Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 26, 2020
Open Peer Review Period: Jan 26, 2021 - Mar 26, 2021
Date Accepted: Jul 13, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of a web-based self-help program to reduce alcohol use in adults with drinking patterns considered harmful, hazardous, or suggestive of dependence: results from a randomized controlled trial in four low- to middle-income countries
ABSTRACT
Background:
Background:
Given the scarcity of alcohol prevention and use disorder treatments in many low- and middle-income countries (LMIC), the World Health Organization has launched an e-health portal that includes the Web-based self-help program "Alcohol e-Health".
Objective:
Objective:
To study the effectiveness of the Alcohol e-Health program.
Methods:
Methods:
Ours was a two-arm individually-randomized and controlled trial, across four LMIC, that compared this self-help program and a psycho-education and Internet-access-as-usual waiting list. Participants were broadly recruited from community samples in Belarus, Brazil, India and Mexico from January 2016 through January 2019. The primary outcome measure was change in the Alcohol Use Disorders Identification Test (AUDIT) score between baseline and 6-month follow-up. Secondary outcomes included self-reported numbers of standard drinks over the previous week, and cessation of harmful or hazardous drinking (AUDIT < 8).
Results:
Results:
For this study, we recruited 1,380 predominantly male (70.0%) at least harmful or hazardous alcohol drinkers, mean age 37.6 years (SD=10.5), from Brazil (n=587), Mexico (n=491), India (n=212), and Belarus (n=90). Overall intention-to-treat analysis identified higher AUDIT changes in the intervention group (B=-3.80, 95% CI: -5.01 to -2.59, P<.001, d=0.51) that were mirrored by changes in weekly standard drinks (B=-10.30, 95% CI: -15.51 to -5.10, P<.001, d=0.27) and cessation rates for harmful or hazardous drinking (Χ2(1, N=542)=14.65, P<.001).
Conclusions:
Conclusions:
The Alcohol e-Health program effectively reduces drinking considered harmful, hazardous or suggestive of dependence. Expanding an updated version of the program into LMIC countries with underdeveloped prevention and treatment systems is recommended. Clinical Trial: This study is registered at ISRCTN (trial number ISRCTN14037475).
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