Abstract
BackgroundIn European countries, including Switzerland, cannabis is the most commonly used illicit drug. Offering a Web-based self-help tool could potentially reach users who otherwise would not seek traditional help. However, such Web-based self-help tools often suffer from low adherence.ObjectiveThrough adherence-focused guidance enhancements, the aim of this study was to increase adherence in cannabis users entering a Web-based self-help tool to reduce their cannabis use and, in this way, augment its effectiveness.MethodsThis paper presents the protocol for a three-arm randomized controlled trial (RCT) to compare the effectiveness of (1) an adherence-focused, guidance-enhanced, Web-based self-help intervention with social presence; (2) an adherence-focused, guidance-enhanced, Web-based self-help intervention without social presence; and (3) a treatment-as-usual at reducing cannabis use in problematic users. The two active interventions, each spanning 6 weeks, consist of modules designed to reduce cannabis use and attenuate common mental disorder (CMD) symptoms, including depression, anxiety, and stress-related disorder symptoms based on the approaches of motivational interviewing and cognitive behavioral therapy. With a target sample size of 528, data will be collected at baseline, 6 weeks, and 3 months after baseline. The primary outcome measurement will be the number of days of cannabis use on the preceding 7 days. Secondary outcomes will include the quantity of cannabis used in standardized cannabis joints, the severity of cannabis dependence, changes in CMD symptoms, and adherence to the program. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models.ResultsThe project commenced in August 2016; recruitment is anticipated to end by December 2018. First results are expected to be submitted for publication in summer 2019.ConclusionsThis study will provide detailed insights on if and how the effectiveness of a Web-based self-help intervention aiming to reduce cannabis use in frequent cannabis users can be improved by theory-driven, adherence-focused guidance enhancement.Trial RegistrationInternational Standard Randomized Controlled Trial Number Registry: ISRCTN11086185; http://www.isrctn.com/ISRCTN11086185 (Archived by WebCite at http://www.webcitation.org/6wspbuQ1M)
Highlights
5.4% der Schweizer Bevölkerung konsumieren gegenwärtig Cannabis
Cannabiskonsum ist in der Schweiz nicht selten
Tabelle 7.2: Prävalenz des Cannabiskonsums und des problematischen Cannabiskonsums (originaler Cannabis Use Disorder Identification Test" (CUDIT)) 2004 und 2014 - Total und nach Alter, nur 15- bis 24-Jährige n ungewichtet n gewichtet
Summary
Abbildung 3.1: Abbildung 3.2: Abbildung 3.3: Abbildung 4.1: Abbildung 4.2: Abbildung 5.1: Abbildung 5.2: Abbildung 6.1: Abbildung 6.2: Abbildung 6.3: Abbildung 7.1: Abbildung 7.2: Tabellenverzeichnis. In der Romandie sind mit 1.3% etwas mehr Personen vom problematischen Cannabiskonsum betroffen als in der deutschsprachigen (1.0%) oder der italienischsprachigen Schweiz (0.9%). Von den Personen, die in den letzten 6 Monaten Cannabis konsumiert haben, weisen 20.3% einen problematischen Cannabiskonsum auf. Bei Personen mit einem Konsum viermal oder häufiger pro Woche sind drei Viertel problematisch Cannabiskonsumierende. Die Prävalenz des problematischen Cannabiskonsums liegt in der Gesamtbevölkerung mit 3.2% deutlich darunter. Bei den Vollzeit-Erwerbstätigen (3.8%) und den Personen in Ausbildung oder Lehre (2.9%) ist die Prävalenz des problematischen Cannabiskonsums in etwa mit jener in der Gesamtbevölkerung vergleichbar. Im Jahr 2004 lag die Prävalenz des problematischen Cannabiskonsum bei den 15- bis 24-Jährigen bei 5.3%, im Jahr 2012 lag sie mit 4.6% etwas niedriger und sank bis zum Jahr 2014 erneut leicht auf 3.6%
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