Using Ecological Momentary Assessment in Testing the Effectiveness of an Alcohol Intervention: A Two-Arm Parallel Group Randomized Controlled Trial Online Alcohol Assessment and Feedback for Hazardous and Harmful Drinkers: Findings From the AMADEUS-2 Randomized Controlled Trial of Routine Practice in Swedish Universities Web-based alcohol screening and brief intervention for Māori and non-Māori: the New Zealand e-SBINZ trials Effectiveness of a Web-based Intervention for Problem Drinkers and Reasons for Dropout: Randomized Controlled Trial Social network influences on initiation and maintenance of reduced drinking among college students. A brief motivational interview in a pediatric emergency department, plus 10-day telephone follow-up, increases attempts to quit drinking among youth and young adults who screen positive for problematic drinking. Randomized controlled trial of computerized alcohol intervention for college students: role of class level Effects of a Web-Based Tailored Intervention to Reduce Alcohol Consumption in Adults: Randomized Controlled Trial Effectiveness of a Proactive Mail-Based Alcohol Internet Intervention for University Students: Dismantling the Assessment and Feedback Components in a Randomized Controlled Trial Improving Adherence to Antiretroviral Therapy for Youth Living with HIV/AIDS: A Pilot Study Using Personalized, Interactive, Daily Text Message Reminders Mobile health messages help sustain recent weight loss. Testing the effects of e-mailed personalized feedback on risky alcohol use among college students. Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management: baseline findings and six-month outcomes A theory-based online health behaviour intervention for new university students (U@Uni:LifeGuide): results from a repeat randomized controlled trial Alcohol assessment and feedback by email for university students: main findings from a randomised controlled trial Using Ecological Momentary Assessment to Test the Effectiveness of a Web-Based Brief Alcohol Intervention Over Time Among Heavy-Drinking Students: Randomized Controlled Trial Correcting injunctive norm misperceptions motivates behavior change: a randomized controlled sun protection intervention. A theory-based online health behaviour intervention for new university students (U@Uni): results from a randomised controlled trial Randomized trial comparing computer-delivered and face-to-face personalized feedback interventions for high-risk drinking among college students. A Text Message–Based Intervention for Weight Loss: Randomized Controlled Trial Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Pragmatic randomized controlled trial of providing access to a brief personalized alcohol feedback intervention in university students Feasibility and User Perception of a Fully Automated Push-Based Multiple-Session Alcohol Intervention for University Students: Randomized Controlled Trial The Effectiveness of a Web-Based Personalized Feedback and Social Norms Alcohol Intervention on United Kingdom University Students: Randomized Controlled Trial Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial A theory-based intervention to reduce alcohol drinking in excess of guideline limits among undergraduate students. Web-based alcohol screening and brief intervention for university students: a randomized trial. Improvement in Patient Performance of Skin Self-examinations After Intervention With Interactive Education and Telecommunication Reminders: A Randomized Controlled Study. The impact of focusing a program to prevent heavier drinking on a pre-existing phenotype, the low level of response to alcohol. A feasibility study of short message service text messaging as a surveillance tool for alcohol consumption and vehicle for interventions in university students Personalised Normative Feedback for Preventing Alcohol Misuse in University Students: Solomon Three-Group Randomised Controlled Trial An Interactive Text Message Intervention to Reduce Binge Drinking in Young Adults: A Randomized Controlled Trial with 9-Month Outcomes Web-based alcohol intervention for Mäori university students: double-blind, multi-site randomized controlled trial The effect of the 'What Do You Drink' web-based brief alcohol intervention on self-efficacy to better understand changes in alcohol use over time: randomized controlled trial using ecological momentary assessment. Personalized Feedback as a Universal Prevention Approach for College Drinking: A Randomized Trial of an e-Mail Linked Universal Web-Based Alcohol Intervention The efficacy of a targeted personalized drinking feedback intervention among intercollegiate athletes: a randomized controlled trial. What makes group MET work? A randomized controlled trial of college student drinkers in mandated alcohol diversion. A Mobile App to Aid Smoking Cessation: Preliminary Evaluation of SmokeFree28 Pilot and Feasibility Test of Adolescent-Controlled Text Messaging Reminders A mobile health intervention for inner city patients with poorly controlled diabetes: proof-of-concept of the TExT-MED program. Decisional Balance: Alcohol Decisional Balance Intervention for Heavy Drinking Undergraduates Text-message-based drinking assessments and brief interventions for young adults discharged from the emergency department. Feasibility, Acceptability, and Preliminary Efficacy of an Online HIV Prevention Program for Diverse Young Men who have Sex with Men: The Keep It Up! Intervention Efficacy of web-based personalized normative feedback: a two-year randomized controlled trial. Targeting Individuals with Problematic Alcohol Use via Web-Based Cognitive-Behavioral Self-Help Modules, Personalized Screening Feedback or Assessment Only: A Randomized Controlled Trial Using personalized feedback to reduce alcohol use among hazardous drinking college students: the moderating effect of alcohol-related negative consequences. Randomized controlled trial of web-based decisional balance feedback and personalized normative feedback for college drinkers. Improving the effectiveness of computer-delivered personalized drinking feedback interventions for college students. Randomized controlled trial of a web-based primary care intervention for multiple health risk behaviors. Providing Web-Based Feedback and Social Norms Information to Reduce Student Alcohol Intake: A Multisite Investigation Two Fully Automated Web-Based Interventions for Risky Alcohol Use: Randomized Controlled Trial Reductions in Drinking and Alcohol-Related Harms Reported by First-Year College Students Taking an Online Alcohol Education Course: A Randomized Trial A computer-based feedback only intervention with and without a moderation skills component. Impact of text and email messaging on the sexual health of young people: a randomised controlled trial Efficacy of a Web-Based, Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings Effects of AlcoholEdu for college on alcohol-related problems among freshmen: a randomized multicampus trial. Computerized versus motivational interviewing alcohol interventions: impact on discrepancy, motivation, and drinking. Risk Estimation Modeling and Feasibility Testing for a Mobile eHealth Intervention for Binge Drinking Among Young People: The D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults) Project. Evaluation of an Internet-based alcohol misuse prevention course for college freshmen: findings of a randomized multi-campus trial. The effectiveness of the 'what do you drink' web-based brief alcohol intervention in reducing heavy drinking among students: a two-arm parallel group randomized controlled trial. Using Facebook to deliver a social norm intervention to reduce problem drinking at university. Web-based alcohol prevention for incoming college students: a randomized controlled trial. Electronic screening and brief intervention for risky drinking in Swedish university students--a randomized controlled trial. Efficacy of brief motivational intervention in reducing binge drinking in young men: A randomized controlled trial. The efficacy of computerized alcohol intervention tailored to drinking motives among college students: a quasi-experimental pilot study The college drinker's check-up: outcomes of two randomized clinical trials of a computer-delivered intervention.
Background Alcohol consumption of college students has a fluctuating nature , which might impact the measurement of intervention effects . By using 25 follow-up time-points , this study tested whether intervention effects are robust or might vary over time . Methods Data were used from a two-arm parallel group r and omized controlled trial applying ecological momentary assessment ( EMA ) with 30 data time-points in total . Students between 18 and 24 years old who reported heavy drinking in the past six months and who were ready to change their alcohol consumption were r and omly assigned to the experimental ( n = 456 : web-based brief alcohol intervention ) and control condition ( n = 451 : no intervention ) . Outcome measures were weekly alcohol consumption , frequency of binge drinking , and heavy drinking status . Results According to the intention-to-treat principle , regression analyses revealed that intervention effects on alcohol consumption varied when exploring multiple follow-up time-points . Intervention effects were found for a ) weekly alcohol consumption at 1 , 2 , 3 , 4 , and 7 weeks follow-up , b ) frequency of binge drinking at 1 , 2 , 7 , and 12 weeks follow-up , and c ) heavy drinking status at 1 , 2 , 7 , and 16 weeks follow-up . Conclusions This research showed that the commonly used one and six month follow-up time-points are relatively arbitrary and not using EMA might bring forth erroneous conclusions on the effectiveness of interventions . Therefore , future trials in alcohol prevention research and beyond are encouraged to apply EMA when assessing outcome measures and intervention effectiveness . Trial registration Netherl and s Trial Register Background Previous research on the effectiveness of online alcohol interventions for college students has shown mixed results . Small benefits have been found in some studies and because online interventions are inexpensive and possible to implement on a large scale , there is a need for further study . Objective This study evaluated the effectiveness of national provision of a brief online alcohol intervention for students in Sweden . Methods Risky drinkers at 9 colleges and universities in Sweden were invited by mail and identified using a single screening question . These students ( N=1605 ) gave consent and were r and omized into a 2-arm parallel group r and omized controlled trial consisting of immediate or delayed access to a fully automated online assessment and intervention with personalized feedback . Results After 2 months , there was no strong evidence of effectiveness with no statistically significant differences in the planned analyses , although there were some indication of possible benefit in sensitivity analyses suggesting an intervention effect of a 10 % reduction ( 95 % CI –30 % to 10 % ) in total weekly alcohol consumption . Also , differences in effect sizes between universities were seen with participants from a major university ( n=365 ) reducing their weekly alcohol consumption by 14 % ( 95 % CI –23 % to –4 % ) . However , lower recruitment than planned and differential attrition in the intervention and control group ( 49 % vs 68 % ) complicated interpretation of the outcome data . Conclusions Any effects of current national provision are likely to be small and further research and development work is needed to enhance effectiveness . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 02335307 ; http://www.is rct n.com/IS RCT N02335307 ( Archived by WebCite at http://www.webcitation.org/6ZdPUh0R4 ) Background Hazardous alcohol consumption is a leading modifiable cause of mortality and morbidity among young people .  Screening and brief intervention ( SBI ) is a key strategy to reduce alcohol-related harm in the community , and web-based approaches ( e-SBI ) have advantages over practitioner-delivered approaches , being cheaper , more acceptable , administrable remotely and infinitely scalable . An efficacy trial in a university population showed a 10-minute intervention could reduce drinking by 11 % for 6 months or more among 17 - 24 year-old undergraduate hazardous drinkers . The e-SBINZ study is design ed to examine the effectiveness of e-SBI across a range of universities and among Māori and non-Māori students in New Zeal and . Methods / Design The e-SBINZ study comprises two parallel , double blind , multi-site , individually r and omised controlled trials . This paper outlines the background and design of the trial , which is recruiting 17 - 24 year-old students from seven of New Zeal and 's eight universities . Māori and non-Māori students are being sample d separately and are invited by e-mail to complete a web question naire including the AUDIT-C. Those who score > 4 will be r and omly allocated to no further contact until follow-up ( control ) or to assessment and personalised feedback ( intervention ) via computer . Follow-up assessment will occur 5 months later in second semester . Recruitment , consent , r and omisation , intervention and follow-up are all online . Primary outcomes are ( i ) total alcohol consumption , ( ii ) frequency of drinking , ( iii ) amount consumed per typical drinking occasion , ( iv ) the proportions exceeding medical guidelines for acute and chronic harm , and ( v ) scores on an academic problems scale . Discussion The trial will provide information on the effectiveness of e-SBI in reducing hazardous alcohol consumption across diverse university student population s with separate effect estimates for Māori and non-Māori students . Trial registration Australian New Zeal and Clinical Trials Registry ( ANZCTR ) Background Online self-help interventions for problem drinkers show promising results , but the effectiveness of online therapy with active involvement of a therapist via the Internet only has not been examined . Objective The objective of our study was to evaluate an e-therapy program with active therapeutic involvement for problem drinkers , with the hypotheses that e-therapy would ( 1 ) reduce weekly alcohol consumption , and ( 2 ) improve health status . Reasons for dropout were also systematic ally investigated . Method In an open r and omized controlled trial , Dutch-speaking problem drinkers in the general population were r and omly assigned ( in blocks of 8 , according to a computer-generated r and om list ) to the 3-month e-therapy program ( n = 78 ) or the waiting list control group ( n = 78 ) . The e-therapy program consisted of a structured 2-part online treatment program in which the participant and the therapist communicated asynchronously , via the Internet only . Participants in the waiting list control group received “ no-reply ” email messages once every 2 weeks . The primary outcome measures were ( 1 ) the difference in the score on weekly alcohol consumption , and ( 2 ) the proportion of participants drinking under the problem drinking limit . Intention-to-treat analyses were performed using multiple imputations to deal with loss to follow-up . A dropout question naire was sent to anyone who did not complete the 3-month assessment . Reasons for dropout were independently assessed by the first and third author . Results Of the 156 individuals who were r and omly assigned , 102 ( 65 % ) completed assessment at 3 months . In the intention-to-treat analyses , the e-therapy group ( n = 78 ) showed a significantly greater decrease in alcohol consumption than those in the control group ( n = 78 ) at 3 months . The e-therapy group decreased their mean weekly alcohol consumption by 28.8 units compared with 3.1 units in the control group , a difference in means of 25.6 units on a weekly basis ( 95 % confidence interval 15.69 - 35.80 , P < .001 ) . The between-group effect size ( pooled SD ) was large ( d = 1.21 ) . The results also showed that 68 % ( 53/78 ) of the e-therapy group was drinking less than 15 ( females ) or 22 ( males ) units a week , compared with 15 % ( 12/78 ) in the control group ( OR 12.0 , number needed to treat 1.9 , P < .001 ) . Dropout analysis showed that the main reasons for dropouts ( n = 54 ) were personal reasons unrelated to the e-therapy program , discomfort with the treatment protocol , and satisfaction with the positive results achieved . Conclusions E-therapy for problem drinking is an effective intervention that can be delivered to a large population who otherwise do not seek help for their drinking problem . Insight into reasons for dropout can help improve e-therapy programs to decrease the number of dropouts . Additional research is needed to directly compare the effectiveness of the e-therapy program with a face-to-face treatment program . Trial registration IS RCT N39104853 ; http://controlled-trials.com/IS RCT N39104853/IS RCT N39104853 ( Archived by WebCite at http://www.webcitation.org/5uX1R5xfW OBJECTIVE To determine whether ( a ) social networks influence the extent to which college students initiate and /or maintain reductions in drinking following an alcohol intervention and ( b ) students with riskier networks respond better to a counselor-delivered , vs. a computer-delivered , intervention . METHOD M and ated students ( N = 316 ; 63 % male ) provided their perceptions of peer network members ' drinking statuses ( e.g. , heavy drinker ) and how accepting each friend would be if the participant reduced his or her drinking . Next , they were r and omized to receive a brief motivational intervention ( BMI ) or Alcohol Edu for Sanctions ( EDU ) . In latent growth models controlling for baseline levels on outcomes , influences of social networks on 2 phases of intervention response were examined : initiation of reductions in drinks per heaviest week , peak blood alcohol content ( BAC ) , and consequences at 1 month ( model intercepts ) and maintenance of reductions between 1 and 12 months ( model slopes ) . RESULTS Peer drinking status predicted initiation of reductions in drinks per heaviest week and peak BAC ; peer acceptability predicted initial reductions in consequences . Peer Acceptability × Condition interactions were significant or marginal for all outcomes in the maintenance phase . In networks with higher perceived acceptability of decreasing use , BMI and EDU exhibited similar growth rates . In less accepting networks , growth rates were significantly steeper among EDU than BMI participants . For consumption outcomes , lower perceived peer acceptability predicted steeper rates of growth in drinking among EDU but not BMI participants . CONCLUSIONS Underst and ing how social networks influence behavior change and how interventions mitigate their influence is important for optimizing efficacy of alcohol interventions OBJECTIVES Adolescents in their late teens and early 20s have the highest alcohol consumption in the United States ; binge drinking peaks at age 21 - 25 years . Underage drinking is associated with many negative consequences , including academic problems and risk of intentional and unintentional injuries . This study tested the effectiveness of pediatric emergency department ( PED ) screening and brief intervention to reduce alcohol consumption and associated risks . METHODS A three-group r and omized assignment trial was structured to test differences between intervention ( I ) and st and ard assessed control ( AC ) groups in alcohol consumption and alcohol-related behaviors from baseline to 12 months and to compare the AC group with a minimally assessed control ( MAC ) group to adjust for the effect of assessment reactivity on control group behavior . Patients aged 14 - 21 years were eligible if they screened positive on the Alcohol Use Disorders Identification Test ( AUDIT ) or for binge drinking or high-risk behaviors . The MAC group received a re source h and out , written advice about alcohol-related risks , and a 12-month follow-up appointment . Patients in the AC group were assessed using st and ardized instruments in addition to the MAC protocol . The I group received a peer-conducted motivational intervention , referral to community re sources and treatment if indicated , and a 10-day booster in addition to assessment . Measurements included 30-day self-report of alcohol consumption and alcohol-related behaviors , screens for depression and posttraumatic stress disorder , and self-report of attempts to quit , cut back , or change conditions of use , all repeated at follow-up . Motor vehicle records and medical records were also analyzed for changes from baseline to 1-year follow-up . RESULTS Among 7,807 PED patients screened , 1,202 were eligible ; 853 enrolled ( I , n = 283 ; AC , n = 284 ; MAC , n = 286 ) , with a 12-month follow-up rate of 72 % . At 12 months , more than half of enrollees in Reaching Adolescents for Prevention ( RAP ) attempted to cut back on drinking , and over a third tried to quit . A significantly larger proportion of the I group made efforts to quit drinking and to be careful about situations when drinking compared to AC enrollees , and there was a numerically but not significantly greater likelihood ( p = 0.065 ) among the I group for efforts to cut back on drinking . At 3 months , the likelihood of the I group making attempts to cut back was almost triple that of ACs . For efforts to quit , it was double , and for trying to be careful about situations when drinking , there was a 72 % increase in the odds ratio ( OR ) for the I group . Three-month results for attempts were sustained at 12 months for quit attempts and efforts to be careful . Consumption declined in both groups from baseline to 3 months to 12 months , but there were no significant between-group differences in alcohol-related consequences at 12 months or in alcohol-related risk behaviors . We found a pattern suggestive of assessment reactivity in only one variable at 12 months : the attempt to cut back ( 73.3 % for the I group vs. 64.9 % among the AC group and 54.8 % among the MAC group ) . CONCLUSIONS Brief motivational intervention result ed in significant efforts to change behavior ( quit drinking and be careful about situations while drinking ) but did not alter between-group consumption or consequences ABSTRACT Background : Because of their ability to reach a much wider audience than face-to-face counseling or psychoeducation , computer-delivered interventions for risky or potentially problematic use have been increasing on college campuses . However , there are very few studies that examine who benefits most from such interventions . Objectives : The purpose of this study was to determine if participation in Alcohol-Wise , a computerized intervention , is associated with changes in alcohol drinking behavior and its consequences , perceptions of college drinking norms , and expectancies . It was hypothesized that class level ( i.e. freshman/sophomore versus junior/senior ) would moderate the effectiveness of Alcohol-Wise . Method : College students ( n = 58 ) were r and omly assigned to one of two conditions : ( i ) the computer-delivered intervention or ( ii ) wait-list control . Measures were completed at baseline and approximately 30-days later . Results : At follow-up , freshman and sophomore students in the intervention group showed significant reduction in peak number of st and ard drinks and blood alcohol concentration , but the effect was not observed for juniors and seniors . The intervention group reported more accurate estimates of drinking norms at follow-up relative to controls . There were no significant changes over time in alcohol expectancies in either group . Conclusion : This study provides support for the potential usefulness of Alcohol-Wise intervention at reducing short-term drinking among underclassmen but not upperclassmen in a 4-year college setting . These findings suggest that computerized interventions may be more effective when provided early , but not later , in a student ’s college career Background Web-based tailored interventions provide users with information that is adapted to their individual characteristics and needs . R and omized controlled trials assessing the effects of tailored alcohol self-help programs among adults are scarce . Furthermore , it is a challenge to develop programs that can hold respondents ’ attention in online interventions . Objective To assess whether a 3-session , Web-based tailored intervention is effective in reducing alcohol intake in high-risk adult drinkers and to compare 2 computer-tailoring feedback strategies ( alternating vs summative ) on behavioral change , dropout , and appreciation of the program . Methods A single-blind r and omized controlled trial was conducted with an experimental group and a control group ( N=448 ) in Germany in 2010 - 2011 . Follow-up took place after 6 months . Drinking behavior , health status , motivational determinants , and demographics were assessed among participants recruited via an online access panel . The experimental group was divided into 2 subgroups . In the alternating condition ( n=132 ) , the tailored feedback was split into a series of messages discussing individual topics offered while the respondent was filling out the program . Participants in the summative condition ( n=181 ) received all advice at once after having answered all questions . The actual texts were identical for both conditions . The control group ( n=135 ) only filled in 3 question naires . To identify intervention effects , logistic and linear regression analyses were conducted among complete cases ( n=197 ) and after using multiple imputation . Results Among the complete cases ( response rate : 197/448 , 44.0 % ) who did not comply with the German national guideline for low-risk drinking at baseline , 21.1 % of respondents in the experimental group complied after 6 months compared with 5.8 % in the control group ( effect size=0.42 ; OR 2.65 , 95 % CI 1.14 - 6.16 , P=.02 ) . The experimental group decreased by 3.9 drinks per week compared to 0.4 drinks per week in the control group , but this did not reach statistical significance ( effect size=0.26 ; beta=−0.12 , 95 % CI −7.96 to 0.03 , P=.05 ) . Intention-to-treat analyses also indicated no statistically significant effect . Separate analyses of the 2 experimental subgroups showed no differences in intervention effects . The dropout rate during the first visit to the intervention website was significantly lower in the alternating condition than in the summative condition ( OR 0.23 , 95 % CI 0.08 - 0.60 , P=.003 ) . Program appreciation was comparable for the 2 experimental groups . Conclusions Complete case analyses revealed that Web-based tailored feedback can be an effective way to reduce alcohol intake among adults . However , this effect was not confirmed when applying multiple imputations . There was no indication that one of the tailoring strategies was more effective in lowering alcohol intake . Nevertheless , the lower attrition rates we found during the first visit suggest that the version of the intervention with alternating questions and advice may be preferred . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 91623132 ; http://www.controlled-trials.com/IS RCT N91623132 ( Archived by WebCite at http://www.webcitation.org/6J4QdhXeG ) Background University students in Sweden routinely receive proactive mail-based alcohol Internet interventions sent from student health services . This intervention provides personalized normative feedback on alcohol consumption with suggestions on how to decrease drinking . Earlier feasibility trials by our group and others have examined effectiveness in simple parallel-groups design s. Objective To evaluate the effectiveness of electronic screening and brief intervention , using a r and omized controlled trial design that takes account of baseline assessment reactivity ( and other possible effects of the research process ) due to the similarity between the intervention and assessment content . The design of the study allowed for exploration of the magnitude of the assessment effects per se . Methods This trial used a dismantling design and r and omly assigned 5227 students to 3 groups : ( 1 ) routine practice assessment and feedback , ( 2 ) assessment -only without feedback , and ( 3 ) neither assessment nor feedback . At baseline all participants were blinded to study participation , with no contact being made with group 3 . We approached students 2 months later to participate in a cross-sectional alcohol survey . All interventions were fully automated and did not have any human involvement . All data used in the analysis were based on self- assessment using question naires . The participants were unaware that they were participating in a trial and thus were also blinded to which group they were r and omly assigned . Results Overall , 44.69 % ( n = 2336 ) of those targeted for study completed follow-up . Attrition was similar in groups 1 ( 697/1742 , 40.01 % ) and 2 ( 737/1742 , 42.31 % retained ) and lower in group 3 ( 902/1743 , 51.75 % retained ) . Intention-to-treat analyses among all participants regardless of their baseline drinking status revealed no differences between groups in all alcohol parameters at the 2-month follow-up . Per- protocol analyses of groups 1 and 2 among those who accepted the email intervention ( 36.2 % of the students who were offered the intervention in group 1 and 37.3 % of the students in group2 ) and who were risky drinkers at baseline ( 60.7 % follow-up rate in group 1 and 63.5 % in group 2 ) suggested possible small beneficial effects on weekly consumption attributable to feedback . Conclusions This approach to outcome evaluation is highly conservative , and small benefits may follow the actual uptake of feedback intervention in students who are risky drinkers , the precise target group . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 24735383 ; http://www.controlled-trials.com/IS RCT N24735383 ( Archived by WebCite at http://www.webcitation.org/6Awq7gjXG Background For youth living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome ( AIDS ) , nonadherence to antiretroviral therapy ( ART ) can lead to poor health outcomes and significantly decreased life expectancy . Objective To evaluate the feasability , acceptability , and preliminary efficacy of short message service ( SMS ) or text message reminders to improve adherence to ART for youth living with HIV/AIDS . Methods We conducted this prospect i ve pilot study using a pre – post design from 2009 to 2010 at a community-based health center providing clinical services to youth living with HIV/AIDS . Eligibility criteria included HIV-positive serostatus , age 14–29 years , use of a personal cell phone , English-speaking , and being on ART with documented poor adherence . During the 24-week study period , participants received personalized daily SMS reminders and a follow-up message 1 hour later assessing whether they took the medication , and asking participants to respond via text message with the number 1 if they took the medication and 2 if they did not . Outcome measures were feasibility , acceptability , and adherence . Self-reported adherence was determined using the visual analog scale ( VAS ) and AIDS Clinical Trial Group ( ACTG ) question naire 4-day recall . Viral load and CD4 cell count were followed as biomarkers of adherence and disease progression at 0 , 12 , and 24 weeks . Results Participants ( N = 25 ) were mean age 23 ( range 14–29 ) years , 92 % ( n = 23 ) male , 60 % ( n = 15 ) black , and 84 % ( n = 21 ) infected through unprotected sex . Mean VAS scores significantly increased at 12 and 24 weeks in comparison with baseline ( week 0 : 74.7 , week 12 : 93.3 , P < .001 ; week 24 : 93.1 , P < .001 ) . ACTG question naire 4-day recall also improved ( week 0 : 2.33 , week 12 : 3.24 , P = .002 ; week 24 : 3.19 , P = .005 ) . There was no significant difference in CD4 cell count or viral load between baseline and 12- or 24-week follow-up , although there was a trend toward improvement of these biomarkers and a small to moderate st and ardized effect size ( range of Cohen d : –0.51 to 0.22 ) . Of 25 participants , 21 ( 84 % ) were retained , and 20 of the 21 ( 95 % ) participants who completed the study found the intervention helpful to avoid missing doses . Conclusions In this pilot study , personalized , interactive , daily SMS reminders were feasible and acceptable , and they significantly improved self-reported adherence . Larger controlled studies are needed to determine the impact of this intervention on ART adherence and other related health outcomes for youth living with HIV/AIDS BACKGROUND Using regulatory focus theory , an intervention of daily weight loss-sustaining messages was developed and tested for acceptability , feasibility , and efficacy on helping people sustain weight loss .  METHODS Participants ( n = 120 ) were r and omized to a promotion , prevention , or an attention-control text message group  after completion of a weight loss program .  Participants completed baseline assessment s , and reported their weight at 1 and 3 months postbaseline . RESULTS Participants found the message content and intervention acceptable and valuable . A minimum of one message per day delivered at approximately 8:00 am was deemed the optimal delivery time and frequency . The sustained weight loss rate at month 3 for the control , promotion , and prevention groups was 90 % , 95 % , and 100 % , respectively . Medium-to-large effects were observed for the promotion and prevention groups at month 1 and for prevention at month 3 relative to controls . The mean weight loss for promotion and prevention was 15 pounds , compared with 10 in the controls at month 3 . CONCLUSION A clinical ly significant decrease in mean weight , higher rate of sustained weight loss , and medium-to-large effects on sustained weight loss occurred in the promotion and prevention interventions . Tools such as this text message-based intervention that are constructed and guided by evidence -based content and theoretical constructs show promise in helping people sustain healthy behaviors that can lead to improved health outcomes OBJECTIVE Although research utilizing the Internet to intervene with college student drinkers is growing , this study is the first to investigate the use of a theoretically-based and empirically supported personalized feedback form delivered via a single e-mail to college students . METHOD Students ( n=191 ) completed measures of their alcohol use , related consequences , and peer perceptions at baseline and 6weeks after the intervention . Students were r and omly assigned to receive either e-mailed personalized feedback or e-mailed generic feedback . RESULTS Students who received e-mailed personalized feedback reported consuming significantly fewer drinks in a given week , as well as a fewer number of days being drunk in the previous 30days . They also exhibited a significant reduction in the number of days they perceived their peers to have drunk alcohol and in the amount of alcohol they perceived their peers to consume per drinking occasion . CONCLUSION e-Mailed personalized feedback appears to help students become more aware of normative drinking behavior and reduce the quantity of alcohol they consume . Furthermore , e-mailed personalized feedback may be a cost-effective manner in which to intervene with college student drinkers Background Effective self-management of diabetes is essential for the reduction of diabetes-related complications , as global rates of diabetes escalate . Methods R and omised controlled trial . Adults with type 2 diabetes ( n = 120 ) , with HbA1c greater than or equal to 7.5 % , were r and omly allocated ( 4 × 4 block r and omised block design ) to receive an automated , interactive telephone-delivered management intervention or usual routine care .  Baseline sociodemographic , behavioural and medical history data were collected by self-administered question naires and biological data were obtained during hospital appointments . Health-related quality of life ( HRQL ) was measured using the SF-36 . Results The mean age of participants was 57.4 ( SD 8.3 ) , 63 % of whom were male . There were no differences in demographic , socioeconomic and behavioural variables between the study arms at baseline . Over the six-month period from baseline , participants receiving the Australian TLC ( Telephone-Linked Care ) Diabetes program showed a 0.8 % decrease in geometric mean HbA1c from 8.7 % to 7.9 % , compared with a 0.2 % HbA1c reduction ( 8.9 % to 8.7 % ) in the usual care arm ( p = 0.002 ) . There was also a significant improvement in mental HRQL , with a mean increase of 1.9 in the intervention arm , while the usual care arm decreased by 0.8 ( p = 0.007 ) . No significant improvements in physical HRQL were observed . Conclusions These analyses indicate the efficacy of the Australian TLC Diabetes program with clinical ly significant post-intervention improvements in both glycaemic control and mental HRQL . These observed improvements , if supported and maintained by an ongoing program such as this , could significantly reduce diabetes-related complications in the longer term . Given the accessibility and feasibility of this kind of program , it has strong potential for providing effective , ongoing support to many individuals with diabetes in the future Background This paper reports the results of a repeat trial assessing the effectiveness of an online theory-based intervention to promote healthy lifestyle behaviours in new university students . The original trial found that the intervention reduced the number of smokers at 6-month follow-up compared with the control condition , but had non-significant effects on the other targeted health behaviours . However , the original trial suffered from low levels of engagement , which the repeat trial sought to rectify . Methods Three weeks before staring university , all incoming undergraduate students at a large university in the UK were sent an email inviting them to participate in the study . After completing a baseline question naire , participants were r and omly allocated to intervention or control conditions . The intervention consisted of a self-affirmation manipulation , health messages based on the theory of planned behaviour and implementation intention tasks . Participants were followed-up 1 and 6 months after starting university . The primary outcome measures were portions of fruit and vegetables consumed , physical activity levels , units of alcohol consumed and smoking status at 6-month follow-up . Results The study recruited 2,621 students ( intervention n = 1346 , control n = 1275 ) , of whom 1495 completed at least one follow-up ( intervention n = 696 , control n = 799 ) . Intention-to-treat analyses indicated that the intervention had a non-significant effect on the primary outcomes , although the effect of the intervention on fruit and vegetable intake was significant in the per- protocol analyses . Secondary analyses revealed that the intervention had significant effects on having smoked at university ( self-report ) and on a biochemical marker of alcohol use . Conclusions Despite successfully increasing levels of engagement , the intervention did not have a significant effect on the primary outcome measures . The relatively weak effects of the intervention , found in both the original and repeat trials , may be due to the focus on multiple versus single health behaviours . Future interventions targeting the health behaviour of new university students should therefore focus on single health behaviours . Trial registration Current Controlled Trials IS RCT N07407344 Background Brief interventions can be efficacious in changing alcohol consumption and increasingly take advantage of the internet to reach high-risk population s such as students . Aims To evaluate the effectiveness of a brief online intervention , controlling for the possible effects of the research process . Method A three-arm parallel groups design was used to explore the magnitude of the feedback and assessment component effects . The three groups were : alcohol assessment and feedback ( group 1 ) ; alcohol assessment only without feedback ( group 2 ) ; and no contact , and thus neither assessment nor feedback ( group 3 ) . Outcomes were evaluated after 3 months via an invitation to participate in a brief cross-sectional lifestyle survey . The study was undertaken in two universities r and omising the email addresses of all 14 910 students ( the AMADEUS-1 study , trial registration : IS RCT N28328154 ) . Results Overall , 52 % ( n = 7809 ) of students completed follow-up , with small differences in attrition between the three groups . For each of the two primary outcomes , there was one statistically significant difference between groups , with group 1 having 3.7 % fewer risky drinkers at follow-up than group 3 ( P = 0.006 ) and group 2 scoring 0.16 points lower than group 3 on the three alcohol consumption questions from the Alcohol Use Disorders Identification Test ( AUDIT-C ) ( P = 0.039 ) . Conclusions This study provides some evidence of population -level benefit attained through intervening with individual students Background Web-based brief alcohol interventions are effective in reducing alcohol use among students when measured at limited follow-up time points . To date , no studies have tested Web-based brief alcohol intervention effectiveness over time by using a large number of measurements . Objective Testing whether the What Do You Drink ( WDYD ) Web-based brief alcohol intervention can sustain a reduction in alcohol use among heavy-drinking students aged 18 - 24 years at 1- , 3- , and 6-month follow-up intervals . Methods A purely Web-based , 2-arm , parallel-group r and omized controlled trial applying an ecological momentary assessment approach with 30 weekly measurements was conducted in the Netherl and s ( 2010 - 2011 ) . Participants were recruited offline and online . A total of 907 participants were r and omized into the experimental condition ( n=456 ) including the single-session and fully automated WDYD intervention , or into the control condition ( n=451 ) including assessment only . Weekly alcohol consumption and frequency of binge drinking were the self-assessed outcome measures . Results  Attrition rates of the 907 participants were 110 ( 12.1 % ) , 130 ( 14.3 % ) , and 162 ( 17.9 % ) at 1- , 3- , and 6-month follow-up intervals , respectively . Latent growth curve analyses according to the intention-to-treat principle revealed that participants in the experimental condition had significantly lower weekly alcohol consumption compared to participants in the control condition that was sustained at 3-month follow-up ( intercept=–2.60 , P<.001 ; slope=0.16 , P=.08 ) . Additional linear regression analyses indicated that this intercept difference result ed from significantly higher levels of alcohol units per week for participants in the control condition compared to those in the experimental condition at 1-month ( beta=–2.56 , SE 0.74 , Cohen ’s d=0.20 , P=.001 ) , 3-month ( beta=–1.76 , SE 0.60 , Cohen ’s d=0.13 , P=.003 ) , and 6-month ( beta=–1.21 , SE 0.58 , Cohen ’s d=0.09 , P=.04 ) follow-up intervals . Latent growth curve analyses further indicated that participants in the experimental condition had a significantly lower frequency of binge drinking compared to participants in the control condition that was sustained at 6-month follow-up ( intercept=–0.14 , P=.01 ; slope=0.004 , P=.19 ) . This intercept difference result ed from higher levels in this outcome for participants in the control condition relative to participants in the experimental condition at 1-month ( beta=–1.15 , SE 0.06 , Cohen ’s d=0.16 , P=.01 ) , 3-month ( beta=–0.12 , SE 0.05 , Cohen ’s d=0.09 , P=.01 ) , and 6-month ( beta=–0.09 , SE 0.05 , Cohen ’s d=0.03 , P=.045 ) follow-up intervals . Conclusions The WDYD intervention was shown to be effective in preventing an increase in weekly alcohol consumption and frequency of binge drinking directly after the intervention . This effect was sustained 3 and 6 months after the intervention . Trial Registration Netherl and s Trial Register NTR2665 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=2665 ( Archived by WebCite at http://webcitation.org/6LuQVn12 M ) OBJECTIVE Despite long-st and ing social psychological research supporting the influence of injunctive norms ( i.e. , what is commonly approved or disapproved ) on behavior , support for this influence on health behaviors is limited . We examined the utility of correcting misperceptions of injunctive norms for improving sun protection and whether changes in attitudes mediated the injunctive norm-intention relationship . METHOD At baseline 263 community residing primarily White women , aged 37 to 77 years , reported their beliefs about sun protection and tanning and their perceptions of " typical women 's " approval of sun protection versus tanning . Women underestimated approval of sun protection and overestimated approval of tanning . In a r and omized trial , 189 of these women received either information about sun protection or information plus personalized normative feedback ( PNF ) . PNF compared each woman 's own perceptions of typical women 's approval of tanning and sun protection with actual normative values , both measured at baseline . PNF communicated that most women approve of others who sun protect . RESULTS PNF led to more positive sun protection injunctive norms , attitudes , and intentions at immediate posttest and more positive intentions and self-reported behavior at 4-week follow-up . Baseline discrepancy between a woman 's beliefs and actual normative values related negatively to changes in sun protection in the control condition but positively in the PNF condition . As hypothesized , changes in attitudes partially mediated the influence of PNF on changes in intentions . CONCLUSIONS The present research demonstrates the utility of correcting injunctive norm misperceptions for promoting healthy behaviors . That attitudes changed in response to PNF and mediated the norm-intention relationship suggests a method for influencing attitudes that may limit reactance Background Too few young people engage in behaviours that reduce the risk of morbidity and premature mortality , such as eating healthily , being physically active , drinking sensibly and not smoking . This study sought to assess the efficacy and cost-effectiveness of a theory-based online health behaviour intervention ( based on self-affirmation theory , the Theory of Planned Behaviour and implementation intentions ) targeting these behaviours in new university students , in comparison to a measurement-only control . Methods Two-weeks before starting university all incoming undergraduates at the University of Sheffield were invited to take part in a study of new students ’ health behaviour . A r and omised controlled design , with a baseline question naire , and two follow-ups ( 1 and 6 months after starting university ) , was used to evaluate the intervention . Primary outcomes were measures of the four health behaviours targeted by the intervention at 6-month follow-up , i.e. , portions of fruit and vegetables , metabolic equivalent of tasks ( physical activity ) , units of alcohol , and smoking status . Results The study recruited 1,445 students ( intervention n = 736 , control n = 709 , 58 % female , Mean age = 18.9 years ) , of whom 1,107 completed at least one follow-up ( 23 % attrition ) . The intervention had a statistically significant effect on one primary outcome , smoking status at 6-month follow-up , with fewer smokers in the intervention arm ( 8.7 % ) than in the control arm ( 13.0 % ; Odds ratio = 1.92 , p = .010 ) . There were no significant intervention effects on the other primary outcomes ( physical activity , alcohol or fruit and vegetable consumption ) at 6-month follow-up . Conclusions The results of the RCT indicate that the online health behaviour intervention reduced smoking rates , but it had little effect on fruit and vegetable intake , physical activity or alcohol consumption , during the first six months at university . However , engagement with the intervention was low . Further research is needed before strong conclusions can be made regarding the likely effectiveness of the intervention to promote health lifestyle habits in new university students . Trial registration Current Controlled Trials , IS RCT N67684181 This study evaluated the efficacy of two brief personalized feedback interventions ( PFIs ) using identical feedback and motivational interviewing strategies aim ed at reducing alcohol consumption and alcohol-related problems to two control conditions among a sample of high-risk drinking college students . Students ( N = 152 ) were r and omly assigned to a computer-delivered PFI with a video interviewer , a face-to-face PFI with a live interviewer , a comprehensive assessment condition , or a minimal assessment -only condition . At 10 weeks posttreatment , the face-to-face PFI significantly reduced weekly drinking quantity and peak and typical blood alcohol concentration compared with the comprehensive assessment and minimal assessment -only conditions ( d values ranged from 0.32 to 0.61 ) . No significant between-group differences were evidence d for the computer-delivered PFI condition , although effect sizes were comparable to other college drinking studies using computer-delivered interventions ( d values ranged from 0.20 to 0.27 ) . Results provide further support for the use of a face-to-face PFI to help reduce  college students ' alcohol consumption and suggest that a video interviewer in the context of a computer-delivered PFI is likely a helpful but not necessarily a complete substitute for a live interviewer Background To our knowledge , no studies have evaluated whether weight loss can be promoted in overweight adults through the use of an intervention that is largely based on daily SMS ( Short Message Service : text ) and MMS ( Multimedia Message Service : small picture ) messages transmitted via mobile phones . Objective This paper describes the development and evaluation of a text message – based intervention design ed to help individuals lose or maintain weight over 4 months . Methods The study was a r and omized controlled trial , with participants being exposed to one of the following two conditions , lasting 16 weeks : ( 1 ) receipt of monthly printed material s about weight control ; ( 2 ) an intervention that included personalized SMS and MMS messages sent two to five times daily , printed material s , and brief monthly phone calls from a health counselor . The primary outcome was weight at the end of the intervention . A mixed-model repeated- measures analysis compared the effect of the intervention group to the comparison group on weight status over the 4-month intervention period . Analysis of covariance ( ANCOVA ) models examined weight change between baseline and 4 months after adjusting for baseline weight , sex , and age . Results A total of 75 overweight men and women were r and omized into one of the two groups , and 65 signed the consent form , completed the baseline question naire , and were included in the analysis . At the end of 4 months , the intervention group ( n = 33 ) lost more weight than the comparison group ( −1.97 kg difference , 95 % CI −0.34 to −3.60 kg , P = .02 ) after adjusting for sex and age . Intervention participants ’ adjusted average weight loss was 2.88 kg ( 3.16 % ) . At the end of the study , 22 of 24 ( 92 % ) intervention participants stated that they would recommend the intervention for weight control to friends and family . Conclusions Text messages might prove to be a productive channel of communication to promote behaviors that support weight loss in overweight adults . Trial Registration Clinical trials.gov NCT00415870 ; http:// clinical trials.gov/ct2/show/NCT00415870 ( Archived by WebCite at http://www.webcitation.org/5dnolbkFt Objectives : To determine the effectiveness of a mobile phone text messaging smoking cessation programme . Design : R and omised controlled trial Setting : New Zeal and Participants : 1705 smokers from throughout New Zeal and who wanted to quit , were aged over 15 years , and owned a mobile phone were r and omised to an intervention group that received regular , personalised text messages providing smoking cessation advice , support , and distraction , or to a control group . All participants received a free month of text messaging ; starting for the intervention group on their quit day to assist with quitting , and starting for the control group at six months to encourage follow up . Follow up data were available for 1624 ( 95 % ) at six weeks and 1265 ( 74 % ) at six months . Main outcome measures : The main trial outcome was current non-smoking ( that is , not smoking in the past week ) six weeks after r and omisation . Secondary outcomes included current non-smoking at 12 and 26 weeks . Results : More participants had quit at six weeks in the intervention compared to the control group : 239 ( 28 % ) v 109 ( 13 % ) , relative risk 2.20 ( 95 % confidence interval 1.79 to 2.70 ) , p < 0.0001 . This treatment effect was consistent across subgroups defined by age , sex , income level , or geographic location ( p homogeneity > 0.2 ) . The relative risk estimates were similar in sensitivity analyses adjusting for missing data and salivary cotinine verification tests . Reported quit rates remained high at six months , but there was some uncertainty about between group differences because of incomplete follow up . Conclusions : This programme offers potential for a new way to help young smokers to quit , being affordable , personalised , age appropriate , and not location dependent . Future research should test these findings in different setting s , and provide further assessment of long term quit rates Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background There is a growing body of evidence indicating that web-based personalized feedback interventions can reduce the amount of alcohol consumed in problem drinking college students . This study sought to evaluate whether providing voluntary access to such an intervention would have an impact on drinking . Methods College students responded to an email inviting them to participate in a short drinking survey . Those meeting criteria for risky drinking ( and agreeing to participate in a follow-up ) were r and omized to an intervention condition where they were offered to participate in a web-based personalized feedback intervention or to a control condition ( intervention not offered ) . Participants were followed-up at six weeks . Results A total of 425 participants were r and omized to condition and 68 % ( n = 290 ) completed the six-week follow-up . No significant difference in drinking between conditions was observed . Conclusions Web-based personalized feedback interventions that are offered to students on a voluntary basis may not have a measurable impact on problem drinking . Trial Registration Clinical Trials.gov : Background In recent years , many electronic health behavior interventions have been developed in order to reach individuals with unhealthy behaviors , such as risky drinking . This is especially relevant for university students , many of whom are risky drinkers . Objective This study explored the acceptability and feasibility in a nontreatment-seeking group of university students ( including both risk and nonrisk drinkers ) , of a fully automated , push-based , multiple-session , alcohol intervention , comparing two modes of delivery by r and omizing participants to receive the intervention either by SMS text messaging ( short message service , SMS ) or by email . Methods A total of 5499 students at Luleå University in northern Sweden were invited to participate in a single-session alcohol assessment and feedback intervention ; 28.04 % ( 1542/5499 ) students completed this part of the study . In total , 29.44 % ( 454/1542 ) of those participating in the single-session intervention accepted to participate further in the extended multiple-session intervention lasting for 4 weeks . The students were r and omized to receive the intervention messages via SMS or email . A follow-up question naire was sent immediately after the intervention and 52.9 % ( 240/454 ) responded . Results No difference was seen regarding satisfaction with the length and frequency of the intervention , regardless of the mode of delivery . Approximately 15 % in both the SMS ( 19/136 ) and email groups ( 15/104 ) would have preferred the other mode of delivery . On the other h and , more students in the SMS group ( 46/229 , 20.1 % ) stopped participating in the intervention during the 4-week period compared with the email group ( 10/193 , 5.2 % ) . Most students in both groups expressed satisfaction with the content of the messages and would recommend the intervention to a fellow student in need of reducing drinking . A striking difference was seen regarding when a message was read ; 88.2 % ( 120/136 ) of the SMS group read the messages within 1 hour in contrast to 45.2 % ( 47/104 ) in the email group . In addition , 83.1 % ( 113/136 ) in the SMS group stated that they read all or almost all the messages , compared with only 63.5 % ( 66/104 ) in the email group . Conclusions Based on the feedback from the students , an extended , multiple-session , push-based intervention seems to be a feasible option for students interested in additional support after a single-session alcohol intervention . SMS as a mode of delivery seems to have some advantages over email regarding when a message is read and the proportion of messages read . However , more students in the SMS group stopped the intervention than in the email group . Based on these promising findings , further studies comparing the effectiveness of single-session interventions with extended multiple-session interventions delivered separately or in combination are warranted Background Alcohol consumption in the student population continues to be cause for concern . Building on the established evidence base for traditional brief interventions , interventions using the Internet as a mode of delivery are being developed . Published evidence of replication of initial findings and ongoing development and modification of Web-based personalized feedback interventions for student alcohol use is relatively rare . The current paper reports on the replication of the initial Unitcheck feasibility trial . Objective To evaluate the effectiveness of Unitcheck  , a Web-based intervention that provides instant personalized feedback on alcohol consumption . It was hypothesized that use of Unitcheck would be associated with a reduction in alcohol consumption . Methods A r and omized control trial with two arms ( control= assessment only ; intervention = fully automated personalized feedback delivered using a Web-based intervention ) . The intervention was available week 1 through to week 15 . Students at a UK university who were completing a university-wide annual student union electronic survey were invited to participate in the current study . Participants ( n=1618 ) were stratified by sex , age group , year of study , self-reported alcohol consumption , then r and omly assigned to one of the two arms , and invited to participate in the current trial . Participants were not blind to allocation . In total , n=1478 ( n=723 intervention , n=755 control ) participants accepted the invitation . Of these , 70 % were female , the age ranged from 17 - 50 years old , and 88 % were white/white British . Data were collected electronically via two websites : one for each treatment arm . Participants completed assessment s at weeks 1 , 16 , and 34 . Assessment included CAGE , a 7-day retrospective drinking diary , and drinks consumed per drinking occasion . Results The regression model predicted a monitoring effect , with participants who completed assessment s reducing alcohol consumption over the final week . Further reductions were predicted for those allocated to receive the intervention , and additional reductions were predicted as the number of visits to the intervention website increased . Conclusions Unitcheck can reduce the amount of alcohol consumed , and the reduction can be sustained in the medium term ( ie , 19 weeks after intervention was withdrawn ) . The findings suggest self-monitoring is an active ingredient to Web-based personalized feedback Summary Background Smoking cessation programmes delivered via mobile phone text messaging show increases in self-reported quitting in the short term . We assessed the effect of an automated smoking cessation programme delivered via mobile phone text messaging on continuous abstinence , which was biochemically verified at 6 months . Methods In this single-blind , r and omised trial , undertaken in the UK , smokers willing to make a quit attempt were r and omly allocated , using an independent telephone r and omisation system , to a mobile phone text messaging smoking cessation programme ( txt2stop ) , comprising motivational messages and behavioural-change support , or to a control group that received text messages unrelated to quitting . The system automatically generated intervention or control group texts according to the allocation . Outcome assessors were masked to treatment allocation . The primary outcome was self-reported continuous smoking abstinence , biochemically verified at 6 months . All analyses were by intention to treat . This study is registered , number IS RCT N 80978588 . Findings We assessed 11 914 participants for eligibility . 5800 participants were r and omised , of whom 2915 smokers were allocated to the txt2stop intervention and 2885 were allocated to the control group ; eight were excluded because they were r and omised more than once . Primary outcome data were available for 5524 ( 95 % ) participants . Biochemically verified continuous abstinence at 6 months was significantly increased in the txt2stop group ( 10·7 % txt2stop vs 4·9 % control , relative risk [ RR ] 2·20 , 95 % CI 1·80–2·68 ; p<0·0001 ) . Similar results were obtained when participants that were lost to follow-up were treated as smokers ( 268 [ 9 % ] of 2911 txt2stop vs 124 [ 4 % ] of 2881 control [ RR 2·14 , 95 % CI 1·74–2·63 ; p<0·0001 ] ) , and when they were excluded ( 268 [ 10 % ] of 2735 txt2stop vs 124 [ 4 % ] of 2789 control [ 2·20 , 1·79–2·71 ; p<0·0001 ] ) . No significant heterogeneity was shown in any of the prespecified subgroups . Interpretation The txt2stop smoking cessation programme significantly improved smoking cessation rates at 6 months and should be considered for inclusion in smoking cessation services . Funding UK Medical Research Council , Primary Care Research Networks OBJECTIVES Undergraduate students frequently exceed guideline limits for alcohol intake in a single session and are highly susceptible to associated health , social , and economic problems . Psychological theory suggests that interventions aim ed at reducing alcohol consumption should target both motivational and volitional phases of action to be effective . This study reports an integrated theory-based intervention aim ed at reducing undergraduates ' alcohol consumption in excess of guideline limits . DESIGN The study adopted a 2 ( motivation : mental simulation vs. no mental simulation ) × 2 ( volitional : implementation intention vs. no implementation intention ) r and omized controlled design presented in an online format . METHODS Undergraduate students ( N= 238 ; females , n= 133 , M age = 20.11 , SD= 2.09 ; males , n= 105 , M age = 20.38 , SD= 1.35 ) completed baseline psychological measures and self-reported alcohol consumption as units consumed and heavy episodic drinking occasions followed by the intervention manipulation ( if any ) . One month later participants completed follow-up measures of the psychological variables and alcohol consumption . RESULTS Significant reductions in alcohol consumption were observed at follow-up . Participants receiving a mental simulation intervention reported significantly fewer units of alcohol consumed and heavy episodic drinking occasions . Among participants with high baseline alcohol consumption , participants in the combined mental simulation and implementation intention intervention group consumed significantly fewer units than other groups . CONCLUSION Results support the use of these theory-based strategies to reduce alcohol drinking in excess of guideline limits among undergraduates . There was preliminary support for the interaction between the two strategies among heavier drinkers . Targeting both motivational and implemental phases of action poses a high probability for success in changing alcohol-related behaviour in this population IMPORTANCE Unhealthy alcohol use is a leading contributor to the global burden of disease , particularly among young people . Systematic review s suggest efficacy of web-based alcohol screening and brief intervention and call for effectiveness trials in setting s where it could be sustainably delivered . OBJECTIVE To evaluate a national web-based alcohol screening and brief intervention program . DESIGN , SETTING , AND PARTICIPANTS A multisite , double-blind , parallel-group , individually r and omized trial was conducted at 7 New Zeal and universities . In April and May of 2010 , invitations containing hyperlinks to the Alcohol Use Disorders Identification Test-Consumption ( AUDIT-C ) screening test were e-mailed to 14,991 students aged 17 to 24 years . INTERVENTIONS Participants who screened positive ( AUDIT-C score ≥4 ) were r and omized to undergo screening alone or to 10 minutes of assessment and feedback ( including comparisons with medical guidelines and peer norms ) on alcohol expenditure , peak blood alcohol concentration , alcohol dependence , and access to help and information . MAIN OUTCOMES AND MEASURES A fully automated 5-month follow-up assessment was conducted that measured 6 primary outcomes : consumption per typical occasion , drinking frequency , volume of alcohol consumed , an academic problems score , and whether participants exceeded medical guidelines for acute harm ( binge drinking ) and chronic harm ( heavy drinking ) . A Bonferroni-corrected significance threshold of .0083 was used to account for the 6 comparisons and a sensitivity analysis was used to assess possible attrition bias . RESULTS Of 5135 students screened , 3422 scored 4 or greater and were r and omized , and 83 % were followed up . There was a significant effect on 1 of the 6 prespecified outcomes . Relative to control participants , those who received intervention consumed less alcohol per typical drinking occasion ( median 4 drinks [ interquartile range { IQR } , 2 - 8 ] vs 5 drinks [ IQR 2 - 8 ] ; rate ratio [ RR ] , 0.93 [ 99.17 % CI , 0.86 - 1.00 ] ; P = .005 ) but not less often ( RR , 0.95 [ 99.17 % CI , 0.88 - 1.03 ] ; P = .08 ) or less overall ( RR , 0.95 [ 99.17 % CI , 0.81 - 1.10 ] ; P = .33 ) . Academic problem scores were not lower ( RR , 0.91 [ 99.17 % CI , 0.76 - 1.08 ] ; P = .14 ) and effects on the risks of binge drinking ( odds ratio [ OR ] , 0.84 [ 99.17 % CI , 0.67 - 1.05 ] ; P = .04 ) and heavy drinking ( OR , 0.77 [ 99.17 % CI , 0.56 - 1.05 ] ; P = .03 ) were not significantly significant . In a sensitivity analysis accounting for attrition , the effect on alcohol per typical drinking occasion was no longer statistically significant . CONCLUSIONS AND RELEVANCE A national web-based alcohol screening and brief intervention program produced no significant reductions in the frequency or overall volume of drinking or academic problems . There remains a possibility of a small reduction in the amount of alcohol consumed per typical drinking occasion . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12610000279022 OBJECTIVE To determine if interactive computerized patient education , skin self-examination ( SSE ) tutorials , and telecommunication reminders could be combined to increase patient performance of SSEs , increase confidence in ability to identify melanoma , and influence individual melanoma risk perception . DESIGN A total of 132 adult participants from our dermatology clinics were enrolled in an interventional study and r and omized to a control group or an intervention group . Survey data were collected from all participants on the day of enrollment and 3 months after enrollment . SETTING University Hospitals Case Medical Center outpatient dermatology clinics . PARTICIPANTS English speakers older than 18 years . INTERVENTIONS The intervention group ( 1 ) participated in a computer-assisted learning tutorial , ( 2 ) took part in a h and s-on SSE tutorial , ( 3 ) received monthly telecommunication reminders to perform SSEs for 12 weeks , and ( 4 ) received a brochure on melanoma detection . The control group received only the brochure on melanoma detection . MAIN OUTCOME MEASURES Self-report of performance of SSEs . Melanoma risk perception and confidence in ability to identify melanoma were secondary considerations . Logistic regressions , controlling for race , age , sex , education , and family history of melanoma , were used to assess the effectiveness of the intervention . RESULTS At the 3-month follow-up , those in the intervention group were more likely to perform SSEs ( odds ratio [ OR ] , 2.36 ; P ≤ .05 ) . In addition , those who participated in the intervention were more likely to report being confident in their ability to identify melanoma during an SSE ( OR , 2.72 ; P ≤ .05 ) . CONCLUSION Computer-assisted patient education used in conjunction with a h and s-on SSE tutorial and telecommunication reminders can increase patient performance of SSEs and confidence in the ability to identify melanoma BACKGROUND Heavy drinking is common during transitions from high school to college . Optimal programs for diminishing risks for high alcohol consumption often tailor the approach to the specific needs of students . This study describes the results of an Internet-based prevention protocol that tailors the information to the risk associated with a pre-existing phenotype , the Low level of Response ( Low LR ) to alcohol . METHODS Using stratified r and om assignment , 454 freshmen with Low and High LR values were assigned to  2 education groups ( LR-based where all examples were given the context of the Low LR model of heavy drinking or a State Of The Art ( SOTA ) Group where the same lessons were taught but without an emphasis on LR ) or a no-intervention Control Group . Individuals in the 2 education groups viewed 50-minute online videos once per week for 4 weeks . Changes in drinking patterns were assessed at Baseline , 4 weeks , and 8 weeks using a 2 ( LR status ) by 3 ( education group ) by 3 ( time points ) analysis of variance , with additional tests for ethnicity and sex . RESULTS Low LR participants tended to decrease their usual ( p < 0.06 ) and maximum ( p < 0.05 ) drinks per occasion most prominently when assigned to the LR-based protocol , while those with High LRs improved more in the SOTA Group . The most robust differences were seen when controlling for ethnicity . The effect sizes were small to medium . CONCLUSIONS These results support the advantages of carrying out prevention via the Internet and in tailoring the approach to a pre-existing phenotype Background Practitioners who come into contact with the intoxicated , such as those in unscheduled care , often have limited re sources to provide structured interventions . There is therefore a need for cost-effective alcohol interventions requiring minimal input . This study assesses the barriers , acceptability and validity of text messaging to collect daily alcohol consumption data and explores the feasibility of a text-delivered intervention in an exploratory r and omised controlled trial . Methods Study I. Participants ( n = 82 ) completed the initial online screening survey  and those eligible were asked each day , for 157 days via text message , to reply with the number of alcohol units consumed the previous day . Analyses compared st and ard measures of hazardous consumption with self-report alcohol use . Attrition and sampling biases were examined . Study I included secondary exploratory analyses using data from 70 participants to determine associations between events ( including Christmas and other celebratory occasions ) and consumption . Study I further included the thematic analysis of semi-structured interview data and assessed the feasibility of and barriers to surveillance and interventions delivered through text messaging . Developing findings from Study I , Study II developed an exploratory r and omised control trial that delivered a single message on monthly alcohol expenditure in order to assess effect size and test generalisability . Results Self-report alcohol consumption data was significantly associated with FAST and AUDIT scores . Attrition from the study was not associated with greater alcohol use . Greater alcohol use was observed on Fridays , Saturdays and Wednesdays as were notable celebratory events . Interview data indicated that text messaging was acceptable to participants and preferred over email and web-based methods . The exploratory r and omised controlled trial suggested that a simple text delivered intervention might be effective in eliciting a reduction in alcohol consumption in a future trial . Conclusions The ubiquity of mobile telephones and the acceptability of text messaging suggests that this approach can be developed as a surveillance tool to collect high frequency consumption data to identify periods of vulnerability and that it can offer a platform through which targeted interventions can be delivered Background Young people tend to over-estimate peer group drinking levels . Personalised normative feedback ( PNF ) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups . PNF is intended to raise motivation for behaviour change and has been highlighted for alcohol misuse prevention by the British Government Behavioural Insight Team . The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse . Methodology Solomon three-group r and omised controlled trial . 1751 students , from 22 British Universities , allocated to a PNF group , a normal control group , or a delayed measurement control group to allow assessment of any measurement effects . PNF was provided by email . Participants completed online question naires at baseline , 6- and 12-months ( only 12-months for the delayed measurement controls ) . Drinking behaviour measures were ( i ) alcohol disorders ; ( ii ) frequency ; ( iii ) typical quantity , ( iv ) weekly consumption ; ( v ) alcohol-related problems ; ( vi ) perceived drinking norms ; and ( vii ) positive alcohol expectancies . Analyses focused on high-risk drinkers , as well as all students , because of research evidence for the prevention paradox in student drinkers . Principal Findings Follow-up rates were low , with only 50 % and 40 % responding at 6- and 12-months , respectively , though comparable to similar European studies . We found no evidence for any systematic attrition bias . Overall , statistical analyses with the high risk sub- sample , and for all students , showed no significant effects of the intervention , at either time-point , in a completed case analysis and a multiple imputation analysis . Conclusions We found no evidence for the effectiveness of PNF for the prevention of alcohol misuse and alcohol-related problems in a UK student population . Registration Controlled-Trials.com IS RCT Background Binge drinking is associated with numerous negative consequences . The prevalence and intensity of binge drinking is highest among young adults . This r and omized trial tested the efficacy of a 12-week interactive text message intervention to reduce binge drinking up to 6 months after intervention completion among young adults . Methods and Findings Young adult participants ( 18–25 y ; n = 765 ) drinking above the low-risk limits ( AUDIT-C score > 3/4 women/men ) , but not seeking alcohol treatment , were enrolled from 4 Emergency Departments ( EDs ) in Pittsburgh , PA . Participants were r and omized to one of three conditions in a 2:1:1 allocation ratio : SMS Assessment s + Feedback ( SA+F ) , SMS Assessment s ( SA ) , or control . For 12 weeks , SA+F participants received texts each Thursday querying weekend drinking plans and prompting drinking limit goal commitment and each Sunday querying weekend drinking quantity . SA+F participants received tailored feedback based on their text responses . To contrast the effects of SA+F with self-monitoring , SA participants received texts on Sundays querying drinking quantity , but did not receive alcohol-specific feedback . The control arm received st and ard care . Follow-up outcome data collected through web-based surveys were provided by 78 % of participants at 3- months , 63 % at 6-months and 55 % at 9-months . Multiple imputation-derived , intent-to-treat models were used for primary analysis . At 9-months , participants in the SA+F group reported greater reductions in the number of binge drinking days than participants in the control group ( incident rate ratio [ IRR ] 0.69 ; 95 % CI .59 to.79 ) , lower binge drinking prevalence ( odds ratio [ OR ] 0.52 ; 95 % CI 0.26 to 0.98 ] ) , less drinks per drinking day ( beta -.62 ; 95 % CI -1.10 to -0.15 ) and lower alcohol-related injury prevalence ( OR 0.42 ; 95 % CI 0.21 to 0.88 ) . Participants in the SA group did not reduce drinking or alcohol-related injury relative to controls . Findings were similar using complete case analyses . Conclusions An interactive text-message intervention was more effective than self-monitoring or controls in reducing alcohol consumption and alcohol-related injury prevalence up to 6 months after intervention completion . These findings , if replicated , suggest a scalable approach to help achieve sustained reductions in binge drinking and  accompanying injuries among young adults . Trial Registration Clinical Trials.gov Aims Like many indigenous peoples , New Zeal and Māori bear a heavy burden of alcohol-related harm relative to their non-indigenous compatriots , and disparities are greatest among young adults . We tested the effectiveness of web-based alcohol screening and brief intervention ( e-SBI ) for reducing hazardous drinking among Māori university students . Design Parallel , double-blind , multi-site , r and omized controlled trial . Setting Seven of New Zeal and 's eight universities . Participants In April 2010 , we sent e-mail invitations to all 6697 17–24-year-old Māori students to complete a brief web question naire including the Alcohol Use Disorders Identification Test (AUDIT)-C , a screening tool for hazardous and harmful drinking . Those screening positive were computer r and omized to : < 10 minutes of web-based alcohol assessment and personalized feedback ( intervention ) or screening alone ( control ) . Measurements We conducted a fully automated 5-month follow-up assessment with observers and participants blinded to study hypotheses , design and intervention delivery . Pre-determined primary outcomes were : ( i ) frequency of drinking , ( ii ) amount consumed per typical drinking occasion , ( iii ) overall volume of alcohol consumed and ( iv ) academic problems . Findings Of the participants , 1789 were hazardous or harmful drinkers ( AUDIT-C ≥ 4 ) and were r and omized : 850 to control , 939 to intervention . Follow-up assessment s were completed by 682 controls ( 80 % ) and 733 intervention group members ( 78 % ) . Relative to controls , participants receiving intervention drank less often [ RR = 0.89 ; 95 % confidence interval ( CI ) : 0.82–0.97 ] , less per drinking occasion ( RR = 0.92 ; 95 % CI : 0.84–1.00 ) , less overall ( RR = 0.78 ; 95 % CI : 0.69–0.89 ) and had fewer academic problems ( RR = 0.81 ; 95 % CI : 0.69–0.95 ) . Conclusions Web-based screening and brief intervention reduced hazardous and harmful drinking among non-help-seeking Māori students in a large-scale pragmatic trial . The study has wider implication s for behavioural intervention in the important but neglected area of indigenous health BACKGROUND To examine whether ( 1 ) the ' What Do You Drink ' ( WDYD ) intervention result ed in drinking refusal self-efficacy ( DRSE ) changes directly after the intervention , and if so , whether these changes sustained at six-months follow-up and ( 2 ) DRSE was related to alcohol use over time , and if so , whether the strength of these relationships differed across conditions . Insight herein can help explain the sustained preventive effects of the WDYD intervention on alcohol use , as reported previously . METHODS Alcohol use and DRSE data were collected from 907 participants ( 60.3 % male ; M=20.8 ( SD=1.7 ) in a two-arm parallel group r and omized controlled trial applying ecological momentary assessment with 30 time-points . Participants were r and omized to the experimental ( n=456 : WDYD intervention ) or control condition ( n=451 : no intervention ) . RESULTS Latent Growth Curve ( LGC ) analyses that modeled individual change in DRSE over time by condition revealed that participants in the experimental condition experienced a higher social pressure DRSE compared to participants in the control condition at six-months follow-up . Moreover , LGC analyses with time-varying covariates revealed that DRSE was negatively related to weekly alcohol consumption and social pressure DRSE to frequency of binge drinking . The WDYD intervention did not affect the strength of these relationships . CONCLUSIONS The WDYD intervention increased the level of social pressure DRSE directly after the intervention that sustained at six-months follow-up . This change is likely to be responsible for the sustained preventive effects of the WDYD intervention on alcohol use , as reported previously Alcohol use among first-year university students continues to be a central health concern . Efforts to address drinking in this population have increasingly relied on web-based interventions , which have the capacity to reach large numbers of students through a convenient and highly utilized medium . Despite evidence for the utility of this approach for reducing hazardous drinking , recent studies that have examined the effectiveness of this approach as a universal prevention strategy in campus-wide studies have produced mixed results . We sought to test the effectiveness of a web-based alcohol intervention as a universal prevention strategy for first-year students . An e-mail invitation linked to a brief , web-based survey on health behaviors was sent to all first-year students during the fall semester . Those who completed the baseline assessment were r and omized to receive either a feedback-based alcohol intervention ( intervention condition ) or feedback about other health-related behaviors such as sleep and nutrition ( control condition ) . A second web-based survey was used to collect follow-up drinking data 5 months later . The number of heavy drinking episodes in the previous month and alcohol-related consequences in the previous 3 months served as the primary dependent variables . Negative binomial regression analyses did not indicate a significant effect of the intervention at follow-up on either heavy drinking episodes or alcohol-related consequences . Analyses of additional drinking outcomes among the sub sample of students who reported that they did not drink at baseline showed that those who received the alcohol intervention were subsequently less likely to drink alcohol . These results suggest that web-based alcohol interventions may be a potentially useful method of maintaining abstinence among underage , non-drinking students . Overall , however , results indicate that an e-mail-linked , campus-wide , web-intervention approach to address alcohol use among first-year students may have limited effectiveness as an approach to minimize hazardous drinking over the course of the year College athletes are an at-risk population for excessive alcohol use and subsequent alcohol-related harms . The purpose of this study was to test the efficacy of an electronically delivered personalized drinking feedback ( PDF ) intervention targeted specifically to college athletes , both in comparison with a st and ard ( i.e. , nontargeted ) PDF intervention and an education-only ( EO ) condition that also included targeted information . Data were collected on 263 intercollegiate athletes from three colleges ( 76 % women , 86 % White ) who were r and omly assigned to one of the conditions . Results provided partial support for the efficacy of the targeted PDF intervention . Students in the targeted PDF condition reported a lower peak blood alcohol concentration ( BAC ) at the 6-month follow-up than those in the other conditions . Heavy drinking students in the targeted PDF condition reported a lower peak BAC than those in the other conditions at the 1-month follow-up and a lower peak BAC than those in the EO condition at the 6-month follow-up . Finally , in-season athletes in the targeted PDF condition reported fewer drinks per week than those in the PDF-st and ard condition at the 1-month follow-up . These findings provide preliminary support for the use of targeted PDF interventions with at-risk alcohol users , such as college athletes Nationally , college drinkers exhibit the highest rates of alcohol consumption and represent the largest percentage of problem drinkers . Group motivational enhancement therapy ( GMET ) has been found to catalyze problem drinking reductions among college student sample s. Although research supporting the use of single-session GMET in college sample s ( general and m and ated ) is emergent , no studies have evaluated a comprehensive model of the potential active ingredients of this group intervention . College students ( N = 206 ; 88 % White ; 63 % men ; M age = 18.6 ) m and ated to a university alcohol diversion program were r and omly assigned to 1 of 3 conditions : the st and ard-of-care 2-session " Focus on Alcohol Concerns " education group ( FAC ) , a single GMET , or a single alcohol information-only control group ( AI ) to evaluate the role of 5 putative mediators : readiness to change , self-efficacy , perceived risk , norm estimates , and positive drinking expectancies . At 3- and 6-month follow-ups , GMET students demonstrated greater reductions in problem drinking outcomes ( drinks per drinking day , hazardous drinking symptoms , and alcohol-related problems ) . Of the 5 mediators proposed , only self-efficacy emerged as a significant mediator Background Little is known about the effectiveness of mobile apps in aiding smoking cessation or their validity for automated collection of data on smoking cessation outcomes . Objective We conducted a preliminary evaluation of SF28 ( SF28 is the name of the app , short for SmokeFree28)—an app aim ed at helping smokers to be smoke-free for 28 days . Methods Data on sociodemographic characteristics , smoking history , number of logins , and abstinence at each login were uploaded to a server from SF28 between August 2012 and August 2013 . Users were included if they were aged 16 years or over , smoked cigarettes at the time of registration , had set a quit date , and used the app at least once on or after their quit date . Their characteristics were compared with data from a representative sample of smokers trying to stop smoking in Engl and . The percentage of users recording 28 days of abstinence was compared with a value of 15 % estimated for unaided quitting . Correlations were assessed between recorded abstinence for 28 days and well-established abstinence predictors . Results A total of 1170 users met the inclusion criteria . Compared with smokers trying to quit in Engl and , they had higher consumption , and were younger , more likely to be female , and had a non-manual rather than manual occupation . In total , 18.9 % ( 95 % CI 16.7 - 21.1 ) were recorded as being abstinent from smoking for 28 days or longer . The mean number of logins was 8.5 ( SD 9.0 ) . The proportion recording abstinence for 28 days or longer was higher in users who were older , in a non-manual occupation , and in those using a smoking cessation medication . Conclusions The recorded 28-day abstinence rates from the mobile app , SF28 , suggest that it may help some smokers to stop smoking . Further evaluation by means of a r and omized trial appears to be warranted Purpose . This pilot study assessed the feasibility , acceptability , and utility of a text messaging system that allowed teenagers with asthma to generate and control medical reminders sent to their mobile phones . Methods . The 12 teens in the study group were able to create their own reminder text messages , add or change reminders , and determine when and how often the messages were sent to their cell phone . Results . In total , 18 of the 21 unique messages created were reminders to take medication . No teen made changes to their original text messages or delivery schedule on their own . They gave high ratings on the usefulness , acceptability , and ease of use of the text messaging system . Self-reported asthma control at baseline was similar for both the study and comparison groups and did not change significantly . Conclusions . Allowing teens to control the timing and content of reminder text messages may support self-management of chronic disease OBJECTIVE Numerous mobile health ( mHealth ) interventions are being developed to aid in management of complex chronic medical conditions . However , the acceptance of mHealth programs by low-income , bilingual population s has not yet been evaluated . The Trial to Examine Text-based mHealth for  Emergency department patients with Diabetes ( TExT-MED ) program is a text message-based mHealth program design ed specifically for re source -poor patients with diabetes . We conducted a prospect i ve proof-of-concept trial to assess satisfaction and preliminary effectiveness of the TExT-MED program . RESEARCH DESIGN AND METHODS A consecutive sample of adult patients in the emergency department with diabetes and a text message-capable mobile phone was enrolled in the TExT-MED program .  Participants received three text messages daily for 3 weeks in English or Spanish in the following domains : educational/motivational , medication reminders , healthy living challenges , diabetes trivia , and links to free diabetes management tools . RESULTS Twenty-three patients with diabetes ( median hemoglobin A1c , 8.9 % ) were enrolled in TExT-MED .  In the week before TExT-MED , 56.5 % of subjects reported eating fruits/vegetables daily versus 83 % after , 43.5 % reported exercising before versus 74 % after , and 74 % reported performing foot checks before versus 85 % after . Self-efficacy , measured by the Diabetes Empowerment Scale-Short Form , improved from 3.9 to 4.2 . Scores on the Morisky Medication Adherence Scale improved more dramatically from 3.5 to 4.75 . Ninety percent of participants indicated they would like to continue the program , and 100 % would recommend the program to family or friends . CONCLUSIONS This pilot trial of the TExT-MED program demonstrated increased healthy behaviors , improved diabetes self-efficacy and medication adherence , and received excellent satisfaction scores in re source -poor , inner city patients with diabetes Background : This study evaluated a decisional balance intervention among heavy drinking undergraduates and compared a nonweighted decisional balance proportion ( DBP ; Collins , Carey , & Otto , 2009 ) to a participant-weighted DBP with weights based on relative importance of items . We expected : ( 1 ) the intervention to decrease drinking compared to control ; ( 2 ) the weighted intervention to be more effective compared to the nonweighted or control in reducing drinking ; and ( 3 ) intervention efficacy to be moderated by initial DBP . Method : Participants ( N = 162 , Mean age = 24.37 , SD = 6.81 , 27 % male ) were r and omly assigned to an alcohol intervention wherein they were either asked to assign weights of importance to pros and cons ( weighted intervention ) , or not ( nonweighted intervention ) , or to control . Participants completed web-based question naires at baseline and again during a one month follow-up assessment . Results : Consistent with expectations , the nonweighted intervention was associated with reduced follow-up weekly drinking , and the weighted intervention was associated with reductions in drinking frequency . Results further indicated that initial decisional balance did not moderate intervention efficacy . Discussion : Findings suggest that the decisional balance procedure can reduce drinking but there was not compelling evidence for the addition of weights . This study lays the groundwork for enhancing future interventions by increasing empirical knowledge of the role motivation plays in heavy alcohol use BACKGROUND Brief interventions have the potential to reduce heavy drinking  in young adults who present to the emergency department ( ED ) , but require time and re sources rarely available . Text-messaging ( TM ) may provide an effective way to collect drinking data from young adults after ED discharge as well as to provide immediate feedback and ongoing support for behavior change . The feasibility of screening young adults in the ED , recruiting them for a TM-based interventional trial , collecting weekly drinking data through TM , and the variance in drinking outcomes remains unknown . METHODS Young adults in 3 urban EDs ( n = 45 ; aged 18 to 24 years , 54 % women ) identified as hazardous drinkers by the Alcohol Use Disorders Identification Test-Consumption score were r and omly assigned to weekly TM-based feedback with goal setting ( Intervention ) , weekly TM-based drinking assessment s without feedback ( Assessment ) , or control . Participants in the Intervention group who reported ≥5 ( for men ) and ≥4 ( for women ) maximum drinks during any one 24-hour period were asked whether they would set a goal to reduce their drinking the following week . We describe the interaction with TM and goal setting . We also describe the heavy drinking days ( HDDs ) , drinks per drinking day ( DPDD ) using timeline follow-back procedure at baseline and 3 months . RESULTS We screened 109 young adults over 157 hours across 24 unique days and 52 ( 48 % ; 95 % CI 38 to 50 ) screened positive for hazardous drinking . Of these , 45 ( 87 % ; 95 % CI 74 to 94 ) met inclusion criteria , were enrolled and r and omized , and 6 ( 13 % ; 95 % CI 5 to 27 ) did not complete 3-month web-based follow-up ; 88 % ( 95 % CI 84 to 91 ) of weekly TM-based drinking assessment s were answered , with 77 % ( 95 % CI 58 to 90 ) of participants responding to all 12 weeks . Agreeing to set a goal was associated with a repeat HDD 36 % ( 95 % CI 17 to 55 ) of the time compared with 63 % ( 95 % CI 44 to 81 ) when not willing to set a goal . At 3 months , participants that were exposed to the TM-based intervention had 3.4 ( SD 5.4 ) fewer HDDs in the last month and 2.1 ( SD 1.5 ) fewer DPDD when compared to baseline . CONCLUSIONS TM can be used to assess drinking in young adults and can deliver brief interventions to young adults discharged from the ED . TM-based interventions have the potential to reduce heavy drinking among young adults but larger studies are needed to establish efficacy Young men who have sex with men ( YMSM ) are disproportionately infected with HIV/AIDS and there are few prevention programs with published efficacy for this population . This study evaluated the feasibility , acceptability , and preliminary efficacy of an online , interactive , and highly engaging HIV prevention program called Keep It Up ! The intervention was design ed to be delivered to diverse YMSM upon receiving an HIV negative text result , with the goal for them to “ Keep It Up ” and stay negative . In a r and omized clinical trial , the intervention was compared to an online didactic HIV knowledge condition . The study sample included 102 sexually active YMSM . Participants reported completing online modules in setting s that were private and not distracting . Mixed methods data showed intervention participants felt the program was valuable and acceptable . Compared to the control condition , participants in the intervention arm had a 44 % lower rate of unprotected anal sex acts at the 12-week follow-up ( p < 0.05).ResumenLos hombres jóvenes que tienen relaciones sexuales con hombres ( HJSH ) están desproporcionadamente infectados con el VIH/SIDA y son pocos los programas de prevención con eficacia publicada para esta población . Este estudio evaluó la viabilidad , aceptabilidad y eficacia preliminar de un programa de prevención del VIH llamado Manténgalo ! ( Keep It Up ! en ingles ) que se ofrece por internet y que es interactivo y atrayente . La intervención se diseñó para ser entregada a diversos HJSH al recibir estos un result ado negativo de VIH . El objetivo es que se “ mantengan ” negativos . En una prueba clínica aleatoria se comparó la intervención con una condición didáctica de conocimiento del VIH ofrecida por internet . La muestra de estudio incluyó 102 HJSH sexualmente activos . Los participantes informaron haber completado módulos por internet en entornos privados y sin distracciones . Los datos obtenidos mediante diferentes métodos muestran que quienes participaron en la intervención sintieron que el programa era valioso y aceptable . Comparado con la condición de control , los participantes en el grupo de intervención presentaron una reducción del 44 % en los actos de sexo anal sin protección en su seguimiento 12 semanas después ( p < 0.05 ) OBJECTIVE Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost ; however , few controlled evaluations have been conducted to date . The present study was design ed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback ( PNF ) with single versus biannual administration in a 2-year r and omized controlled trial targeting a large sample of heavy-drinking college students . METHOD Participants included 818 freshmen ( 57.6 % women ; 42 % non-Caucasian ) who reported 1 or more heavy-drinking episodes in the previous month at baseline . Participants were r and omly assigned in a 2 ( gender-specific vs. gender-nonspecific PNF ) × 2 ( single vs. biannual administration of PNF ) + 1 ( attention control ) design . Assessment s occurred every 6 months for a 2-year period . RESULTS Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking . Relative to control , gender-specific biannual PNF was associated with reductions over time in weekly drinking ( d = -0.16 , 95 % CI [ -0.02 , -0.31 ] ) , and this effect was partially mediated by changes in perceived norms . For women , but not men , gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control ( d = -0.29 , 95 % CI [ -0.15 , -0.58 ] ) . Few other effects were evident . CONCLUSIONS The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies Background / Aims : Most problematic alcohol users never seek professional help to reduce their use , and Web-based interventions might fulfill users ' unmet needs for professional support . Methods : This r and omized controlled trial compared two open Web-based interventions , one extended self-help program and one brief screening and feedback intervention , with an assessment -only control group .  Participants were 633 Internet help seekers with at least hazardous alcohol use ( Alcohol Use Disorders Identification Test , AUDIT ≥6 for women and ≥8 for men ) . Results : All groups reduced their alcohol use at 3-month follow-up ( p < 0.001 ) , remaining stable at the 6- and 12-month follow-ups ( n.s . ) according to AUDIT-C and AUDIT scores ( intention-to-treat , ITT , analysis ) . Per protocol ( PP ) analysis , including only participants who accessed the interventions and also reported accessing additional outside interventions during the trial , showed that about 75 % of extended self-help participants moved from probable dependence , harmful or hazardous use to lower alcohol use levels at 3- and 6- and 12-month follow-ups , compared to about 40 - 60 % of brief intervention users and controls who accessed extra help ( p < 0.05 ) . Conclusion : ITT analysis suggested parity over time for all interventions , including assessment only , in reducing problematic alcohol use . In contrast , PP analysis suggested that cognitive-behavioral extended self-help in combination with other interventions was more effective in changing alcohol use than brief intervention or assessment only UNLABELLED Web-based screening and brief interventions that include personalized feedback about their alcohol use have proven to be particularly promising for reducing hazardous drinking among university students . Despite the increasing use of these approaches , there is still relatively little known about how the content of these interventions may influence outcomes and who may benefit most from these approaches . The current study sought to address these issues by examining how individual differences in alcohol consequences influence outcomes of a laboratory-based computerized intervention . METHODS One-hundred and nineteen introductory psychology students who either had two episodes of heavy episodic drinking in the past month or scored ≥8 on the AUDIT participated in this r and omized controlled trial for course credit . Participants were assigned to 1 of 4 conditions in this 2 Intervention ( Alcohol Feedback vs. Control) × 2 Assessment ( Motivational Assessment vs. No Motivational Assessment ) between-subjects design . Quantity of alcohol consumed per week and heavy episodic drinking one month later were the primary dependent variables . RESULTS Controlling for corresponding baseline alcohol measures , hierarchical linear regression analyses showed a significant interaction between intervention condition and baseline alcohol-related consequences . For those who reported more alcohol consequences at baseline , the alcohol intervention result ed in significantly less alcohol use and fewer heavy drinking episodes at follow-up , while no difference was observed between intervention conditions for those with few baseline consequences . Assessment did not moderate intervention effects . DISCUSSION These findings suggest that a feedback-based computerized intervention that includes normative information about alcohol use and consequences may be more effective for hazardous drinking students who are experiencing higher levels of alcohol-related consequences OBJECTIVE Web-based personalized feedback interventions , particularly personalized normative feedback ( PNF ) , are efficacious in improving  college drinking outcomes ; however , no personalized feedback interventions to date have provided college drinkers with feedback about their own decisional balance . This study tested the relative efficacy of a novel decisional balance feedback ( DBF ) intervention , PNF , and an assessment -only control condition . METHOD Participants ( N = 724 ; 56 % female ) were undergraduate students at a 4-year university in the U.S. Pacific Northwest and were r and omized to receive one-time exposure to web-based DBF , PNF , or assessment only . Web-based assessment occurred at baseline and at 1- , 6- , and 12-month follow-ups and included measures of motivation to change , drinking quantity norms , drinking frequency/quantity , and alcohol-related problems . RESULTS At the 1-month follow-up , DBF and PNF participants reported reductions in alcohol-related problems ; however , only PNF participants reduced their drinking frequency and quantity . At the 6-month follow-up , only DBF participants showed significant reductions in drinking quantity and alcohol-related problems . Neither group maintained reductions in alcohol use or alcohol-related problems at the 12-month follow-up . CONCLUSIONS This study provided preliminary evidence that web-based DBF and PNF are efficacious interventions for college drinkers , with DBF having somewhat longer lasting effects This study evaluated methods of enhancing college students ' retention of information provided to them in a computer-delivered personalized drinking feedback intervention and whether enhanced retention reduced alcohol consumption during the two-week period following the intervention . Participants were 98 college students who reported at least one heavy drinking episode in the past two weeks . After participating in an online , personalized drinking feedback intervention , students were r and omly assigned to one of three experimental conditions : 1 ) typical , in which they were simply sent home , 2 ) reading , in which they were asked to spend the next 20 minutes re-reading the feedback , and 3 ) recall , in which they were asked to spend the next 20 minutes writing down as much of the information from the feedback as they could remember . Two weeks following the intervention , participants completed a recall test and provided information on their alcohol use during the previous two weeks . Results indicated that participants in the reading and recall conditions retained more of the feedback information than did participants in the typical condition . In addition , participants in the reading and recall conditions reported reduced alcohol consumption in the two-week period following the intervention , compared to those in the typical condition . Information retention partially mediated the effects of the reading and recall conditions on drinking outcomes BACKGROUND Physical inactivity , low fruit and vegetable intake , hazardous drinking , and smoking are leading risk factors for disease and injury . The aim of this study was to obtain estimates of efficacy in reducing the first three of these behaviors . METHOD The design was a r and omized controlled trial : 218 patients ( 17 - 24 years ) attending a student health service at a New Zeal and university in 2003 were assigned to : ( A ) web-based assessment and personalized feedback ( n = 72 ) ; or ( B ) assessment only ( n = 74 ) ; or ( C ) minimal contact ( n = 72 ) . Outcome measures were the proportion meeting recommendations for fruit and vegetable consumption , physical activity , and alcohol consumption 6 weeks later . RESULTS Follow-up assessment s were attained for 86 % of participants , with no evidence of differential attrition . There were significant differences in the proportion meeting recommendations for fruit and vegetable consumption and physical activity in group A relative to C. Hazardous drinking prevalence did not vary significantly by group . CONCLUSIONS Differences appear attributable to the intervention . The intervention could be routinely provided in primary care , and its efficacy could be assessed in a large r and omized controlled trial Background Unhealthy alcohol use among university students is cause for concern , yet the level of help seeking behavior for alcohol use is low within the student population . Electronic brief interventions delivered via the Internet present an alternative to traditional treatments and could enable the delivery of interventions on a population basis . Further evidence is needed of the effectiveness of Internet-delivered interventions and of their generalizability across educational institutions . Objective Our objective was to evaluate the effectiveness across 4 UK universities of a Web-based intervention for student alcohol use . Methods In total , 1112 participants took part . Participants were stratified by educational institution , gender , age group , year of study , and self-reported weekly consumption of alcohol and r and omly assigned to either the control arm or to the immediate or delayed intervention arms . Intervention participants gained access to the intervention between weeks 1 to 7 or weeks 8 to 15 , respectively . The intervention provided electronic personalized feedback and social norms information on drinking behavior accessed by logging on to a website . Participants registered interest by completing a brief screening question naire and were then asked to complete 4 further assessment s across the 24 weeks of the study . Assessment s included a retrospective weekly drinking diary , the Alcohol Use Disorders Identification Test ( AUDIT ) , and a readiness-to-change algorithm . The outcome variable was the number of units of alcohol consumed in the last week . The effect of treatment arm and time on units consumed last week and average units consumed per drinking occasion were investigated using repeated measures multivariate analysis of covariance ( MANCOVA ) . In addition , the data were modeled using a longitudinal regression with time points clustered within students . Results MANCOVA revealed a main effect of time on units of alcohol consumed over the last week . A longitudinal regression model showed an effect of assessment across time predicting that participants who completed at least 2 assessment s reduced their drinking . The model predicted an additional effect of being assigned to an intervention arm , an effect that increased across time . Regression analysis predicted that being male or being assigned to an intervention arm increased the odds of not completing all assessment s. The number of units of alcohol consumed over the last week at registration , age , university educational institution , and readiness to change were not predictive of completion . Conclusions Delivering an electronic personalized feedback intervention to students via the Internet can be effective in reducing weekly alcohol consumption . The effect does not appear to differ by educational institution . Our model suggested that monitoring alone is likely to reduce weekly consumption over 24 weeks but that consumption could be further reduced by providing access to a Web-based intervention . Further research is needed to underst and the apparent therapeutic effect of monitoring and how this can be utilized to enhance the effectiveness of brief Web-based interventions Background Excessive alcohol use is a widespread problem in many countries , especially among young people . To reach more people engaging in high-risk drinking behaviors , a number of online programs have been developed in recent years . Change Your Drinking is a German , diary-based , fully automated alcohol intervention . In 2010 , a revised version of the program was developed . It is more strongly oriented to concepts of relapse prevention than the previous version , includes more feedback , and offers more possibilities to interact with the program . Moreover , the program duration was extended from 10 to 14 days . Objective This paper examines whether the revised version of Change Your Drinking is more effective in reducing alcohol consumption than the original version . Methods The effectiveness of both program versions was compared in a Web-based , open , r and omized controlled trial with follow-up surveys 6 weeks and 3 months after registration . Participants were recruited online and were r and omly assigned to either the original or the revised version of Change Your Drinking . The following self-assessed outcomes were used : alcohol use days , alcohol intake in grams , the occurrence of binge drinking and risky drinking ( all referring to the past 7 days prior to each survey ) , and the number of alcohol-related problems . Results A total of 595 participants were included in the trial .  Follow-up rates were 58.0 % after 6 weeks and 49.6 % after 3 months . No significant group differences were found in any of the outcomes . However , the revised version was used by more participants ( 80.7 % ) than the original version ( 55.7 % ) . A significant time effect was detected in all outcomes ( alcohol use days : P=.002 ; alcohol intake in grams : P<.001 ; binge drinking : P<.001 ; alcohol-related problems : P=.004 ; risky drinking : P<.001 ) . Conclusions The duration and complexity of the program played a minor role in reducing alcohol consumption . However , differences in program usage between the versions suggest the revised version was more attractive to participants . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 31586428 ; http://www.controlled-trials.com/IS RCT N31586428/ ( Archived by WebCite at http://www.webcitation.org/6BFxApCUT A r and omized control trial was conducted at a midsized private university in the Northeast to evaluate the short-term impact of AlcoholEdu for College 8.0 , an online alcohol course for first-year students . In September 2007 , 1,620 matriculated first-year students were r and omly assigned to either a treatment group or an assessment -only control group . Both groups of students completed a baseline survey and knowledge test . Treatment group students finished the course , took a second knowledge test , and 30 days later completed a postintervention survey . Control group students completed the postintervention  survey and knowledge test during the same time period . Compared with the control group , treatment group students reported a significantly lower level of alcohol use , fewer negative drinking consequences , and less positive alcohol-related attitudes . AlcoholEdu 8.0 had a positive impact on the first-year students ' alcohol-related attitudes , behaviors , and consequences . Additional investigations of online alcohol education courses are warranted Research on the efficacy of computer-delivered feedback-only interventions ( FOIs ) for college alcohol misuse has been mixed . Limitations to these FOIs include participant engagement and variation in the use of a moderation skills component . The current investigation sought to address these limitations using a novel computer-delivered FOI , the Drinkers Assessment and Feedback Tool for College Students ( DrAFT-CS ) .  Heavy drinking college students ( N=176 ) were r and omly assigned to DrAFT-CS , DrAFT-CS plus moderation skills ( DrAFT-CS+ ) , moderation skills only ( MSO ) , or assessment only ( AO ) group , and were assessed at 1-month follow-up ( N=157 ) . Participants in the DrAFT-CS and DrAFT-CS+groups reported significantly lower estimated blood alcohol concentrations ( eBACs ) on typical heaviest drinking day than participants in the AO group . The data also supported the incorporation of a moderation skills component within FOIs , such that participants in DrAFT-CS+group reported significantly fewer drinks per week and drinks per heaviest drinking occasion than participants in the AO group Objective To carry out a r and omised controlled trial on the effect of a new method of health promotion — email and mobile phone text messages ( short messaging service (SMS))—on  young people 's sexual health . Methods 994 people aged 16–29 were recruited at a music festival to a non-blinded r and omised controlled trial . Participants were r and omised to either receive sexual health promotion messages ( n=507 ) or the control group ( n=487 ) . The 12-month intervention included SMS ( catchy sexually transmissible infections prevention slogans ) and emails . Participants completed question naires at the festival at baseline and online after 3 , 6 and 12 months . Outcomes were differences between the control and intervention groups in health-seeking behaviour , condom use with risky partners ( new or casual partners or two or more partners within 12 months ) and STI knowledge . Results 337 ( 34 % ) completed all three follow-up question naires and 387 ( 39 % ) completed the final question naire . At 12 months , STI knowledge was higher in the intervention group for both male ( OR=3.19 95 % CI 1.52 to 6.69 ) and female subjects ( OR=2.36 95 % CI 1.27 to 4.37 ) . Women ( but not men ) in the intervention group were more likely to have had an STI test ( OR=2.51 , 95 % CI 1.11 to 5.69 ) , or discuss sexual health with a clinician ( OR=2.92 , 95 % CI 1.66 to 5.15 ) than their control counterparts . There was no significant impact on condom use . Opinions of the messages were favourable . Conclusion This simple intervention improved STI knowledge in both sexes and STI testing in women , but had no impact on condom use . SMS and email are low cost , popular and convenient , and have considerable potential for health promotion . Clinical trial registration number Australian Clinical Trials Registry - ACTRN12605000760673 Abstract Objective : Reduce college student  at-risk drinking ( ARD ) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students ( M-PASS ) . Participants : Participants included 1,137 r and omly sample d first-year college students , including 59 % female , 80 % white , and averaged age 18.1 years . Methods : Intervention group participants ( n = 616 ) attended 4 online M-PASS sessions , receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories . Control group participants ( n = 521 ) completed a mid-phase survey , and both groups were surveyed at baseline and posttest . Results : Evidence of M-PASS 's efficacy was found . The intervention was associated with advanced stage of change , lower tolerance of drinking and drink/driving , fewer reasons to drink , and use of more strategies to avoid ARD . Preliminary evidence of behavioral change was also found . Efficacy was greater for women than men . Conclusions : Web-based programs may be useful in reducing alcohol-related risk among college students . Further evaluation is needed OBJECTIVE AlcoholEdu for College is a 2- to 3-hour online course for incoming college freshmen . This study was the first multicampus trial to examine effects of AlcoholEdu for College on alcohol-related problems among freshmen . METHOD Thirty universities participated in the study . Fifteen were r and omly assigned to receive AlcoholEdu  , and the other 15 were assigned to the control condition . AlcoholEdu was implemented by intervention schools during the summer and /or fall semester . Cross-sectional surveys of freshmen were conducted at each university beginning before the intervention in spring 2008/2009 ; post-intervention surveys were administered in fall 2008/2009 and spring 2009/2010 . The surveys included questions about the past-30-day frequency of 28 alcohol-related problems  , from which we created indices for the total number of problems and problems in seven domains : physiological , academic , social , driving under the influence/ riding with drinking drivers , aggression , sexual risk taking , and victimization . Multilevel Poisson regression analyses were conducted to examine intent-to-treat and dosage effects of AlcoholEdu for College on these outcomes . RESULTS Multilevel intent-to-treat analyses indicated significant reductions in the risk for past-30-day alcohol problems in general and problems in the physiological , social , and victimization domains during the fall semester immediately after completion of the course . However , these effects did not persist in the spring semester . Additional analyses suggested stronger  AlcoholEdu effects on these outcomes at colleges with higher rates of student course completion . No  AlcoholEdu effects were observed for alcohol-related problems in the other four domains . CONCLUSIONS AlcoholEdu for College appears to have beneficial short-term effects on victimization and the most common types of alcohol-related problems among freshmen . Universities may benefit the most by m and ating AlcoholEdu for College for all incoming freshmen and by implementing this online course along with environmental prevention strategies The authors conducted two r and omized clinical trials with ethnically diverse sample s of college student drinkers in order to determine ( a ) the relative efficacy of two popular computerized interventions versus a more comprehensive motivational interview approach ( BASICS ) and ( b ) the mechanisms of change associated with these interventions . In Study 1 , heavy drinking participants recruited from a student health center ( N = 74 , 59 % women , 23 % African American ) were r and omly assigned to receive BASICS or the Alcohol 101 CD-ROM program . BASICS was associated with greater post-session motivation to change and self-ideal and normative discrepancy relative to Alcohol 101 , but there were no group differences in the primary drinking outcomes at 1-month follow-up . Pre to post session increases in motivation predicted lower follow-up drinking across both conditions . In Study 2 , heavy drinking freshman recruited from a core university course ( N = 133 , 50 % women , 30 % African American ) were r and omly assigned to BASICS , a web-based feedback program ( e-CHUG ) , or assessment -only . BASICS was associated with greater post-session self-ideal discrepancy than e-CHUG , but there were no differences in motivation or normative discrepancy . There was a significant treatment effect on typical weekly and heavy drinking , with participants in BASICS reporting significantly lower follow-up drinking relative to assessment only participants . In Study 2 , change in the motivation or discrepancy did not predict drinking outcomes . Across both studies , African American students assigned to BASICS reported medium effect size reductions in drinking whereas African American students assigned to Alcohol 101 , e-CHUG , or assessment did not reduce their drinking BACKGROUND Binge drinking is common among young people but often relevant risk factors are not recognized . eHealth apps , attractive for young people , may be useful to enhance awareness of this problem . We aim ed at developing a current risk estimation model for binge drinking , incorporated into an eHealth app -- D-ARIANNA ( Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults)--for young people . METHODS A longitudinal approach with phase 1 ( risk estimation ) , phase 2 ( design ) , and phase 3 ( feasibility ) was followed . Risk/protective factors identified from the literature were used to develop a current risk estimation model for binge drinking . Relevant odds ratios were subsequently pooled through meta-analytic techniques with a r and om-effects model , deriving weighted estimates to be introduced in a final model . A set of questions , matching identified risk factors , were nested in a question naire and assessed for wording , content , and acceptability in focus groups involving 110 adolescents and young adults . RESULTS Ten risk factors ( 5 modifiable ) and 2 protective factors showed significant associations with binge drinking and were included in the model . Their weighted coefficients ranged between -0.71 ( school proficiency ) and 1.90 ( cannabis use ) . The model , nested in an eHealth app question naire , provides in percent an overall current risk score , accompanied by appropriate images . Factors that mostly contribute are shown in summary messages . Minor changes have been realized after focus groups review . Most of the subjects ( 74 % ) regarded the eHealth app as helpful to assess binge drinking risk . CONCLUSIONS We could produce an evidence -based eHealth app for young people , evaluating current risk for binge drinking . Its effectiveness will be tested in a large trial BACKGROUND Internet-based alcohol misuse prevention programs are now used by many universities . One popular 2- to 3-hour online course known as AlcoholEdu for College is typically required for all incoming freshmen and thus constitutes a campus-level strategy to reduce  student alcohol misuse . PURPOSE Multi-campus study to evaluate the effectiveness of an Internet-based alcohol misuse prevention course . DESIGN RCT with 30 universities : 21 entered the study in Fall 2007 , nine in Fall 2008 . Fifteen were r and omly assigned to receive the online course and the other 15 were assigned to the control condition .  The course was implemented by intervention schools during the late summer and /or fall semester . Cross-sectional surveys of freshmen were conducted at each university , beginning prior to the intervention in Spring 2008 - 2009 ; post-intervention surveys were administered in Fall 2008 - 2009 and Spring 2009 - 2010 . SETTING / PARTICIPANTS Public and private universities of varying sizes across the U.S. R and om sample s of 200 freshmen per campus were invited to participate in online surveys  for the evaluation . Overall survey response rates ranged from 44 % to 48 % ( M ≈ 90 participants per campus ) . INTERVENTION The online course includes five modules ; the first four ( Part I ) are typically offered in the late summer before matriculation , and the fifth ( Part II ) in early fall . Course content includes defining a st and ard drink , physiologic effects of alcohol , the need to monitor blood alcohol level , social influences on alcohol use , alcohol laws , personalized normative feedback , and alcohol harm-reduction strategies . Students must pass an exam after Part I to advance to Part II . MAIN OUTCOME MEASURES Past-30-day alcohol use , average number of drinks per occasion , and binge drinking . RESULTS Multilevel intent-to-treat analyses indicated significant reductions in the frequency of past-30-day alcohol use ( beta = -0.64 , p<0.05 ) and binge drinking ( beta = -0.26 , p<0.05 ) during the fall semester immediately after completion of the course . However , these effects did not persist when assessed in the spring semester . Post hoc comparisons suggested stronger course effects on these outcomes at colleges with higher rates of student course completion . No course effects were observed for average number of drinks per occasion or prevalence of binge drinking , regardless of the campus course completion rate . CONCLUSIONS This study provides initial evidence that the Internet-based alcohol misuse prevention course has beneficial short-term effects on hazardous drinking behavior among first-year college students , which should be reinforced through effective environmental prevention strategies AIMS To evaluate the effectiveness of a web-based brief alcohol intervention ' What Do You Drink ' ( WDYD ) among heavy drinking students at 1- and 6-month post-intervention . Additionally , it was investigated whether certain subgroups would benefit more than others from the WDYD intervention . METHODS A two-arm parallel group r and omized controlled trial was conducted online in the Netherl and s in 2010 - 2011 . Inclusion criteria were : ( 1 ) being between 18- and 24-year old , ( 2 ) reporting heavy drinking in the past 6 months , ( 3 ) being motivated to change alcohol consumption , ( 4 ) having access to the Internet and ( 5 ) giving informed consent . Participants ( n = 913 ) were r and omized to the experimental ( WDYD intervention ) or control condition ( no intervention ) . Measures were heavy drinking , frequency of binge drinking and weekly alcohol consumption . RESULTS Analyses according to the intention-to-treat principle revealed no significant main intervention effects in reducing the alcohol measures at the follow-up assessment s. Secondary analyses revealed that gender , freshmen and fraternity or sorority membership did not moderate the effect of the WDYD intervention at both follow-ups . Readiness to change , problem drinking and carnival participation moderated intervention effects such that contemplators , those with severe symptoms of alcohol abuse or dependence , and those who participated in carnival benefited more than others from the WDYD intervention regarding weekly alcohol consumption at 1-month follow-up . CONCLUSIONS The WDYD intervention was not effective in reducing the alcohol measures among heavy drinking students at 1- and 6-month post-intervention . However , there is preliminary evidence that the WDYD intervention is effective in lowering drinking levels for subgroups of heavy drinking students in the short term INTRODUCTION AND AIMS University students usually overestimate peer alcohol use , result ing in them ' drinking up ' to perceived norms . Social norms theory suggests correcting these inflated perceptions can reduce alcohol consumption . Recent findings by the current authors show portraying oneself as ' a drinker ' is considered by many students to be a socially desirable component of their Facebook identity , perpetuating an online culture that normalises binge drinking . However , social networking sites have yet to be utilised in social norms interventions . DESIGN AND METHODS Actual and perceived descriptive and injunctive drinking norms were collected from 244 university students . Ninety-five students screened positive for hazardous drinking and were r and omly allocated to a control group or intervention group that received social norms feedback via personalised Facebook private messages over three sessions . RESULTS At 1 month post-intervention , the quantity and frequency of alcohol consumed by intervention group during the previous month had significantly reduced compared with baseline and controls . Reductions were maintained 3 months post-intervention . Intervention group perceived drinking norms were significantly more accurate post-intervention . DISCUSSION AND CONCLUSIONS This is the first study to test the feasibility of using Facebook to deliver social norms interventions . Correcting misperceptions of peer drinking norms result ed in clinical ly significant reductions in alcohol use . Facebook has many advantages over traditional social norms delivery , providing an innovative method for tackling problem drinking at university . These results have implication s for the use of Facebook to deliver positive messages about safe alcohol use to students , which may counter the negative messages regarding alcohol normally seen on Facebook College students are an at-risk population based on their heavy alcohol consumption and associated consequences . First-year students are at particular risk due to greater freedom and access to alcohol on campus . Web-based ( electronic ) interventions ( e- interventions ) are being rapidly adopted as a universal approach to prevent high-risk drinking , but have not been well evaluated . The objective of this study was to investigate the effectiveness of the two most widely adopted EIs , AlcoholEdu and The Alcohol eCHECKUP TO GO ( e-Chug ) , in reducing both alcohol use and alcohol-related consequences in incoming college students . To do so , we conducted a 3-group r and omized trial ( N=82 ) comparing AlcoholEdu and e-Chug to an assessment -only control group . Compared to the assessment -only control group , participants in the AlcoholEdu and e-Chug groups reported lower levels of alcohol use across multiple measures at 1-month follow-up . Participants who received AlcoholEdu showed significantly fewer lower alcohol-related consequences than assessment -only controls , while there was a trend for reduced consequences in participants who received e-Chug versus assessment -only . Findings indicate that e-intervention is a promising prevention approach to address the problem of college student  alcohol consumption , especially for campuses that have limited re sources BACKGROUND The limited number of electronic screening and brief intervention ( e-SBI ) projects taking place in young adult student population s has left knowledge gaps about the specific methods needed to motivate reduced drinking . The aim of the present study was to compare differences in alcohol consumption over time after a series of e-SBIs was conducted with two groups of young adult students who were considered risky drinkers . The intervention group ( IG ) ( n=80 ) received extensive normative feedback ; the control group ( CG ) ( n=78 ) received very brief feedback consisting of only three statements . METHOD An e-SBI project was conducted in naturalistic setting s among young adult students at a Swedish university . This study used a r and omized controlled trial design , with respondents having an equal chance of being assigned to either the IG or the CG . The study assessed changes comparing the IG with the CG on four alcohol-related measurements : proportion with risky alcohol consumption , average weekly alcohol consumption , frequency of heavy episodic drinking ( HED ) and peak blood alcohol concentration ( BAC ) . Follow-up was performed at 3 and 6 months after baseline . RESULTS The study documented a significant decrease in the average weekly consumption for the IG over time but not for the CG , although the differences between the groups were non-significant . The study also found that there were significant decreases in HED over time within both groups ; the differences were about equal in both groups at the 6-month follow-up . The proportion of risky drinkers decreased by about a third in both the CG and IG at the 3- and 6-month follow-ups . CONCLUSIONS As the differences between the groups at 6 months for all alcohol-related outcome variables were not significant , the shorter , generic brief intervention appears to be as effective as the longer one including normative feedback . However , further studies in similar naturalistic setting s are warranted with delayed assessment groups as controls in order to increase our underst and ing of reactivity assessment in email-based interventions among students BACKGROUND Brief motivational intervention ( BMI ) is one of the few effective strategies targeting alcohol consumption , but has not been tested in young men in the community . We evaluated the efficacy of  BMI  in reducing alcohol use and related problems among binge drinkers and in maintaining low-risk drinking among non-bingers . METHODS A r and om sample of a census of men included during army conscription ( which is m and atory for 20-year-old males in Switzerl and ) was r and omized to receive a single face-to-face BMI session ( N=199 ) or no intervention ( N=219 ) . A six-month follow-up rate was obtained for 88.7 % of the subjects . RESULTS Among binge drinkers , there was 20 % less drinking in the BMI group versus the control group ( incidence rate ratio=0.80 , confidence interval 0.66 - 0.98 , p=0.03 ) ; the BMI group showed a weekly reduction of 1.5 drinks compared to an increase of 0.8 drinks weekly in the control group . Among subjects who experienced one or more alcohol-related consequences over the last 12 months , there was 19 % less drinking in the BMI group compared to the control group ( incidence rate ratio=0.81 , confidence interval 0.67 - 0.97 , p=0.04 ) . Among non-bingers , BMI did not contribute to the maintenance of low-risk drinking . CONCLUSION BMI reduced the alcohol use of binge drinkers , particularly among those who experienced certain alcohol-related adverse consequences . No preventive effect of BMI was observed among non-bingers . BMI is a plausible secondary preventive option for young binge drinkers Abstract Background : Although motivational processes may influence the intervention effects and help prevention programmes identify students at great risk for alcohol-related problems , no computerized alcohol intervention has yet to be tailored to drinking motives . Objective : To describe the development and initial pilot testing of a computer-delivered intervention tailored to drinking motives , to prevent alcohol abuse and its adverse consequences among university students in general and among baseline hazardous drinkers specifically . Methods : 124 college students attending a public university in northeastern Italy participated in this study in October of 2012 ( 89.2 % female- mean age = 21.64–34 % baseline hazardous drinkers ) . Two classes ( one undergraduate , one graduate ) were assigned to one of two conditions : intervention and control group . Both groups received profile-specific feedback and then the intervention group received profile-specific online training for 4 weeks . This profile was based on their risk type ( high-low ) and drinking motives ( enhancement-social-conformity-coping ) . Results : Controlling for corresponding baseline alcohol measures , analyses showed a significant interaction between intervention condition and hazardous drinkers at baseline . For hazardous drinkers at baseline , the alcohol intervention results showed a significant decrease in frequency and quantity of alcohol use at follow-up , while no difference was observed between intervention conditions for non-hazardous drinkers at baseline . Conclusions : The results suggest that hazardous drinkers ( college students ) who completed the specific training and received personalized feedback seemed to do better on frequency and quantity of alcohol use than hazardous drinkers ( college students ) who received only personalized feedback . These results seem to provide support for a larger trial of the intervention and for more appropriate evaluations The objective of the study was to evaluate the effectiveness of a computer-delivered intervention ( CDI ) to reduce  heavy drinking and alcohol-related problems in college students in two r and omized clinical trials . In Experiment 1 , we r and omized 144 students to either the CDI or an assessment -only control group  with follow-ups at 1 and 12 months . In Experiment 2 , we r and omized 82 students to either the CDI or a delayed- assessment control group with follow-up at 1 month . In Experiment 1 , participants in both groups significantly reduced their drinking at both follow-ups . Compared to the control group , the CDI group reduced their drinking significantly more at 1 and 12 months on three drinking measures at α < .05 . Using a more conservative , Bonferroni-adjusted criterion yielded one significant difference in a measure of heavier drinking at the 1 month follow-up . The mean between-groups effect sizes were d = .34 and .36 at 1 and 12 months , respectively . Experiment 2 . Compared to the delayed assessment control group , the CDI group significantly reduced ( by the Bonferroni-adjusted criterion ) their drinking on all consumption measures . These results support the effectiveness of the CDI with heavy drinking college students when used in a clinical setting . In addition , the significant reductions in typical drinking in the control group in Experiment 1 and not in Experiment 2 combined with comparable baseline characteristics suggests that the control group in Experiment 1 demonstrated assessment reactivity
Previous review s have specifically looked at computer-based or Internet-based approaches .
However , there has been no systematic review focused upon electronic communication based interventions for hazardous young drinkers .