Curbing Problem Drinking with Personalized-Feedback Interventions A Meta-Analysis

Innovation Centre of Mental Health and Technology, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands.
American journal of preventive medicine (Impact Factor: 4.53). 04/2009; 36(3):247-55. DOI: 10.1016/j.amepre.2008.10.016
Source: PubMed


The effectiveness of personalized-feedback interventions to reduce problem drinking has been evaluated in several RCTs and systematic reviews. A meta-analysis was performed to examine the overall effectiveness of brief, single-session personalized-feedback interventions without therapeutic guidance.
The selection and analyses of studies were conducted in 2008. Fourteen RCTs of single-session personalized-feedback interventions without therapeutic guidance were identified, and their combined effectiveness on the reduction of problematic alcohol consumption was evaluated in a meta-analysis. Alcohol consumption was the primary outcome measure.
The pooled standardized-effect size (14 studies, 15 comparisons) for reduced alcohol consumption at post-intervention was d=0.22 (95% CI=0.16, 0.29; the number needed to treat=8.06; areas under the curve=0.562). No heterogeneity existed among the studies (Q=10.962; p=0.69; I(2)=0).
The use of single-session personalized-feedback interventions without therapeutic guidance appears to be a viable and probably cost-effective option for reducing problem drinking in student and general populations. The Internet offers ample opportunities to deliver personalized-feedback interventions on a broad scale, and problem drinkers are known to be amenable to Internet-based interventions. More research is needed on the long-term effectiveness of personalized-feedback interventions for problem drinking, on its potential as a first step in a stepped-care approach, and on its effectiveness with other groups (such as youth obliged to use judicial service programs because of violations of minimum-age drinking laws) and in other settings (such as primary care).


Available from: Heleen Riper
    • "Investigation of causal processes is critical for the advancement of both interventions and evidence-based practice (Longabaugh et al., 2005). Thus, theory may be useful in determining which principles of change to target in future research and incorporate in future interventions, as many current interventions yield small to moderate effects on drinking (Riper et al., 2009). It would also be ideal to operationalise and standardise measurement of the constructs reviewed. "
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    ABSTRACT: Although personalised feedback interventions (PFIs) for alcohol misuse among college students have demonstrated reliable efficacy, effect sizes are modest and little improvement in efficacy has been observed in the last 15 years. More systematic and explicit application of theory may enhance our understanding of PFI mechanisms and lead to incremental improvements in efficacy. The current review identified intervention trials of PFIs (N = 93), the theoretical frameworks (N = 20) on which they were based, the extent to which theory was utilised in development and evaluation of the intervention, and the principles of behaviour change implicated in each of those theories. Though the majority of studies identified a theoretical framework for interventions, theory is not being tested uniformly across current studies of PFIs. A review of the most commonly cited theories resulted in identification of 11 theoretical principles of behaviour change: alternatives to behaviour, autonomy, commitment, expectancies, goals/change plan, interpersonal discrepancy, intrapersonal discrepancy, awareness of contingent outcomes, self-efficacy, skills necessary to overcome barriers and therapeutic relationship. Potential applications of these theoretical principles in PFI development and testing are discussed.
    Addiction Research and Theory 01/2015; 23(4). DOI:10.3109/16066359.2014.1001840 · 1.03 Impact Factor
    • "The brief motivational interview has been shown to be effective in reducing alcohol consumption in non-alcoholic patients (Vasilaki et al., 2006). Moreover, the exclusive use of information technology without supportive therapy has been shown to be cost-effective in reducing alcohol consumption in the general population (Riper et al., 2009; Bewick et al., 2008). Finally, it has been suggested that the use of pamphlets or other paper-based interventions which do not require a face-to-face interview are more effective for people who are reluctant to talk about their problems (Apodaca and Miller, 2003). "
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    ABSTRACT: Objective: To evaluate the effectiveness of brief interventions in the primary health care setting to decrease alcohol consumption in non-alcoholic adult drinkers. Method: Systematic review of systematic reviews and meta-analyses of randomized clinical trials published in English and Spanish and indexed in EMBASE, MEDLINE (PubMed), Web of Science, Scopus, and The Cochrane Library, from their inception to January 2014. The quality of the studies was evaluated with the AMSTAR instrument. Results: Seven studies, published from 1999 to 2011, were included in the review (six meta-analyses, one systematic review). These studies were heterogeneous in terms of design, type and length of interventions analyzed, participants, responsible professionals, and results. Five studies reported a moderate decrease in alcohol consumption and four showed a decrease in the number of participants who consumed alcohol above the established risk level. Conclusion: Brief interventions have a moderate effect on reducing alcohol consumption among excessive drinkers or people who consume excessive amounts of alcohol and as a consequence these interventions increased the number of people drinking alcohol below established limits of risk. Brief interventions with multiple contacts or follow-up sessions are the most effective.
    Preventive Medicine 12/2014; 76. DOI:10.1016/j.ypmed.2014.12.010 · 3.09 Impact Factor
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    • "No studies to date, however, have provided feedback based on student-generated decisional balance data. Considering the positive fi ndings for web-based personalized feedback interventions in the literature (Carey et al., 2007; Cronce and Larimer, 2011; Riper et al., 2009; Walters and Neighbors, 2005), decisional balance feedback (DBF) may be a novel variant of such interventions by providing students with a summary of their motivation to change (e.g., overall balance toward change, summary of perceived advantages/disadvantages, and the weight of their importance and likelihood). DBF is well positioned to support drinking reductions among college students. "
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    ABSTRACT: Objective: Web-based personalized feedback interventions, particularly personalized normative feedback (PNF), are efficacious in improving college drinking outcomes; however, no personalized feedback interventions to date have provided college drinkers with feedback about their own decisional balance. This study tested the relative efficacy of a novel decisional balance feedback (DBF) intervention, PNF, and an assessment-only control condition. Method: Participants (N = 724; 56% female) were undergraduate students at a 4-year university in the U.S. Pacific Northwest and were randomized to receive one-time exposure to web-based DBF, PNF, or assessment only. Web-based assessment occurred at baseline and at 1-, 6-, and 12-month follow-ups and included measures of motivation to change, drinking quantity norms, drinking frequency/quantity, and alcohol-related problems. Results: At the 1-month follow-up, DBF and PNF participants reported reductions in alcohol-related problems; however, only PNF participants reduced their drinking frequency and quantity. At the 6-month follow-up, only DBF participants showed significant reductions in drinking quantity and alcohol-related problems. Neither group maintained reductions in alcohol use or alcohol-related problems at the 12-month follow-up. Conclusions: This study provided preliminary evidence that web-based DBF and PNF are efficacious interventions for college drinkers, with DBF having somewhat longer lasting effects.
    Journal of studies on alcohol and drugs 11/2014; 75(6):982-92. DOI:10.15288/jsad.2014.75.982 · 2.76 Impact Factor
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