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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to develop and test a web-based tool to help partners support each other in reducing alcohol use. The study examines how communication between partners can influence drinking habits and overall relationship well-being. Participants will either use the web tool or receive general information to determine which approach is more effective. Couples who live together, feel safe, and have internet access might be a good fit.

As an unphased trial, this study offers participants the chance to contribute to innovative research that could enhance relationship dynamics and promote healthier lifestyles.

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 prior data suggests that this web-based intervention is safe?

Research has shown that online programs for treating alcohol problems are generally safe and well-received. Studies have found that internet-based treatment is as effective as in-person therapy in helping people reduce their drinking. This indicates that online therapy is both safe and effective.

In one study, participants used online cognitive behavioral therapy (CBT) with weekly check-ins and reported positive results without major safety issues. Another study found that online CBT programs serve as a good alternative to in-person therapy for reducing alcohol use and related problems.

Overall, these findings suggest that online treatments for alcohol use are safe and can be a good choice for those seeking help. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this web-based intervention for alcohol use disorder because it offers a unique approach compared to traditional treatments like counseling or medication. This intervention is particularly innovative as it provides personalized feedback to partners (CPs) of individuals with drinking problems (DPs), emphasizing how their communication can impact drinking behaviors. By utilizing principles from Community Reinforcement and Family Training (CRAFT) and focusing on relationship dynamics, it aims to improve both individual and relational outcomes. The use of technology to deliver the intervention allows for greater accessibility and the potential to reach more people who might not engage with conventional treatment methods.

What evidence suggests that this web-based intervention is effective for alcohol use disorder?

Research has shown that online programs can be as effective as face-to-face therapy in helping people reduce alcohol intake. Some studies have found that these digital programs lead to more individuals staying sober and feeling happier with their drinking habits. Participants often report better control over their drinking and are more likely to refuse drinks. Online tools, especially those based on cognitive behavioral therapy, have shown promise in changing drinking behaviors. This trial will compare a Web-based Intervention (WBI) to a psychoeducation control group to evaluate its effectiveness in supporting healthier drinking habits among partners. The online program under development could effectively help partners support healthier drinking habits. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

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

Have a computer, tablet, or phone with internet access

I live with my partner.

Exclusion Criteria

Report 4/5+ on the AUDIT-C

Timeline for a Trial Participant

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)

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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