Reducing problematic alcohol use in employees: economic evaluation of guided and unguided web-based interventions alongside a three-arm randomized controlled trial

What do we know about alcohol internet interventions aimed at employees?-A scoping review

Background

Internet interventions are a promising avenue for delivering alcohol prevention to employees. The objective of this scoping review was to map all research on alcohol internet interventions aimed at employees regardless of design, to gain an overview of current evidence and identify potential knowledge gaps.

Methods

We conducted a literature search in three data bases (PsycInfo, PubMed, and Web of Science). Eligibility criteria were that (1) the study targeted employees age ≥18 years; (2) the intervention was delivered predominantly online; (3) the study focused specifically or in part on alcohol use; and (4) the study was published in English in a peer-reviewed academic journal. Two reviewers independently screened, reviewed, and extracted data.

Results

Twenty studies were included, of which 10 were randomized controlled trials, five were secondary analyses, three were feasibility trials, one was a cohort study and one described the rationale and development of an intervention. No qualitative studies were found. Randomized trials tended to show effects when interventions were compared to waitlists but not when more intensive interventions were compared to less intensive ones. We identified two design-related aspects where studies differed; (1) whether all applicants were included regardless of alcohol use level and (2) whether the intervention was explicitly framed as alcohol-focused or not. Significant recruitment problems were noted in several studies.

Conclusions

Alcohol internet interventions hold promise in delivering alcohol prevention to employees, but heterogeneity in study design and difficulties in recruitment complicate interpretation of findings.

Systematic review registration

https://osf.io/25x7e/, Open Science Framework.

Using peer-support coaching to improve adherence to online ACT self-help for college mental health: A randomized controlled trial

Online self-help programs such as the Acceptance and Commitment Therapy (ACT) Guide address significant barriers to receiving therapy but suffer from low adherence rates. Peer-delivered coaching, using undergraduate students as coaches, is an innovative alternative to traditional coaching methods which may improve adherence in a more scalable format. To test the efficacy of peer-support coaching for college students using ACT Guide in a naturalistic setting, we conducted a pragmatic randomized controlled trial with three conditions (phone coaching, text message coaching, and a no support control group; N = 230). Participants were block randomized, and program adherence (i.e., number of modules completed) was the primary outcome. Participants completed significantly more ACT Guide modules in phone (M = 7.1, SD = 4.9) and text (M = 5.7, SD = 5) coaching than the no support control condition (M = 1.6, SD = 3.3, p < .001). Participants who received phone coaching experienced significant improvements across almost all measured outcomes as compared to the control group, while participants who received text coaching improved only on some outcomes compared to control (ps < .05). These results support peer-support coaching, particularly when delivered through phone calls, as an efficacious method for improving adherence to and outcomes from online self-help programs.