Internet-based brief interventions for behavioural change: results of a RCT on risky drinking

Abstract

Background: Brief interventions (BI) delivered in primary care are effective tools in reducing risky drinking, but implementation is limited. Facilitated access to a digital application offers a novel alternative to face-to-face intervention, but its effectiveness is unknown. A British alcohol reduction website was adapted to the Italian culture. The aim of this study was to determine whether BI delivered by a facilitated access to this website was non-inferior to face to face BI in reducing harmful drinking behaviour. Methods: 58 general practitioners recruited 9080 patients. Those screening positive on AUDIT C partecipated to the trial. Baseline, 3 and 12 months assessments were carried out using AUDIT C as primary outcome measure. Brief motivational interview was administered in both conditions. 4529 (49.9%) logged on to the website and 3841 (84.8%) undertook online screening. 822 (21.4%) screened positive and 763 (19.9%) were recruited to the trial. 347 (45.5 %) were allocated to facilitated-access and 416 (54.5%) to face-to-face. 698 (91.5%) were followed up at 3 months and 620 (81.2%) at 12 months. Findings: AUDIT C average scores were at Baseline, face-to-face = 5.50 (DS = 1,50), facilitated-access = 5,49 (DS = 1,49); at 3MFU, face-to-face = 4 (DS = 1,65), facilitated-access = 4,13 (DS = 1,79); at 12MFU face-to-face = 3,68 (DS = 1,71), facilitated-access = 3.94 (DS = 1,85). Non-inferiority of 10% for facilitated access was demonstrated at three months follow-up. Discussion: Internet-based BI can be an important added value to the work of primary care professionals in behavioural change.