JMIR Publications

ABSTRACT

Background:

Alcohol misuse is a major health concern among military members. Reserve component members face unique barriers as they live off base with limited access to behavioral health services. Web and app-based brief interventions are a promising means to improve access to treatment for those who misuse alcohol, with the use of booster sessions to enhance effectiveness, solidify gains, and reinforce changes. However, little is known about who will engage in booster sessions.

Objective:

The purpose of this paper is to evaluate booster engagement across booster delivery modalities (web and peer) and identify participant-specific factors associated with booster session engagement.

Methods:

Following a brief web-based alcohol misuse intervention in National Guard members, we examined engagement in a series of three booster sessions. Using unadjusted and adjusted models, demographic and clinical characteristics that may serve as predictors of booster session engagement were examined across two types of booster sessions, peer-delivered and web-delivered.

Results:

Booster session completion was greater for peer-delivered than web-delivered booster sessions, with 58% of service members in the peer-delivered booster condition completing all three boosters compared to only 44% of participants in the web-delivered condition. Demographic and clinical predictors of booster engagement varied between the two delivery modalities, with higher socioeconomic indicators (education, rank, income) playing a more critical role for web-delivered than peer-delivered booster engagement.

Conclusions:

The use of peer-delivered boosters, especially among subsets of reserve members at-risk for lack of engagement, may foster greater uptake and improve treatment outcomes. Clinical Trial: NCT02181283