from other men with similar experiences was helpful and were grateful for the responses. Quality of information in online health forums is generally good, with physicians and laypeople rating only rare instances of extremely poor information.…”