Components evaluation of a web-based personalized normative feedback intervention for alcohol use among college students: a pragmatic randomized controlled trial with a dismantling design

Autor(es)

Bedendo, Andre ^{[1, 2]} ; McCambridge, Jim ^[2] ; Gaume, Jacques ^[3] ; Souza, Altay A. L. ^[4] ; Formigoni, Maria Lucia O. S. ^[4] ; Noto, Ana R. ^[1]

Afiliação do(s) autor(es)

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

^[2] Univ York, Fac Sci, Dept Hlth Sci, York, N Yorkshire - England

^[3] Lausanne Univ Hosp, Alcohol Treatment Ctr, Lausanne - Switzerland

^[4] Univ Fed Sao Paulo, UNIFESP, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: ADDICTION; v. 115, n. 6 JAN 2020.
• Citações Web of Science: 0

Resumo

Aims To evaluate the effects of the two main components of a personalized normative feedback (PNF) {[}normative feedback only (NFO); and consequences feedback only (CFO)] compared with the full intervention (PNF) in reducing alcohol use and consequences. Design Three-arm pragmatic randomized controlled trial with dismantling design and 1-, 3- and 6-month follow-ups. Setting Web-based among Brazilian college students. Participants College students (aged 18-30 years) who reported alcohol use in the last 3 months (n = 5476). Interventions (1) Full PNF (a) drinking profile; (b) normative comparisons; (c) practical costs; (d) alcohol consequences; (e) strategies to decrease risks; (2) NFO components (a), (b) and (e); or (3) CFO components (c), (d) and (e). Measurements The primary outcome was change in Alcohol Use Disorders Identification Test (AUDIT) score; secondary outcomes were the number of alcohol consequences, drinking frequency and typical/maximum number of drinks. We used mixed models with multiple imputation and a pattern-mixture model to account for attrition. Subgroup analyses considered participant motivation to know more about their drinking (less motivated versus motivated). Findings Dismantled components reduced rather than increased AUDIT score compared to full PNF, with significant effects for NFO at 1 month {[}b = -0.23, 95% confidence interval (CI) = -0.46; -0.002] and for CFO at 3 months (b = -0.33, 95% CI = -0.62; -0.03). Compared with PNF, NFO reduced the number of alcohol consequences at 1 month (b = -0.16, 95% CI = -0.25; -0.06) and drinking frequency at 3 months (b = -0.42, 95% CI = -0.79; -0.05), but increased the number of typical drinks at 6 months (b = 0.38, 95% CI = 0.04; 0.72). CFO reduced drinking frequency at 3 months (b = -0.37, 95% CI = -0.73; -0.01). Attrition models confirmed all results, except for the NFO effect on typical drinks and drinking frequency. Subgroup analyses indicated superiority of dismantled components among the students less motivated in knowing more about their drinking. Conclusions There was no evidence that either the normative or the consequences components of a web-based personalized normative feedback intervention to reduce alcohol use and its consequences contributed to intervention effects. There was some evidence of adverse effects of personalized normative feedback, and these results were driven by 20% of participants who were less motivated in knowing more about their drinking. (AU)

• Processo FAPESP: 18/12729-9 - Estudo do mecanismo de mudança de comportamento de uma intervenção breve via web para uso de álcool entre estudantes universitários através de análises de mediação e moderação
• Beneficiário: André Bedendo de Souza
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Pós-Doutorado
• Processo FAPESP: 13/20341-7 - Desenvolvimento e avaliação da efetividade de uma intervenção breve via internet para o consumo de álcool entre estudantes universitários brasileiros
• Beneficiário: André Bedendo de Souza
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 15/19472-5 - Intervenções inovadoras frente a problemas relacionados ao consumo do álcool no Brasil: busca de novas abordagens para uma antiga questão de saúde pública
• Beneficiário: Ana Regina Noto
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Processo FAPESP: 17/13831-9 - Análise de mediação e moderação da efetividade de uma intervenção via internet sobre o uso de álcool entre universitários brasileiros
• Beneficiário: André Bedendo de Souza
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado