The Moderating Effect of Educational Background on the Efficacy of a Computer-Based Brief Intervention Addressing the Full Spectrum of Alcohol Use: Randomized Controlled Trial Article Swipe
Andreas Staudt
,
Jennis Freyer‐Adam
,
Christian Meyer
,
Gallus Bischof
,
Ulrich John
,
Sophie Baumann
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2196/33345
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2196/33345
Background The alcohol-attributable burden of disease is high among socially disadvantaged individuals. Interventional efforts intending to have a public health impact should also address the reduction of social inequalities due to alcohol. Objective The aim was to test the moderating role of educational background on the efficacy of a computer-based brief intervention addressing the full spectrum of alcohol use. Methods We recruited 1646 adults from the general population aged 18 to 64 years (920 women, 55.9%; mean age 31 years; 574 with less than 12 years of school education, 34.9%) who reported alcohol use in the past year. The participants were randomly assigned a brief alcohol intervention or to assessment only (participation rate, 66.9%, 1646/2463 eligible persons). Recruitment took place in a municipal registry office in one German city. All participants filled out a self-administered, tablet-based survey during the recruitment process and were assessed 3, 6, and 12 months later by study assistants via computer-assisted telephone interviews. The intervention consisted of 3 computer-generated and individualized feedback letters that were sent via mail at baseline, month 3, and month 6. The intervention was based on the transtheoretical model of behavior change and expert system software that generated the feedback letters automatically according to previously defined decision rules. The outcome was self-reported change in number of alcoholic drinks per week over 12 months. The moderator was school education according to highest general educational degree (less than 12 years of education vs 12 years or more). Covariates were sex, age, employment, smoking, and alcohol-related risk level. Results Latent growth modeling revealed that the intervention effect after 12 months was moderated by educational background (incidence rate ratio 1.38, 95% CI 1.08-1.76). Individuals with less than 12 years of school education increased their weekly alcohol use to a lesser extent when they received the intervention compared to assessment only (incidence rate ratio 1.30, 95% CI 1.05-1.62; Bayes factor 3.82). No difference was found between groups (incidence rate ratio 0.95, 95% CI 0.84-1.07; Bayes factor 0.30) among those with 12 or more years of school education. Conclusions The efficacy of an individualized brief alcohol intervention was moderated by the participants’ educational background. Alcohol users with less than 12 years of school education benefited, whereas those with 12 or more years did not. People with lower levels of education might be more receptive to the behavior change mechanisms used by brief alcohol interventions. The intervention approach may support the reduction of health inequalities in the population at large if individuals with low or medium education can be reached. Trial Registration German Clinical Trials Register DRKS00014274; https://www.drks.de/DRKS00014274
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2196/33345
- https://jmir.org/api/download?alt_name=publichealth_v8i6e33345_app1.pdf&filename=d82258b284a5910a21f0c06723209fcb.pdf
- OA Status
- gold
- Cited By
- 10
- References
- 52
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4283719011
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4283719011Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.2196/33345Digital Object Identifier
- Title
-
The Moderating Effect of Educational Background on the Efficacy of a Computer-Based Brief Intervention Addressing the Full Spectrum of Alcohol Use: Randomized Controlled TrialWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-06-30Full publication date if available
- Authors
-
Andreas Staudt, Jennis Freyer‐Adam, Christian Meyer, Gallus Bischof, Ulrich John, Sophie BaumannList of authors in order
- Landing page
-
https://doi.org/10.2196/33345Publisher landing page
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https://jmir.org/api/download?alt_name=publichealth_v8i6e33345_app1.pdf&filename=d82258b284a5910a21f0c06723209fcb.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
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https://jmir.org/api/download?alt_name=publichealth_v8i6e33345_app1.pdf&filename=d82258b284a5910a21f0c06723209fcb.pdfDirect OA link when available
- Concepts
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Medicine, Randomized controlled trial, Moderation, Intervention (counseling), Transtheoretical model, Population, Brief intervention, Public health, Disadvantaged, Psychology, Family medicine, Social psychology, Environmental health, Psychiatry, Nursing, Law, Political science, SurgeryTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
10Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 7, 2023: 2, 2022: 1Per-year citation counts (last 5 years)
- References (count)
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52Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.support | 400 |
| abstract_inverted_index.whereas | 367 |
| abstract_inverted_index.Clinical | 424 |
| abstract_inverted_index.Register | 426 |
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| abstract_inverted_index.feedback | 165, 197 |
| abstract_inverted_index.modeling | 256 |
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| abstract_inverted_index.reached. | 420 |
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| abstract_inverted_index.registry | 123 |
| abstract_inverted_index.reported | 91 |
| abstract_inverted_index.revealed | 257 |
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| abstract_inverted_index.baseline, | 173 |
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| abstract_inverted_index.1.05-1.62; | 310 |
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| abstract_inverted_index.1.08-1.76). | 276 |
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| institutions_distinct_count | 6 |
| corresponding_institution_ids | https://openalex.org/I2799318839, https://openalex.org/I78650965 |
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