Abstract
BackgroundExcessive alcohol use is a prevalent and worldwide problem. Excessive drinking causes a significant burden of disease and is associated with both morbidity and excess mortality. Prototype alteration and provision of a cue reminder could be useful strategies to enhance the effectiveness of online tailored interventions for excessive drinking.ObjectiveThrough a Web-based randomized controlled trial, 2 strategies (ie, prototype alteration and cue reminders) within an existing online personalized feedback intervention (Drinktest) aimed to reduce adults’ excessive drinking. It was expected that both strategies would add to Drinktest and would result in reductions in alcohol consumption by intrinsic motivation and the seizure of opportunities to act.MethodsParticipants were recruited online and through printed materials. Excessive drinking adults (N=2634) were randomly assigned to 4 conditions: original Drinktest, Drinktest plus prototype alteration, Drinktest plus cue reminder, and Drinktest plus prototype alteration and cue reminder. Evaluation took place at 1-month posttest and 6-month follow-up. Differences in drinking behavior, intentions, and behavioral willingness (ie, primary outcomes) were assessed by means of longitudinal multilevel analyses using a last observation carried forward method. Measures were based on self-reports.ResultsAll conditions showed reductions in drinking behavior and willingness to drink, and increased intentions to reduce drinking. Prototype alteration (B=–0.15, P<.05) and cue reminder usage (B=–0.15, P<.05) were both more effective in reducing alcohol consumption than when these strategies were not provided. Combining the strategies did not produce a synergistic effect. No differences across conditions were found regarding intentions or willingness.ConclusionsAlthough individuals’ awareness of their cue was reasonable, their reported alcohol consumption was nevertheless reduced. Individuals appeared to distance their self-image from heavier drinking prototypes. Thus, prototype alteration and cue reminder usage may be feasible and simple intervention strategies to promote reductions in alcohol consumption among adults, with an effect up to 6 months.Trial RegistrationNederlands Trial Register (NTR): 4169; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4169 (Archived by WebCite at http://www.webcitation.org/6VD2jnxmB).
Highlights
BackgroundExcessive alcohol use is a prevalent and worldwide problem [1]
Individuals appeared to distance their self-image from heavier drinking prototypes
Some researchers have suggested that targeting this social reactive process may be more fruitful than addressing the explicit goal-directed route to overcome these issues [21,22,23]. This study addresses these issues by examining the effect of 2 intervention strategies that could potentially help enhance the effect of an existing online tailored intervention, Drinktest.nl: prototype alteration and cue reminders
Summary
In the Netherlands, 12.9% of the general population engages in weekly binge drinking, defined as ≥4 and ≥6 glasses of alcohol (10 gram each) per occasion for women and men, respectively. 8.3% drink excessively, defined as drinking 14 or 21 glasses per week for women and men, respectively [2]. It is associated with both morbidity and excess mortality [4] It is an underlying cause, in part or entirely, of more than 30 health conditions and a contributing factor to many more problems, such as social harm, costs, etc [5]. Excessive drinking causes a significant burden of disease and is associated with both morbidity and excess mortality. Prototype alteration and provision of a cue reminder could be useful strategies to enhance the effectiveness of online tailored interventions for excessive drinking
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