Web-based screening and intervention may reduce drinking in university students

Web-based screening and personalized interventions for alcohol use may reduce drinking in undergraduate students, according to a report in the September 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Unhealthy alcohol use is becoming more prevalent among young adults in many countries, according to background information in the article. "Young people at university have a particularly high prevalence of unhealthy alcohol use and have been found to drink more heavily and to exhibit more clinically significant alcohol-related problems than their non-student peers."

Kypros Kypri, Ph.D., of the University of Newcastle, Callaghan, New South Wales, Australia and the University of Otago, New Zealand, and colleagues analyzed results from a 2007 Web-based Alcohol Use Disorders Identification Test taken by 7,237 undergraduate university students (ages 17 to 24) in Australia. The test consisted of an online questionnaire covering items such as demographics, drinking in the last year, largest number of drinks consumed on one occasion within the last four weeks, duration of drinking episode, secondhand effects such as being pushed, hit or assaulted, opinions on alcohol beverage labeling, smoking history, height and weight.

Participants who scored in the hazardous/harmful drinking range were placed in either a Web-based intervention group, which received motivational assessments and personalized feedback or a control group, which received no feedback. The personalized motivational interventions included information about reducing the associated health risk, an estimated blood alcohol concentration for the respondent's heaviest episode, monetary expenditure, comparison to other students' drinking and hyperlinks to smoking cessation and help with drinking problems. Follow-ups were conducted one and six months after screening.

In total, 2,435 participants scored in the hazardous/harmful drinking range. Of these, 1,251 were randomized to the Web-based motivational feedback group and 1,184 were to the control group. "After one month, participants receiving intervention drank less often, smaller quantities per occasion and less alcohol overall than did controls," the authors write. "Differences in alcohol-related harms were nonsignificant. At six months, intervention effects persisted for drinking frequency and overall volume but not for other variables."

"Given the scale on which proactive Web-based electronic screening and brief intervention (e-SBI) can be delivered and its acceptability to student drinkers, we can be optimistic that a widespread application of this intervention would produce a benefit in this population group," the authors conclude. "The e-SBI, a program that is available free for nonprofit purposes, could be extended to other settings, including high schools, general practices and hospitals."

(Arch Intern Med. 2009;169[16]:1508-1514. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was funded in part by a grant from the Western Australian Health Promotion Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

September 14, 2009