The Effectiveness of a Web-Based Self-Help Program to Reduce Alcohol Use Among Adults With Drinking Patterns Considered Harmful, Hazardous, or Suggestive of Dependence in Four Low-and Middle-Income Countries: Randomized Controlled Trial

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Schaub, Michael P. ^[1] ; Tiburcio, Marcela ^[2] ; Martinez-Velez, Nora ^[2] ; Ambekar, Atul ^[3] ; Bhad, Roshan ^[3] ; Wenger, Andreas ^[1] ; Baumgartner, Christian ^[1] ; Padruchny, Dzianis ^[4] ; Osipchik, Sergey ^[4] ; Poznyak, Vladimir ^[5] ; Rekve, Dag ^[5] ; Moraes, Fabricio Landi ^[6] ; Monezi Andrade, Andre Luiz ^[7] ; Oliveira Souza-Formigoni, Maria Lucia ^[6] ; Hlth, Who E-Hlth Project Alcohol

Afiliação do(s) autor(es)

^[1] Univ Zurich, Swiss Res Inst Publ Hlth & Addict, Konradstr 32, CH-8005 Zurich - Switzerland

^[2] Ramon de la Fuente Muniz Natl Inst Psychiat, Dept Social Sci Hlth, Mexico City, DF - Mexico

^[3] All India Inst Med Sci, Natl Drug Dependence Treatment Ctr, New Delhi - India

^[4] Republican Res & Practice Ctr Mental Hlth, Minsk - BELARUS

^[5] Dept Mental Hlth & Subst Abuse, Geneva - Switzerland

^[6] Univ Fed Sao Paulo, Escola Paulista Med, Dept Psicobiol, Sao Paulo - Brazil

^[7] Pontif Univ Catolica Campinas, Ctr Life Sci, Dept Psychol, Campinas - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF MEDICAL INTERNET RESEARCH; v. 23, n. 8 AUG 27 2021.
• Citações Web of Science: 0

Resumo

Background: Given the scarcity of alcohol prevention and use disorder treatments in many low- and middle-income countries (LMICs), the World Health Organization has launched an eHealth portal that includes the web-based self-help program ``Alcohol e-Health.{''} Objective: We aimed to test the effectiveness of the Alcohol e-Health program in a randomized controlled trial. Methods: This was a two-arm, individually randomized, and controlled trial across four LMICs comparing the self-help program and a psychoeducation and internet access as usual waiting list. Participants were broadly recruited from community samples in Belarus, Brazil, India, and Mexico from January 2016 through January 2019. The primary outcome measure was change in the Alcohol Use Disorders Identification Test (AUDIT) score with a time frame of 6 months between baseline and follow-up. Secondary outcomes included self-reported numbers of standard drinks over the previous week and cessation of harmful or hazardous drinking (AUDIT score <8). Results: For this study, we recruited 1400 predominantly male (n=982, 70.1%) at least harmful or hazardous alcohol drinkers. The mean age was 37.6 years (SD 10.5). The participants were recruited from Brazil (n=587), Mexico (n=509), India (n=212), and Belarus (n=92). Overall, complete case analysis identified higher AUDIT changes in the intervention group (B=-4.18, 95% CI -5.42 to -2.93, P<.001, d=0.56) that were mirrored by changes in weekly standard drinks (B=-9.34, 95% CI -15.90 to -2.77, P=.005, d=0.28) and cessation rates for harmful or hazardous drinking (chi(2)(1) = 14.56, N=561, P<.001). The supplementary intention-to-treat analyses largely confirmed these initial results. Conclusions: The expansion of the Alcohol e-Health program to other LMICs with underdeveloped alcohol prevention and treatment systems for alcohol use disorders should be considered after successful replication of the present results. (AU)

• 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