@文章{信息:doi/10.2196/14967，作者=“Tait, Robert J和Paz Castro, Raquel和Kirkman, Jessica Jane Louise和Moore, Jamie Christopher和Schaub, Michael P”，标题=“解决酒精使用问题的数字干预('' Daybreak'计划):准实验随机对照试验”，期刊=“J Med Internet Res”，年=“2019”，月=“Sep”，日=“04”，卷=“21”，数=“9”，页=“e14967”，关键词=“酒精消费;互联网;数字健康;干预研究;社会营销;健康促进"，摘要="背景:酒精使用在许多社会中普遍存在，对健康产生重大不利影响，但有效干预措施的可用性限制了那些希望获得帮助以改变其酒精使用模式的人的治疗选择。目的:本研究评估了新的Daybreak程序，该程序可通过移动应用程序和桌面访问，由Hello Sunday Morning开发，旨在支持希望改变与酒精关系的高危饮酒人群。特别是，我们比较了通过实时聊天信息添加在线指导(干预组)和其他自我指导计划(对照组)的效果。方法:我们将干预设计为随机对照试验，但作为一些人(n=48;11.9{\%})的对照组能够使用在线辅导，主要分析包括所有参与者。 We collected online surveys at one-month and three-months follow-up. The primary outcome was change in alcohol risk (measured with the alcohol use disorders identification test--consumption [AUDIT--C] score), but other outcomes included the number of standard drinks per week, alcohol-related days out of role, psychological distress (Kessler-10), and quality of life (EUROHIS-QOL). Markers of engagement with the program included posts to the site and comments on the posts of others. The primary analysis used Weighted Generalized Estimating Equations. Results: We recruited 398 people to the intervention group (50.2{\%}) and 395 people to the control group (49.8{\%}). Most were female (71{\%}) and the mean age was 40.1 years. Most participants were classified as probably dependent (550, 69{\%}) on the AUDIT--10, with 243 (31{\%}) classified with hazardous or harmful consumption. We followed up with 334 (42.1{\%}) participants at one month and 293 (36.9{\%}) at three months. By three months there were significant improvements in AUDIT--C scores (down from mean 9.1 [SD 1.9] to 5.8 [SD 3.1]), alcohol consumed per week (down from mean 37.1 [SD 28.3] to mean 17.5 [SD 18.9]), days out of role (down from mean 1.6 [SD 3.6] to 0.5 [SD 1.6]), quality of life (up from 3.2 [SD 0.7] to 3.6 [SD 0.7]) and reduced distress (down from 24.8 [SD 7.0] to 19.0 [SD 6.6]). Accessing online coaching was not associated with improved outcomes, but engagement with the program (eg, posts and comments on the posts of others) were significantly associated with improvements (eg, in AUDIT--C, alcohol use and EUROHIS-QOL). Reduced alcohol use was found for both probably dependent (estimated marginal mean of 40.8 to 20.1 drinks) and hazardous or harmful alcohol users (estimated marginal mean of 22.9 to 11.9 drinks). Conclusions: Clinically significant reductions in alcohol use were found, as well as reduced alcohol risk (AUDIT--C) and days out of role. Importantly, improved alcohol-related outcomes were found for both hazardous or harmful and probably dependent drinkers. Since October 2016, Daybreak has reached more than 50,000 participants. Therefore, there is the potential for the program to have an impact on alcohol-related problems at a population health level, importantly including an effect on probably dependent drinkers. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12618000010291; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373110 International Registered Report Identifier (IRRID): RR2-10.2196/9982 ", issn="1438-8871", doi="10.2196/14967", url="//www.mybigtv.com/2019/9/e14967/", url="https://doi.org/10.2196/14967", url="http://www.ncbi.nlm.nih.gov/pubmed/31486406" }