Internet-based self-assessment of drinking—3-month follow-up data

doi:10.1016/j.addbeh.2006.05.020

Addictive Behaviors

Volume 32, Issue 3, March 2007, Pages 533-542

https://doi.org/10.1016/j.addbeh.2006.05.020 Get rights and content

Abstract

This study aims to make an initial evaluation of an Internet-based self-assessment tool for Finnish drinkers (http://www.paihdelinkki.fi/testaa/juomatapatesti) and its effects on their use of alcohol. The subjects (n = 343) were recruited from among the 1598 anonymous respondents to the survey on this self-assessment service. The subjects' baseline data were first compared to those of a random sample of the users of this Internet service during the same period. Their responses to the survey were then analyzed. Finally, their drinking and drinking-related problems at the baseline and 3 months later were compared. The study participants were heavier drinkers than the average users of this Internet service. More than nine out of ten were satisfied with the service. The response rate to the follow-up was 78%. There were highly significant reductions (p = .000) in all the outcome measures. The service appealed more to women than men, but there were no sex differences in drinking-related outcomes. The results supported the further development of this model to a randomized controlled trial.

Introduction

Improving the self-regulation of drinking among the citizens and facilitating self-change processes is a high-priority goal in many societies. At present this goal is particularly acute in Finland where the pressure to harmonize prices of alcohol within EU (mainly Estonia and Finland) has led to heavy price reductions on particularly the strong spirits in April 2004. Consequently the per capita consumption of pure alcohol has increased from 9.4 l to 10.3 l in less than a year (Österberg, 2005, 80–82). This growth has had many negative consequences. For instance, alcohol-related mortality increased by 19% and both hospitalizations and drunk driving charges by 9% from the year 2003 to 2004 (Mäkelä & Österberg, 2006). Effective ways to intervene in this alarming development are therefore needed.

During the last few years the use of the Internet has also fast expanded in Finland as elsewhere in the world. According to a large Finnish market research company, Taloustutkimus Oy (see www.toy.fi), 70% of people between the ages of 15 and 79 used the Internet in the year 2004. Four out of five did it weekly. The proportion of users varied from 92% to 99% among people under the age of 35, which makes the Internet a viable means for providing primary and secondary prevention of heavy drinking for this population.

In June 2003 an Internet site where people could receive normative feedback on their drinking (see http://www.paihdelinkki.fi/testaa/juomatapatesti) was launched by the A Clinic Foundation, the leading substance abuse service provider in Finland. This free Internet service was modeled after the one created in Toronto (see Cunningham, Humphreys, & Koski-Jännes, 2000) with some minor changes in its set-up. It comprises of a brief assessment and produces a personalized feedback summary designed to motivate change in drinkers. The study at hand aims to make an initial evaluation of this new service and its short-term effects on drinking by its users.

Section snippets

Previous research on internet-based interventions

Excessive drinking appears in many forms (see Whitlock, Polen, Green, Orleans, & Klein, 2004). First there are hazardous or risk drinkers who drink above recommended limits without any noticeable harm yet. Then there are harmful drinkers who have experienced some physical, social or psychological harm without meeting the criteria of dependence. Finally, there are alcohol abusing or dependent drinkers who meet these criteria and continue to use alcohol despite significant negative consequences.

Subjects

The subjects for this study were recruited from March 10 to October 31 in 2004 with a month's break in June. During this period 22,536 self-assessments were completed with this Internet service, 7% of whom also responded to the survey evaluating the personal feedback. At the end of the survey respondents were asked if they wanted to participate in the follow-up. Of the 1598 survey respondents 22% gave their e-mail address for the follow-up. Out of these 351 people we excluded three persons who

The study sample in comparison to average users of this internet service

To get a picture of the self-selection process of the study participants their background information was first compared to a random sample of persons who filled in this self-assessment test during the same period (see Table 1).

The table shows that female sex, higher age, heavier drinking and the experience of more drinking-related problems increased the willingness to respond to the survey and to participate in the follow-up.

Responses to the survey

In the survey 41% regarded the feedback they received as very useful,

Discussion

The Internet service described in this report was very popular from the very beginning. During the 7 month recruitment period the number of tests completed was altogether 22,536 out of a population of about 5 million Finnish speakers. This indicates that the service filled a clear need of the people. This view is supported by the fact that the great majority of individuals who use this self-assessment service, and particularly those who participated in the study, were well above the limit of

Acknowledgements

The research on this study was supported by grants from the University of Tampere and the Finnish Foundation for Alcohol Studies. We are also obliged to the employees of the A Clinic Foundation who helped in setting up the web pages and the data sets for this study.

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View full text

Internet-based self-assessment of drinking—3-month follow-up data

Abstract

Introduction

Section snippets

Previous research on internet-based interventions

Subjects

The study sample in comparison to average users of this internet service

Responses to the survey

Discussion

Acknowledgements

Journal of Substance Abuse Treatment

Addictive Behaviors

Addictive Behaviors

Journal of Substance Abuse Treatment

Journal of Substance Abuse Treatment

Addictive Behaviors

Preventive Medicine

AUDIT—The alcohol use disorders identification test: Guidelines for use in primary health care

Do Internet interventions for consumers cause more harm than good? A systematic review

Health Expectations

Providing personalized assessment feedback for problem drinking on the Internet: A pilot project

Journal of Studies on Alcohol

Behavioral self-control program for Windows: Results of a controlled clinical trial

Journal of Consulting and Clinical Psychology

Web-based screening and brief intervention for hazardous drinking: A double-blind randomized controlled trial

Addiction