Using the Internet to Screen for Risky Alcohol Use
Eric Helmuth, MA
Join Together, Boston University School of Public Health
Online Screening
A New Technique for an Old Problem
Traditional Screening AlcoholScreening.org
• Paper/Pencil• In-person Interview• Specific setting
• Online• Anonymous • At any computer at anytime
Public Health Impact
Graham, A. Disseminating Smoking Cessation Treatment via the Internet: Opportunities and Challenges, presentation.
www.AlcoholScreening.org
• Launched in April 2001
• More than 500,000 screens
• More than 100 Syndicated websites
• Viral marketing
• Links on CNN, WebMD, MSNBC.com
“Thanks for the statistics, I just thought it was ‘normal’.
I will try to cut down, I knew I was at risk because of my family tradition, yet I
thought I was still on the safe side. I have clear data to re-evaluate my habits.”
Email correspondence from AlcoholScreening.org user, (August 2006).
• 13 Questions
• Based on AUDIT
• Additional questions: Binge Drinking
• All Drinkers
• High Risk
Learn More
Get Help
Result
Normative information
Recommendation
Based on the user’s results, they receive a red, yellow,
or green light.
www.AlcoholScreening.org
People coming to AlcoholScreening.org are coming because they are worried about their drinking.
Mean AUDIT Score: 13.4 (Alcohol Dependent)
Public Heath Tests:
Efficacy?
Safe Limits
(<8)
Risky
(8-12)
Dependence (13-19)
Needs Treatment
(20>)
Learn More *
27% 16% 32% 25%
Get Help * 5% 12% 34% 49%
* p<.001
Plans
• Build brief intervention module– NIAAA proposals– Join Together deployment
• Develop paid syndications– Join Together
• Extend college screening– Research on change mechanisms– BU students; other colleges
Online Use Across Populations
Audience % Scores below 8
% Scores 8 and above
AlcoholScreening.org General Population
29% 71%
BU College Study College Freshman
70% 30%
Alcohol Screening on a College Population
The Sample (4,008 Students):
• 55% of college Freshmen completed an online screening test (AUDIT).
• 37% of men and 26% of women had unhealthy alcohol use.
Saitz, R. et al. (unpublished). Screening and brief intervention online for college students: The iHealth Study.
Method
Saitz, R. et al. (unpublished). Screening and brief intervention online for college students: The iHealth Study.
Follow-up Assessment One Month Later
No Hazardous Drinking
Unhealthy Alcohol Use
Minimal Intervention
More Extensive
Intervention
College Freshmen
Screening Invitation: Wellness or Alcohol Specific
Minimal v. More Extensive BI
More Extensive BI
Men Men were more likely to report intentions to seek help.
Women Women had greater increase in readiness to change.
Saitz, R. et al. (unpublished). Screening and brief intervention online for college students: The iHealth Study.
Unhealthy Alcohol use at 1 Month Follow-Up (all subjects)
Baseline Follow-Up
Men 36.6% 37.3%
Women 25.6% 20.3%
Total 29.6% 26.2%
85% follow-up rate
Saitz, R. et al. (unpublished). Screening and brief intervention online for college students: The iHealth Study.
Unhealthy Alcohol use at 1 Month Follow-Up (235 subjects)
• Men: Consequences decreased by 15%
• Women: Unhealthy alcohol use decreased by 33%
All 235 subjects had unhealthy alcohol use at baseline
Saitz, R. et al. (unpublished). Screening and brief intervention online for college students: The iHealth Study.
Aim
• To develop and test a strategy for universal screening for unhealthy alcohol use by college students using the web
Conclusions
• Feasibility and Reach– More than half of all freshmen completed a brief online
alcohol assessment and intervention (BI)– A substantial proportion (30%) of students completing this
assessment had unhealthy alcohol use
• An alcohol-specific invitation (as compared to a general health invitation) did not dissuade freshmen from completing online alcohol screening and BI
• Most participating students completed re-assessment 1-month later
Conclusions
• More extensive BI may have more effect on readiness and help-seeking (men) than minimal– Readiness to change drinking was low to begin
with– Some actually intended to seek help after BI
• BI appears to have reduced unhealthy use– Similarly for more extensive and minimal BI– Reductions primarily observed in women
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