title: Online alcohol interventions: a systematic review.
abstract: BACKGROUND
  There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely.
  
  
  OBJECTIVE
  Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer*; (3) alcohol*; and (4) E\effect*, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention.
  
  
  RESULTS
  The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66.
  
  
  CONCLUSIONS
  The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
authors.affiliation: Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Queensland, Australia. angela.white@uq.edu.au
authors.forename: Angela
authors.initials: A
authors.lastname: White
authors.forename: David
authors.initials: D
authors.lastname: Kavanagh
authors.forename: Helen
authors.initials: H
authors.lastname: Stallman
authors.forename: Britt
authors.initials: B
authors.lastname: Klein
authors.forename: Frances
authors.initials: F
authors.lastname: Kay-Lambkin
authors.forename: Judy
authors.initials: J
authors.lastname: Proudfoot
authors.forename: Judy
authors.initials: J
authors.lastname: Drennan
authors.forename: Jason
authors.initials: J
authors.lastname: Connor
authors.forename: Amanda
authors.initials: A
authors.lastname: Baker
authors.forename: Emily
authors.initials: E
authors.lastname: Hines
authors.forename: Ross
authors.initials: R
authors.lastname: Young
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000628:therapy*; D019973:Alcohol-Related Disorders / Q000517:prevention & control / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000706:statistics & numerical data*; D003194:Computer-Assisted Instruction / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012657:Self-Help Groups; D013813:Therapy, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D055815:Young Adult