JMIR Publications

ABSTRACT

Background:

Internet-delivered cognitive behaviour therapy (ICBT) has been found effective for treating alcohol misuse, but is not available as part of routine care in Canada. Research suggests acceptability, appropriateness, and adoption are three important outcomes that should be addressed when implementing ICBT for alcohol misuse in routine practice.

Objective:

We sought to interview diverse stakeholders to gain an understanding of how ICBT is perceived as a treatment option for alcohol misuse. Specifically, we hoped to learn about the perceived advantages and disadvantages of ICBT for alcohol misuse and elicit recommendations to inform implementation efforts in routine practice.

Objective:

We sought to interview diverse stakeholders to gain an understanding of how ICBT is perceived as a treatment option for alcohol misuse. Specifically, we hoped to learn about the perceived advantages and disadvantages of ICBT for alcohol misuse and elicit recommendations to inform implementation efforts in routine practice.

Methods:

Thirty participants representing five stakeholder groups (i.e., consumer advocates, academic experts, frontline managers, service providers, healthcare decision makers) participated in semi-structured interviews. To be included in the study, stakeholders had to reside in Saskatchewan, Canada and have personal or professional experience with alcohol misuse. Interviews were transcribed verbatim, anonymized, and analyzed using thematic analysis.

Results:

Stakeholders identified numerous advantages of ICBT for alcohol misuse (e.g., accessibility, convenience, privacy, relevance to technology-based culture, fit with stepped-care), as well as several disadvantages (e.g., lack of Internet access and technological literacy, may foster isolation, less accountability, unfamiliarity with ICBT). Stakeholders also provided valuable insight into factors to consider when implementing ICBT for alcohol misuse in routine practice. In terms of intervention design, stakeholders recommended a 6-8 week, guided program that uses online advertising, point-of-sale marketing, and large-scale captive audiences to recruit participants. With regard to treatment content, stakeholders recommended that the program focus on harm reduction rather than abstinence, be evidence-based, appeal to the diverse residents of Saskatchewan, and use language that is simple, encouraging, and non-judgemental. Finally, in terms of population characteristics, stakeholders felt that several features of the alcohol misuse population, such as psychiatric comorbidity, readiness for change, and stigma, should be considered when developing an ICBT program for alcohol misuse.

Conclusions:

Stakeholders’ insights will help maximize the acceptability, appropriateness, and adoption of ICBT for alcohol misuse. The methodology and findings from the present study could be of benefit to others who are seeking to implement ICBT in routine practice.