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Web-based screening and brief intervention for the spectrum of alcohol problems
Richard Saitz1, Eric D Helmuth, Susan E Aromaa
1Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA 02118, USA. rsaitz@bu.edu
Context:
Many persons who drink excessively remain unidentified and do not receive interventions. Screening and intervention using the World Wide Web could make such services more accessible and therefore more widely used.
Objective:
To evaluate the use of a novel alcohol screening and brief intervention Web site.
Design:
A Web site was developed, posted, and its use was evaluated. We analyzed a sample of visitors who completed alcohol screening over a 14-month period to describe their alcohol use, and their use of portions of the Web site that provide information and referral resources.
Setting:
The Internet.
Patients Or Other Participants:
Web site visitors, with a focus on visitors who completed an alcohol-screening questionnaire about their own drinking.
Intervention:
Brief intervention via the Web site, consisting mainly of feedback, advice, and a menu of change options and referral information.
Main Outcome Measures:
Self-reported drinking amounts and alcohol screening test scores, and utilization of Web site components.
Results:
Visitors completed online alcohol screening questionnaires at a rate of 50,711/year of 115,925 visitors/year. In a 14-month period, 39,842 adults completed the questionnaire about their own drinking habits; 66% were men, 90% reported drinking hazardous amounts (per occasion or typical weekly amounts), 88% reported binge (per occasion) drinking, and 55% reported typically exceeding weekly risky drinking limits. Most (65%) had alcohol screening test results (AUDIT > or = 8) consistent with alcohol abuse or dependence; similar proportions of women and men were hazardous drinkers. One-fifth of visitors visited portions of the Web site that provided additional information about alcohol use and referrals. Visitors with possible alcohol abuse or dependence were more likely than those without these disorders to visit a part of the Web site designed for those seeking additional help (33% vs. 8%, P < 0.0001).
Conclusions:
A well-publicized, easily accessible, research-based screening and intervention Web site can attract many users, most of whom are drinking excessively, and many of whom avail themselves of referral information after receiving individualized feedback.