Testing the efficacy of a minimal-guidance online self-help intervention for alcohol misuse in Estonia: study protocol of a randomized controlled trial

Kaal, Esta; Schaub, Michael P; Wenger, Andreas; Ülesoo, Triin; Blankers, Matthijs; Haug, Severin; Ebert, David Daniel; Riper, Heleen; Keough, Matthew T.; Noormets, Helen; Kilp, Karin

doi:10.1186/s12889-020-08791-6

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…Language tailoring Simplify text: shortening text passages, simplifying sentences Less technical phrasing, modify wording for easier readability 87 Use of concrete terms or informal language The polite German form (i.e., ‘Sie’) has been exchanged for the colloquial form (i.e., ‘Du’) 78 Milder descriptions of mental health concepts Describing psychological problems in terms of idioms of distress 94 7. Visualisation of language Use of metaphors Metaphors that appeal better and depict distress and recovery 69 , 89 Use of verbal expressions (sayings, quotes) Cultural specific terms like ‘ciclovía’ (bike rides on sundays) 73 , 138 Use of symbols The Local name selected for the programme—Selge—has two meanings: clear and sober 82 8. Difference in concepts of mental health and its treatment Poor knowledge Rather somatic symptoms (e.g., fatigue, decreased energy, weight changes) 123 Stigmatisation of mental health problems Framing the goal of the intervention as a stress management tool or academic performance tool instead of mental health intervention, in order to reduce the stigma 141 Distrust in treatment/confidentiality Increase trust in the app: lessen worries about data protection or doubts whether the programme would actually help 111 Related to religion/supernatural powers Fatalistic assumption that suffering is given by fate or by God and has to be endured 90 9.…”

Section: Resultsmentioning

confidence: 99%

Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review

et al. 2021

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Providing accessible and effective healthcare solutions for people living in low- and middle-income countries, migrants, and indigenous people is central to reduce the global mental health treatment gap. Internet- and mobile-based interventions (IMI) are considered scalable psychological interventions to reduce the burden of mental disorders and are culturally adapted for implementation in these target groups. In October 2020, the databases PsycInfo, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were systematically searched for studies that culturally adapted IMI for mental disorders. Among 9438 screened records, we identified 55 eligible articles. We extracted 17 content, methodological, and procedural components of culturally adapting IMI, aiming to consider specific situations and perspectives of the target populations. Adherence and effectiveness of the adapted IMI seemed similar to the original IMI; yet, no included study conducted a direct comparison. The presented taxonomy of cultural adaptation of IMI for mental disorders provides a basis for future studies investigating the relevance and necessity of their cultural adaptation.PROSPERO registration number: CRD42019142320.

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Section: Resultsmentioning

confidence: 99%

Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review

et al. 2021

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“…Furthermore, it is possible that problematic shifts persist beyond the end of the pandemic, which emphasizes the relevance of addressing them now with adaptive educational and preventive measures ( Dietze & Peacock, 2020 ), first, with regard to potentially harmful use patterns, and second, to minimize the risk of transmission and severe outcomes of COVID-19 in drug users ( Dietze & Peacock, 2020 ; Jacka et al, 2020 ; Sutherland et al, 2020 ). For example, online preventive and therapeutic harm reduction interventions (e.g., similar to programmes regarding alcohol misuse ( Kaal et al, 2020 ; Ornell et al, 2020 )) could be used.…”

Section: Discussionmentioning

confidence: 99%

No party, no drugs? Use of stimulants, dissociative drugs, and GHB/GBL during the early COVID-19 pandemic

Bendau

Viohl

Petzold

et al. 2022

International Journal of Drug Policy

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Background : The COVID-19 pandemic is presumably having an impact on the consumption of psychoactive substances. Social distancing and lockdown measures may particularly affect the use of “party drugs” (e.g., stimulants, dissociatives, and GHB/GBL) through the absence of typical use settings. We aimed to analyse the use patterns of those substances and underlying motivations before and during the pandemic. Methods : A subsample of 1,231 users of stimulants (amphetamine, methamphetamine, MDMA/ecstasy, cocaine), dissociative drugs (ketamine, dextromethorphan, PCP), and GHB/GBL was assessed from 30 th April to 4 th August 2020 as part of the Corona Drug Survey , a cross-sectional international online survey in five languages that included a total of 5,049 participants. The reported use of distinct substances and the underlying motivations were ascertained before (retrospectively) and during the pandemic. Furthermore, associations between drug use as a coping mechanism, pandemic-related stressors, and substance use were examined. Results : Regarding the reported frequency of use during the pandemic, 48.0–64.8% of the sample ceased or decreased, 11.9–25.5% maintained, and 23.6–29.1% increased their consumption. MDMA/ecstasy showed the strongest decrease and GHB/GBL and dissociatives the highest increase. Participants reported that price, quality, and supply were mostly unaffected by the pandemic. The most common motivations before and during the pandemic were mood-related factors, such as a desire to feel exhilarated, euphoric, high, or buzzed. The relevance of social purposes and mood-related motivators declined during the pandemic, whereas dealing with boredom increased. Overall, 16.4–35.6% perceived drug use as helpful for dealing with pandemic-related stressors, which were associated with an increased consumption frequency. Conclusion : The early stage of the COVID-19 pandemic was associated with major changes in the use of “party drugs”. Those who increased their level of drug use and perceived it as a coping strategy in particular might be targeted with adaptive preventive and therapeutic measures.

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“…The study follows the Consolidated Standards of Reporting Trials (CONSORT) guidelines with published trial protocol [ 16 ]. The Tallinn Medical Research Ethics Committee, Estonia approved the study.…”

Section: Methodsmentioning

confidence: 99%

Effects of a minimal‐guided on‐line intervention for alcohol misuse in Estonia: a randomized controlled trial

et al. 2021

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Background and Aims Estonia has one of the highest alcohol‐attributable mortality rates within the European Union. The aim of this study was to estimate the efficacy of an on‐line self‐help intervention to reduce problem drinking at the population level. Design On‐line open randomized controlled trial with an 8‐week intervention and an active control group (intervention n = 303, control n = 286). Assessments took place at baseline and at 6 months follow‐up. Setting On‐ and offline channels were used for population‐based recruitment within a nation‐wide prevention campaign in Estonia. Participants Inclusion criteria were age ≥ 18 years, heavy drinking [Alcohol Use Disorders Identification (AUDIT) test score ≥ 8], literacy in Estonian and at least weekly access to the internet; n = 589 participants were randomized (50% male, 1% other; mean age 37.86 years; 45% with higher level of education). Intervention and comparator The intervention consisted of 10 modules based on principles of cognitive–behavioral therapy and motivational interviewing. The active control group received access to a website with a self‐test including personalized normative feedback and information for standard alcohol treatment. Measurements The primary outcome was AUDIT scores at 6 months follow‐up adjusted for baseline scores. Findings Intention‐to‐treat analyses were applied. Missing data were addressed by using baseline observation carried forward (BOCF) and multiple imputation by chained equations (MI); 175 completed follow‐up in the intervention group and 209 in the control group. AUDIT score at follow‐up was significantly smaller in the intervention [BOCF mean = 13.91, standard deviation (SD) = 7.61, MI mean = 11.03, SD = 6.55] than control group (BOCF mean = 15.30, SD = 7.31; MI mean = 14.30, SD = 7.21), with a group difference of −1.38 [95% confidence interval (CI) = –2.58, –0.18], P = 0.02 for BOCF and −3.26 (95% CI = –2.01, –4.51), P < 0.001 for MI. Conclusions A randomized controlled trial has found that an on‐line self‐help intervention with minimal guidance was effective at reducing problem drinking in Estonia.

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Testing the efficacy of a minimal-guidance online self-help intervention for alcohol misuse in Estonia: study protocol of a randomized controlled trial

Cited by 6 publications

References 17 publications

Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review

Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review

No party, no drugs? Use of stimulants, dissociative drugs, and GHB/GBL during the early COVID-19 pandemic

Effects of a minimal‐guided on‐line intervention for alcohol misuse in Estonia: a randomized controlled trial

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