Pragmatic randomized controlled trial of a web-based intervention for alcohol use among Brazilian college students: Motivation as a moderating effect

Author(s)

Bedendo, Andre ^{[1, 2]} ; Ferri, Cleusa Pinheiro ^[3] ; Lino de Souza, Altay Alves ^[3] ; Monezi Andrade, Andre Luiz ^[4] ; Noto, Ana Regina ^[1]

Affiliation

^[1] Univ Fed Sao Paulo, UNIFESP, Res Ctr Hlth & Subst Use NEPSIS, Dept Psychobiol, Rua Botucatu, 862 1 Andar, Vila Clementino, BR-04023062 Sao Paulo, SP - Brazil

^[2] Univ York, Fac Sci, Dept Hlth Sci, Seebohm Rowntree Bldg, York Y010 5DD, N Yorkshire - England

^[3] Univ Fed Sao Paulo, UNIFESP, Dept Psychobiol, Rua Botucatu, 862 1 Andar, Vila Clementino, Sao Paulo, SP - Brazil

^[4] Pontificia Univ Catolica Campinas, CCV, Av John Boyd Dunlop, Campinas, SP - Brazil

• Document type: Journal article
• Source: DRUG AND ALCOHOL DEPENDENCE; v. 199, p. 92-100, JUN 1 2019.
• Web of Science Citations: 1

Abstract

Background: Web-based personalized normative feedback (PNF) interventions are less effective than their laboratory versions. Participant motivation may account for this reduced effect, but there is only a limited amount of research into the influence of motivation on PNF effectiveness. We evaluated the effectiveness of a web-based PNF in reducing alcohol use and consequences among college students with different motivation levels. Methods: Pragmatic randomized controlled trial among Brazilian college drinkers aged 18-30 years (N = 4460). Participants were randomized to a Control or PNF group and followed-up after one (T1), three (T2) and six (T3) months. Outcomes were: AUDIT score (primary outcome), the number of consequences, and the typical number of drinks. Motivation for receiving the intervention was assessed with a visual analog scale (range: 0-10). Generalized mixed models assessed intervention effects via two paradigms: observed cases and attrition models. Results: PNF reduced the number of typical drinks at T1 (OR = 0.71, p = 0.002), T2 (OR = 0.60, p < 0.001) and T3 (OR = 0.68, p = 0.016), compared to the control. Motivated students (score 3) receiving PNF also reduced the number of typical drinks at T1 (OR = 0.60, p < 0.001), T2 (OR = 0.55, p < 0.001) and T3 (OR = 0.56, p = 0.001), compared to the control. However, the attrition models were more robust at T1 and T2. In contrast, low-motivated students receiving the PNF increased AUDIT score at T3 (b = 1.49, p < 0.001). Conclusions: The intervention reduced alcohol use, and motivation for receiving the intervention moderated the intervention effects. Motivated students reduced their typical alcohol use, whereas low-motivated students increased their AUDIT score. (AU)

• FAPESP's process: 15/19472-5 - Innovative interventions related to alcohol consumption problems in Brazil: search for new approaches aimed at an old public health issue
• Grantee: Ana Regina Noto
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 13/20341-7 - Development and evaluation of effectiveness of an internet-based brief intervention for alcohol use among Brazilian college students
• Grantee: André Bedendo de Souza
• Support Opportunities: Scholarships in Brazil - Doctorate