Web Intervention for Alcohol Use Disorder

Overseen By Karen Osilla, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Current alcohol treatment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

275 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the web-based intervention treatment for alcohol use disorder?

Research suggests that web-based interventions can be as effective as therapist-delivered treatments for people with less severe alcohol use issues. These online programs can help improve access to care and support ongoing recovery, showing promise in reducing alcohol-related problems. ^{1 2 3 4 5}

Is the web-based intervention for alcohol use disorder safe for humans?

The available research on web-based interventions for alcohol use disorder does not specifically address safety concerns, but these interventions are generally considered safe as they primarily involve online activities and information sharing. ^{1 6 7 8 9}

How is the web-based intervention treatment for alcohol use disorder different from other treatments?

The web-based intervention for alcohol use disorder is unique because it provides treatment through the internet, allowing users to access help from their own homes. This approach can be as effective as traditional therapy for those with less severe alcohol dependency and offers a convenient and accessible option for individuals who may not seek in-person treatment. ^{1 7 9 10 11}

What is the purpose of this trial?

Alcohol misuse is a prevalent and serious problem with significant harms to society, individuals, and their relationships. Romantic partners have a strong influence on their partner's behavior, uniquely positioning them as a motivator and supportive factor in changing their partner's alcohol use, but little evidence exists on the specific ways they can influence their partner. The impact this has on the quality of their relationship, communication, and overall well-being has yet to be explored. Thus, this study utilizes qualitative, quantitative, and ecological momentary assessment (EMA) data from both partners to develop a web-based intervention that applies communication-based personalized feedback to support the concerned partner (CP) in motivating their drinking partner (DP) to reduce drinking and other adverse relationship outcomes.

Eligibility Criteria

This trial is for couples where one partner is concerned about the other's drinking habits. Both partners must be willing to participate and use a web-based intervention (WBI) designed to help reduce alcohol consumption through improved communication.

Inclusion Criteria

Be in a romantic relationship

I live with my partner.

Have a computer, tablet, or phone with internet access

Exclusion Criteria

Report 4/5+ on the AUDIT-C

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Both partners complete baseline surveys to assess CP well-being, DP alcohol use, and relationship quality

1 week

1 visit (virtual)

Ecological Momentary Assessment (EMA)

Both partners complete a 21-day EMA with three daily reports on communication and DP's drinking behavior

3 weeks

Web-Based Intervention (WBI)

CPs participate in a four-session WBI that includes personalized feedback and CRAFT principles

4 weeks

4 sessions (virtual)

Follow-up

Participants are monitored for changes in CP well-being, DP alcohol use, and relationship quality

1 month

1 visit (virtual)

Treatment Details

Interventions

• Web-based Intervention

Trial Overview The study tests a new WBI that provides personalized feedback aimed at helping the concerned partner encourage their significant other to drink less. The effectiveness of this approach on reducing alcohol misuse and improving relationship quality will be assessed using various data collection methods.

Participant Groups

Group I: Develop and evaluate the feasibility and acceptability of a WBI providing personalized feedback Experimental Treatment 1 Intervention

We will use the Behavioral Intervention Technology Model framework to iteratively develop a four-session WBI that includes CRAFT principles and education about communication patterns learned in Aim 1. During the WBI, CPs will receive personalized feedback based on their baseline data on how their communication may influence their DP's drinking. We will evaluate the WBI's feasibility and acceptability with 15 CPs to iteratively improve the WBI.

Group II: Perform a pilot randomized controlled trial (RCT) comparing WBI to psychoeducation control Active Control 1 Intervention

Outcomes include DP drinking (primary), CP well-being (e.g., depression, anxiety, social support), and relationship functioning (e.g., relationship distress). Although the WBI will target CPs, we will collect data from both partners (N=80 couples) at baseline and 1-month follow-up to evaluate effects. Hyp4: DP, CP, and relationship outcomes will show greater improvement in the WBI compared to control.

Group III: Identify CP communication behaviors that elicit or inhibit DP drinking using EMA Active Control 1 Intervention

Couples (N=50 dyads) with one CP and one DP will be recruited from social media. Both partners will independently complete baseline and follow-up surveys. Both the CP and DP will independently complete a 21-day EMA with three daily reports on their communication and DP's drinking (craving, motives, consumption, problems). We will identify specific CP communication behaviors as proximal and long-term predictors of the DP's drinking and non-drinking. Hyp1: CP punishing drinking (e.g., yelling) will relate to increases in DP drinking. Hyp2: CP rewarding drinking (e.g., bringing alcohol home) will relate to increases in DP drinking. Hyp3: CP rewarding sobriety (e.g., planning non-drinking activities) will relate to decreases in DP drinking.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Portland State University

Collaborator

Trials

24

Recruited

26,600+

Findings from Research

Web-based interventions for substance use disorders are currently under-researched, with no large randomized controlled trials available, indicating a significant gap in the evidence base for their effectiveness.

Despite the limited and flawed literature, there is a strong demand for internet-based interventions, suggesting they could be as effective as traditional therapy for less severe cases of substance use disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Web-based interventions for substance use disorders: a qualitative review. Copeland, J., Martin, G.[2006]

A study involving 166 adults with alcohol use disorder found that a therapist-guided high-intensity internet intervention did not significantly outperform an unguided low-intensity intervention in reducing alcohol consumption at the 6-month follow-up.

Both interventions had low rates of negative effects (8-14%) and deterioration (3-5%), indicating that they were relatively safe options for participants seeking help with alcohol use disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High- versus low-intensity internet interventions for alcohol use disorders: results of a three-armed randomized controlled superiority trial. Sundström, C., Eék, N., Kraepelien, M., et al.[2021]

The Internet can significantly enhance addiction treatment by enabling efficient delivery of educational content and secure collection of self-reported data on substance use, making treatment more accessible and effective.

Internet applications support various aspects of addiction treatment, including assessment, monitoring patient outcomes, ongoing recovery support, and training for treatment providers, ultimately improving the quality of care and patient engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How Internet technology can improve the quality of care for substance use disorders. Cucciare, MA., Weingardt, KR., Humphreys, K.[2019]

Computer-based drinking assessment and intervention programs have been evaluated in the general public, revealing that users are typically young males in their early 30s who are at risk for alcohol-related issues.

While dropout rates from these online interventions are high, those who complete the programs generally show improvements in their drinking behaviors, indicating potential efficacy for those who engage fully.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A review of computer-based alcohol problem services designed for the general public. Vernon, ML.[2022]

The What Do You Drink (WDYD) Web-based brief alcohol intervention significantly reduced weekly alcohol consumption and binge drinking frequency among heavy-drinking students aged 18-24, with effects sustained at 3 and 6 months after the intervention.

In a study involving 907 participants, those who received the WDYD intervention reported lower alcohol use compared to a control group, demonstrating the intervention's effectiveness in promoting long-term behavioral change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using ecological momentary assessment to test the effectiveness of a web-based brief alcohol intervention over time among heavy-drinking students: randomized controlled trial. Voogt, C., Kuntsche, E., Kleinjan, M., et al.[2022]

A Web-based brief alcohol intervention effectively reduced weekly drinking among binge drinkers aged 15 to 20, with significant results observed at both 1 and 3 months after the intervention.

The intervention was particularly effective for males, who showed decreased alcohol use and increased moderate drinking, while females did not experience the same benefits, indicating a need for tailored approaches in alcohol interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of a web-based brief alcohol intervention and added value of normative feedback in reducing underage drinking: a randomized controlled trial. Spijkerman, R., Roek, MA., Vermulst, A., et al.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Web-based interventions for substance use disorders: a qualitative review. [2006]

2. England pubmed.ncbi.nlm.nih.gov

High- versus low-intensity internet interventions for alcohol use disorders: results of a three-armed randomized controlled superiority trial. [2021]

3. United Arab Emirates pubmed.ncbi.nlm.nih.gov

How Internet technology can improve the quality of care for substance use disorders. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

A review of computer-based alcohol problem services designed for the general public. [2022]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Effectiveness of guided and unguided online alcohol help: A real-life study. [2022]

6. England pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of an interactive Web-based intervention for reducing alcohol consumption. [2006]

7. India pubmed.ncbi.nlm.nih.gov

A review of web based interventions focusing on alcohol use. [2021]

8. Canada pubmed.ncbi.nlm.nih.gov

Web-Based Alcohol Intervention: Study of Systematic Attrition of Heavy Drinkers. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

The effectiveness of web-based interventions designed to decrease alcohol consumption--a systematic review. [2022]

10. Canada pubmed.ncbi.nlm.nih.gov

Using ecological momentary assessment to test the effectiveness of a web-based brief alcohol intervention over time among heavy-drinking students: randomized controlled trial. [2022]

11. Canada pubmed.ncbi.nlm.nih.gov

Effectiveness of a web-based brief alcohol intervention and added value of normative feedback in reducing underage drinking: a randomized controlled trial. [2021]