title: Effectiveness of E-self-help interventions for curbing adult problem drinking: a meta-analysis.
abstract: BACKGROUND
  Self-help interventions without professional contact to curb adult problem drinking in the community are increasingly being delivered via the Internet.
  
  
  OBJECTIVE
  The objective of this meta-analysis was to assess the overall effectiveness of these eHealth interventions.
  
  
  METHODS
  In all, 9 randomized controlled trials (RCTs), all from high-income countries, with 9 comparison conditions and a total of 1553 participants, were identified, and their combined effectiveness in reducing alcohol consumption was evaluated by means of a meta-analysis.
  
  
  RESULTS
  An overall medium effect size (g = 0.44, 95% CI 0.17-0.71, random effect model) was found for the 9 studies, all of which compared no-contact interventions to control conditions. The medium effect was maintained (g = 0.39; 95% CI 0.23-0.57, random effect model) after exclusion of two outliers. Type of control group, treatment location, type of analysis, and sample size did not have differential impacts on treatment outcome. A significant difference (P = .04) emerged between single-session personalized normative feedback interventions (g = 0.27, 95% CI 0.11-0.43) and more extended e- self-help (g = 0.61, 95% CI 0.33-0.90).
  
  
  CONCLUSIONS
  E-self-help interventions without professional contact are effective in curbing adult problem drinking in high-income countries. In view of the easy scalability and low dissemination costs of such interventions, we recommend exploration of whether these could broaden the scope of effective public health interventions in low- and middle-income countries as well.
authors: Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, Amsterdam, Netherlands. h.riper@psy.vu.nl
authors: Heleen
authors: H
authors: Riper
authors: Viola
authors: V
authors: Spek
authors: Brigitte
authors: B
authors: Boon
authors: Barbara
authors: B
authors: Conijn
authors: Jeannet
authors: J
authors: Kramer
authors: Katherina
authors: K
authors: Martin-Abello
authors: Filip
authors: F
authors: Smit
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000628:therapy*; D006801:Humans; D020407:Internet; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome