Randomized controlled trial of a very brief, multicomponent web-based alcohol intervention for undergraduates with a focus on protective behavioral strategies.

Abstract

Objective THRIVE (Kypri et al., 2009; 2013; 2014), a very brief, freely-available, multi-component web-based alcohol intervention originally developed and tested among students in Australia and New Zealand, was tested in the United States. We also evaluated effects of systematically varying the protective behavioral strategies (PBS) component of the intervention to include shorter, focused lists of Direct (e.g., alternating alcoholic with non-alcoholic drinks) or Indirect (e.g., looking out for friends) strategies. Method Undergraduates with past-month heavy drinking (N=208) were randomized to education/assessment Control or 1 of 3 US-THRIVE variants including Direct PBS only, Indirect PBS only, or Full (Direct and Indirect PBS). Results After 1 month, compared to the Control condition, Full condition participants reported fewer drinks per week (rate ratio [RR]=.62) and lower peak drinking (RR=.74). The Indirect-only condition reported reduced peak drinking (RR=.74) and a trend toward fewer drinks per week (RR=.78). Changes in drinking relative to Control were significant through 6 months for the Full and Indirect-only conditions. There were no significant differences between the Direct-only and Control conditions. US-THRIVE was not associated with decreased heavy drinking or alcohol-related problems relative to Control. Conclusions To our knowledge this was the first study to systematically vary the types of PBS provided in an intervention. Initial results suggest US-THRIVE is efficacious. Compared to Control, presenting Indirect PBS only as part of US-THRIVE was associated with lower drinks per week and peak past 30-day drinking. Targeting Indirect PBS may be more appropriate for non-treatment-seeking young adults receiving a brief intervention.

A Randomized Controlled Pilot Trial of Different Mobile Messaging Interventions for Problem Drinking Compared to Weekly Drink Tracking

“…There were no significant reductions in drinking consequences for any of the treatment groups compared to MA, though the TA group’s consequence reductions trended towards significance. This is similar to the findings of previous studies on brief in-person and web-based interventions which revealed few meaningful reductions in alcohol consequences [ 27 , 35 , 36 ]. It is possible that the reductions in drinking quantity or frequency did not translate into significant reductions in consequences.…”

A Randomized Trial of a Personalized Feedback Intervention for Nonstudent Emerging Adult At‐Risk Drinkers

“…PFI participants experienced slightly, although not significantly, stronger declines from baseline to 1 month and both groups decreased alcohol-related problems over the 9 months. The lack of a commensurate impact on problems in light of observed immediate decreases in drinking may seem a bit surprising; however, this is in line with other studies of brief alcohol interventions showing null results on problems (e.g., Leeman et al, 2016) or differential impact on problems versus use (e.g., Borsari et al, 2012). It is also consistent with research showing brief alcohol intervention’s impact on problems to be relatively weaker in magnitude than consumption (Tanner-Smith et al, 2015).…”

Technology‐Delivered Cognitive‐Behavioral Interventions for Alcohol Use: A Meta‐Analysis

“…The combination of CBT and motivational interviewing became increasingly common following the Combined Behavioral Intervention (CBI) approach (Combine Study Research Group, ) employed for AUD in the COMBINE Study (Anton et al., ). Other programs included in this meta‐analysis are “packaged” approaches that combine cognitive‐behavioral relapse prevention skills with personalized feedback, such as the Tertiary Health Research Intervention via Email ( THRIVE ; Leeman et al., ), or with acceptance and mindfulness exercises ( Balance ; Brendryen et al., ). Thus, the number of “pure” CBT technology‐based interventions, and therefore the evidence for their efficacy, is currently relatively limited.…”