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2022-01-28Zeitschriftenartikel
Social Equity in the Efficacy of Computer-Based and In-Person Brief Alcohol Interventions Among General Hospital Patients With At-Risk Alcohol Use: A Randomized Controlled Trial
dc.contributor.authorFreyer-Adam, Jennis
dc.contributor.authorBaumann, Sophie
dc.contributor.authorBischof, Gallus
dc.contributor.authorStaudt, Andreas
dc.contributor.authorGoeze, Christian
dc.contributor.authorGaertner, Beate
dc.contributor.authorJohn, Ulrich
dc.date.accessioned2024-09-18T13:23:07Z
dc.date.available2024-09-18T13:23:07Z
dc.date.issued2022-01-28none
dc.identifier.other10.2196/31712
dc.identifier.urihttp://edoc.rki.de/176904/12199
dc.description.abstractBackground: Social equity in the efficacy of behavior change intervention is much needed. While the efficacy of brief alcohol interventions (BAIs), including digital interventions, is well established, particularly in health care, the social equity of interventions has been sparsely investigated. Objective: We aim to investigate whether the efficacy of computer-based versus in-person delivered BAIs is moderated by the participants’ socioeconomic status (ie, to identify whether general hospital patients with low-level education and unemployed patients may benefit more or less from one or the other way of delivery compared to patients with higher levels of education and those that are employed). Methods: Patients with nondependent at-risk alcohol use were identified through systematic offline screening conducted on 13 general hospital wards. Patients were approached face-to-face and asked to respond to an app for self-assessment provided by a mobile device. In total, 961 (81% of eligible participants) were randomized and received their allocated intervention: computer-generated and individually tailored feedback letters (CO), in-person counseling by research staff trained in motivational interviewing (PE), or assessment only (AO). CO and PE were delivered on the ward and 1 and 3 months later, were based on the transtheoretical model of intentional behavior change and required the assessment of intervention data prior to each intervention. In CO, the generation of computer-based feedback was created automatically. The assessment of data and sending out feedback letters were assisted by the research staff. Of the CO and PE participants, 89% (345/387) and 83% (292/354) received at least two doses of intervention, and 72% (280/387) and 54% (191/354) received all three doses of intervention, respectively. The outcome was change in grams of pure alcohol per day after 6, 12, 18, and 24 months, with the latter being the primary time-point of interest. Follow-up interviewers were blinded. Study group interactions with education and employment status were tested as predictors of change in alcohol use using latent growth modeling. Results: The efficacy of CO and PE did not differ by level of education (P=.98). Employment status did not moderate CO efficacy (Ps≥.66). Up to month 12 and compared to employed participants, unemployed participants reported significantly greater drinking reductions following PE versus AO (incidence rate ratio 0.44, 95% CI 0.21-0.94; P=.03) and following PE versus CO (incidence rate ratio 0.48, 95% CI 0.24–0.96; P=.04). After 24 months, these differences were statistically nonsignificant (Ps≥.31). Conclusions: Computer-based and in-person BAI worked equally well independent of the patient’s level of education. Although findings indicate that in the short-term, unemployed persons may benefit more from BAI when delivered in-person rather than computer-based, the findings suggest that both BAIs have the potential to work well among participants with low socioeconomic status. Trial Registration: ClinicalTrials.gov NCT01291693; https://clinicaltrials.gov/ct2/show/NCT01291693eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectbrief alcohol interventioneng
dc.subjectelectroniceng
dc.subjecteHealtheng
dc.subjectdigitaleng
dc.subjectmotivational interviewingeng
dc.subjectsocioeconomic statuseng
dc.subjectequityeng
dc.subjectsocial inequalityeng
dc.subjecttranstheorectial modeleng
dc.subjectmoderatoreng
dc.subjectmental healtheng
dc.subjectpublic healtheng
dc.subjectalcohol interventionseng
dc.subjectdigital interventioneng
dc.subjectdigital health interventioneng
dc.subjectalcohol usageeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleSocial Equity in the Efficacy of Computer-Based and In-Person Brief Alcohol Interventions Among General Hospital Patients With At-Risk Alcohol Use: A Randomized Controlled Trialnone
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/12199-9
dc.type.versionpublishedVersionnone
local.edoc.container-titleJMIR Mental Healthnone
local.edoc.container-issn2368-7959none
local.edoc.pages12none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://mental.jmir.org/none
local.edoc.container-publisher-nameJMIR Publicationsnone
local.edoc.container-volume9none
local.edoc.container-issue1none
local.edoc.container-reportyear2022none
dc.description.versionPeer Reviewednone

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