| 1. |
- Andersson, Claes, et al.
(författare)
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Automated telephone interventions for problematic alcohol use in clinical and population samples : a randomized controlled trial
- 2017
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Ingår i: BMC Research Notes. - : BioMed Central. - 1756-0500. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Objective The primary objective was to evaluate 6-month outcomes for brief and extensive automated telephony interventions targeting problematic alcohol use, in comparison to an assessment-only control group. The secondary objective was to compare levels of problematic alcohol use (hazardous, harmful or probable dependence), gender and age among study participants from clinical psychiatric and addiction outpatient settings and from population-based telephone helpline users and Internet help-seeker samples. Results The Alcohol Use Disorders Identification Test (AUDIT) was used for screening of problematic alcohol use and 6-month follow-up assessment. A total of 248 of help-seekers with at least hazardous use (AUDIT scores of ≥ 6/≥ 8 for women/men) were recruited from clinical and general population settings. Minor recruitment group differences were identified with respect to AUDIT scores and age at baseline. One hundred and sixty persons (64.5%) did not complete the follow-up assessment. The attrition group had a higher proportion of probable dependence (71% vs. 56%; p = 0.025), and higher scores on the total AUDIT, and its subscales for alcohol consumption and alcohol problems. At follow up, within-group problem levels had declined across all three groups, but there were no significant between-group differences. Trial registration ClinicalTrials.gov NCT01958359, Registered October 9, 2013. Retrospectively registered
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| 2. |
- Berman, Anne H., et al.
(författare)
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Digital Paths to Changing Problematic alcohol Use : Effectiveness of Unguided and Guided Interventions in a Stepped Care Model
- 2018
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Ingår i: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 25:Supplement 1, s. S43-S44
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction & Purpose: Digital interventions for changing problematic alcohol use have shown small effect sizes in relation to control groups. A meta-analysis (Riper et al., 2014) found an overall effect size of 0.20, with slightly higher effect sizes of 0.23 for interventions with a human guide, compared to 0.20 for unguided interventions. This presentation describes five different interventions, from unguided low-intensity to high-intensity guided interventions, evaluated in separate randomized controlled trials (RCT). Methods: Target groups included internet help-seekers and university students, with hazardous drinking according to the Alcohol Use Disorders Identification Test (AUDIT), excessive drinking based on national public health guidelines, or diagnosed alcohol use disorder (AUD). Study 1 evaluated eScreen.se, offering minimal screening and personal feedback, and alkoholhjalpen.se, a self-help program, with 633 internetbased participants reporting hazardous drinking. Study 2 evaluated the PartyPlanner and Promillekoll smartphone apps with 1932 university students reporting hazardous drinking. Study 3 evaluated the TeleCoach skills-based app with 186 university students who drank excessively. For studies 1-3 assessment-only controls were comparison groups. Study 4 compared the unguided eChange 10-week program to a guided version with 80 internet-based participants having at least hazardous use. Study 5 with 166 participants compared the high-intensity ePlus 13-week program to the unguided eChange program in a 13-week version, and a small wait-list control group. Results: Studies 1-5 are compared with one another in terms of baseline characteristics and results. Although inclusion criteria varied, baseline AUDIT levels out of a maximum of 40 points for studies 1-5 respectively were 20.82 (SD 6.93), 10.55 (3.90); 13.46 (4.69); 21.00 (4.90) and 23.70 (1.40). Within-group and between-group results are compared, showing greater effects for more intensive interventions. Conclusions: Effects vary by target groups, severity levels and interventions, but it is clear that digital interventions contribute to reduced problematic alcohol use.
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| 3. |
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| 4. |
- Berman, Anne H., et al.
(författare)
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Mobile phone apps for university students with hazardous alcohol use : study protocol for two consecutive randomized controlled trials
- 2015
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Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: About 50% of university students overconsume alcohol, and drinking habits in later adulthood are to some extent established during higher educational studies. Several studies have demonstrated that Internet-based interventions have positive effects on drinking habits among university students. Our recent study evaluated two mobile phone apps targeting drinking choices at party occasions via personalized feedback on estimated blood alcohol concentration (eBAC) for students with hazardous drinking. No changes in drinking parameters were found over a seven-week period apart from an increase in number of drinking occasions among men for one of the apps tested. Up to 30% of the study participants drank at potentially harmful levels: higher than the national recommended number of standard drinks per week (a maximum of 9 for women and 14 for men) in Sweden. Objective: (1) To evaluate improved versions of the two mobile phone apps tested in our prior trial, in a new, 3-armed randomized controlled trial among university students with at least hazardous drinking habits according to the Alcohol Use Disorders Identifications Test (AUDIT; Study 1). (2) After 6 weeks, to target study participants showing alcohol consumption higher than the national recommended levels for standard drinks per week by offering them participation in a second, 2-armed randomized trial evaluating an additional mobile phone app with skill enhancement tasks (Study 2). (3) To follow participants at 6, 12 and 18 weeks after recruitment to Study 1 and at 6 and 12 weeks after recruitment to Study 2. Methods: Two randomized controlled trials are conducted. Study 1: Students are recruited at four Swedish universities, via direct e-mail and advertisements on Facebook and student union web sites. Those who provide informed consent, have a mobile phone, and show at least hazardous alcohol consumption according to the AUDIT (≥6 for women; ≥8 points for men) are randomized into three groups. Group 1 has access to the Swedish government alcohol monopoly’s app, Promillekoll, offering real-time estimated eBAC calculation; Group 2 has access to a Web-based app, PartyPlanner, developed by the research group, offering real-time eBAC calculation with planning and follow-up functions; and Group 3 participants are controls. Follow-up is conducted at 6, 12 and 18 weeks. Study 2. Participants who at the first 6-week follow-up show drinking levels higher than 9 (W) or 14 (M) standard drinks (12 g alcohol) per week, are offered participation in Study 2. Those who consent are randomized to either access to a skills training app, TeleCoach or to a wait-list control group. Results: Latent Markov models for Study 1 and mixed models analyses for Study 2 will be performed. Study 2 data will be analyzed for publication during the spring of 2016; Study 1 data will be analyzed for publication during the fall of 2016. Conclusions: If mobile phone interventions for reducing hazardous alcohol use are found to be effective, the prospects for positively influencing substance use-related health among university students can considerably improve.
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| 5. |
- Berman, Anne H, et al.
(författare)
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Mobile phone brief intervention applications for risky alcohol use among university students : Three randomized controlled studies
- 2015
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Ingår i: The 13th International Conference on Treatment of Addictive Behaviors, 31st of May-4th of June 2015, Odense, Denmark. - : The University of New Mexico, CASAA. ; , s. 17-17
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Most university students overconsume alcohol and have smartphones. Brief online interventions reduce students’ alcohol intake. Delivering brief interventions to students via smartphone apps should be investigated. Method: Students at several Swedish universities were invited to the 3 studies described via e-mails and online ads. Students with a smartphone and risky alcohol consumption according to the Alcohol Use Disorders Identification Test (AUDIT) were included, following informed consent. Three apps were tested, two targeting individual drinking choices on party occasions (Promillekoll and PartyPlanner), and one targeting high-risk users (TeleCoach™). Study 1 offered randomization into 3 groups: Promillekoll (1), offering real-time estimated blood alcohol concentration (eBAC) calculation; PartyPlanner (2), a web-based app with real-time eBAC calculation and additional planning/follow-up functions; a control group (3). Follow-up occurred at 7 weeks. Study 2 replicated Study 1; changes included improved apps based on Study 1 results, and follow-up times extended from 7 to 14 and 21 weeks (T1, T2 & T3). Study 3 offered participants at T1 from Study 2, who drank over 9 (women) and 14 (men) standard drinks/week, randomization into an intervention group (TeleCoach™) and a wait-list control group (intervention offered at T2). Results: For Study 1, 1932 fulfilled eligibility criteria for randomization. Attrition was 22.7–39.3 percent, higher among heavier drinkers and highest in Group 2. Per-protocol analyses revealed one significant timeby- group interaction, where Group 1 participants increased the frequency of their drinking occasions compared to controls (p = 0.001). Among all participants, 29 percent showed high-risk drinking, over the recommended weekly drinking levels of 9 (women) and 14 (men) standard glasses. Preliminary results will be reported for Studies 2 and 3. Discussion: Mobile phone apps offer a huge potential for making brief interventions available to more university students than ever before. Research is needed to identify effective app content.
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| 6. |
- Berman, Anne H., et al.
(författare)
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Reducing Risky Alcohol Use via Smartphone App Skills Training Among Adult Internet Help-Seekers : A Randomized Pilot Trial
- 2020
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol is one of the leading risk factors for global disease burden and overconsumption leads to a wide variety of negative consequences in everyday life. Digital interventions have shown small positive effects in contributing to reductions in problematic use. Specific research on smartphone apps is sparse and the few studies published indicate effects ranging from negative or null to small or moderate. TeleCoach™, a web-based skills training smartphone app, has shown positive effects in non-treatment-seeking university students with excessive drinking. This pilot trial aimed to evaluate app effects in a sample of internet help-seekers from the general population in Sweden. A total of 89 participants were recruited via online advertisement. Following baseline assessment for hazardous use, they were randomized to TeleCoach or a web-based control app offering brief information and advice regarding problematic alcohol use. The primary outcome was number of standard drinks per week; secondary outcomes included drinking quantity and frequency, binge drinking and blood alcohol count measures as well as app user data and comorbidity related to depression, anxiety, and drug use. Analysis of baseline and 6-week follow-up outcomes showed significant within-group effects on alcohol consumption but no significant between-group differences. Effect sizes for the within-group changes in the primary outcome over time were significant [F(1, 55)=43.98; p < 0.001], with a Cohen's d of 1.37 for the intervention group and 0.92 for the control group. This difference in effect sizes indicated that continuation of the study as a large randomized, controlled trial with up to 1,000 participants could be worthwhile.
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| 7. |
- Berman, Anne H., et al.
(författare)
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Skills Training for Reducing Risky Alcohol Use in App Form Among Adult Internet Help-seekers
- 2020
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Ingår i: Annals of Behavioral Medicine. - : Oxford University Press. - 0883-6612 .- 1532-4796. ; 54:S1, s. S417-S417
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Problematic alcohol use in Sweden occurs among 16 % of the adult population. Digital interventions of varying intensity have shown positive effects in contributing to reductions in problematic use, and the TeleCoach app has shown positive effects in non-treatment-seeking university students with excessive drinking (Gajecki et al., 2017). This pilot study evaluated the app among adult internet help-seekers, and motivated continued data collection in the current target group. Methods: Adult internet-help seekers, recruited via advertisement, were included if they scored ³6 (women) or ³8 (men) on the Alcohol Use Disorders Identification Test (AUDIT). Those with depression scores of ³31 on the Montgomery Åsberg Depression Rating Scale (MADRS-S) or problematic drug use scores of ³8 on the Drug Use Disorders Identification Test (DUDIT) were contacted for a telephone interview and included following clinical assessment; if not reached they were excluded. Participants randomized at a 1:1 ratio to the TeleCoach™ web-based app or to a web-based app with information texts from primary care-based self-help material for changing problematic alcohol use. At six-week follow-up, the primary outcome was the number of standard drinks per past week (Timeline-Followback). Results: Of 147 persons assessed for eligibility, 89 were assigned to the intervention group (n=42) or control group (n=47). Average AUDIT levels at baseline were ³18.The baseline number of standard drinks per week was 32.73 (SD 21.16) for the intervention group, and 26 (4.08) for the control group; at 6-week follow-up it was 12.73 (10.52) and 13.48 (11.13) for the intervention and control groups, respectively. No significant between-groups effects occurred, but withingroup changes over time were significant (F(1, 55)=43.98; p< 0.000), with an effect size of 1.37 for the intervention group and 0.92 for the control group. Conclusions: The results suggest that web-based apps can be of help to internet help-seekers motivated to reduce problematic alcohol use. We have proceeded with the planned larger randomized, controlled study and will present 6-week follow-up data for the entire study sample (n=∼1000) in this presentation.
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| 8. |
- Berman, Anne H., et al.
(författare)
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Smartphone Apps Targeting Hazardous Drinking Patterns among University Students Show Differential Subgroup Effects over 20 Weeks : Results from a Randomized, Controlled Trial.
- 2019
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 8:11
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Tidskriftsartikel (refereegranskat)abstract
- Overconsumption of alcohol, from hazardous to excessive, heavy, and harmful levels, is common among university students. Consenting Swedish students were assigned to one of two smartphone apps offering feedback on estimated blood alcohol concentration (eBAC; Promillekoll/PartyPlanner) or assessment only (n = 2166; 1:1:1 ratio). App participants with excessive drinking according to public health criteria (>9/>14 drinks/week for women/men, respectively) at a 7 week follow-up were additionally assigned to the skills-based TeleCoach app or waitlist (n = 186; 1:1 ratio). All participants were followed at 14 and 20 weeks. At 7 weeks, Promillekoll users showed higher risk of excessive drinking (odds ratio (OR) = 1.83; p
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| 9. |
- Berman, Anne H, et al.
(författare)
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Smartphone apps targeting risky and excessive drinking patterns among university students show differing subgroup effects over 20 weeks
- 2017
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Ingår i: Addiction science & clinical practice. - : BioMed Central. - 1940-0632 .- 1940-0640. ; 12:Suppl 1, s. 19-20
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and Aims: University students with risky drinking are a clear target group for intervention via smartphone apps. This study compared three different apps over a 20-week period, for university students with hazardous and excessive drinking patterns. Materials and Methods: Students from six campuses were invited to a three-armed trial (A). Those with hazardous alcohol use (n = 2166) were randomly assigned to one of two smartphone apps offer- ing feedback on real-time estimated blood alcohol concentration (eBAC) levels, or to a control group, with three follow-ups at 6, 12 and 20 weeks. At 6 weeks, participants in the app groups with excessive weekly alcohol consumption of >9 (women) or >14 (men) drinks per week (n = 257), were offered participation in a second trial (B); con-senters (n = 186) were randomly assigned to a skills-based app or a waitlist group, and compared with an assessment-only control group. Results: Six-week analyses (n = 2166) replicated our earlier trial from 2014, re-confirming earlier results: the Promillekoll app was associated with higher quantity and frequency of drinking compared to controls, and a higher risk for excessive drinking; the PartyPlanner group did not differ from controls. Lower-risk drinkers from trial A (n = 1177) up to 20 weeks did not differ from controls on main outcomes. However, sub-analyses showed that individuals with higher consumption had higher motivation to reduce intake. In both intervention groups, con-sumption was lower for more highly motivated participants compared to controls at 6- and 20-week follow-ups. Latent class analysis of par- ticipants in both trials (n = 2166) revealed a class (n = 146) that drank several days a week and that differed significantly from the remain- ing cohort in gender, age, and alcohol consumption. For this class, access to the Promillekoll app appeared marginally associated with lower quantity over time; access to the skills-based TeleCoach app was clearly associated with fewer drinking days up to 20 weeks. Conclusions: Smartphone apps targeting eBAC can influence drink-ing levels up to 20 weeks for university students with hazardous use and higher motivation to reduce their drinking. A skills-based app that reduces intake among students with excessive weekly consumption can be particularly effective for students with daily drinking habits.
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