title: Web intervention for OEF/OIF veterans with problem drinking and PTSD symptoms: a randomized clinical trial.
abstract: OBJECTIVE
  Veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) commonly experience alcohol misuse and symptoms of posttraumatic stress disorder (PTSD) following their return from deployment to a war zone. We conducted a randomized clinical trial to evaluate the efficacy of a newly developed, 8-module, self-management web intervention (VetChange) based on motivational and cognitive-behavioral principles to reduce alcohol consumption, alcohol-related problems, and PTSD symptoms in returning combat veterans.
  
  
  METHODS
  Six hundred participants, recruited through targeted Facebook ads, were randomized to either an Initial Intervention Group (IIG; n = 404) or a Delayed Intervention Group (DIG; n = 196) that waited 8 weeks for access to VetChange. Primary outcome measures were Drinks per Drinking Day, Average Weekly Drinks, Percent Heavy Drinking Days, and PTSD symptoms. Intent-to-treat analyses compared changes in outcome measures over time between IIG and DIG as well as within-group changes.
  
  
  RESULTS
  IIG participants demonstrated greater reductions in drinking (p < .001 for each measure) and PTSD symptoms (p = .009) between baseline and end-of-intervention than did DIG participants between baseline and the end of the waiting period. DIG participants showed similar improvements to those in IIG following participation in VetChange. Alcohol problems were also reduced within each group between baseline and 3-month follow-up.
  
  
  CONCLUSIONS
  Results indicate that VetChange is effective in reducing drinking and PTSD symptoms in OIF/OEF veterans. Further studies of VetChange are needed to assess web-based recruitment and retention methods and to determine VetChange's effectiveness in demographic and clinical sub-populations of returning veterans.
authors.affiliation: Behavioral Science Division, National Center for PTSD.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Brief
authors.affiliation: Behavioral Science Division, National Center for PTSD.
authors.forename: Amy
authors.initials: A
authors.lastname: Rubin
authors.affiliation: Behavioral Science Division, National Center for PTSD.
authors.forename: Terence M
authors.initials: TM
authors.lastname: Keane
authors.affiliation: VA Boston Healthcare System.
authors.forename: Justin L
authors.initials: JL
authors.lastname: Enggasser
authors.affiliation: VA Boston Healthcare System.
authors.forename: Monica
authors.initials: M
authors.lastname: Roy
authors.affiliation: Department of Health Policy and Management, Boston University School of Public Health.
authors.forename: Eric
authors.initials: E
authors.lastname: Helmuth
authors.affiliation: VA Boston Healthcare System.
authors.forename: John
authors.initials: J
authors.lastname: Hermos
authors.affiliation: Behavioral Science Division, National Center for PTSD.
authors.forename: Mark
authors.initials: M
authors.lastname: Lachowicz
authors.affiliation: Department of Biostatistics, Boston University School of Public Health.
authors.forename: Denis
authors.identifier: 0000-0002-3657-4829
authors.initials: D
authors.lastname: Rybin
authors.affiliation: Department of Health Policy and Management, Boston University School of Public Health.
authors.forename: David
authors.identifier: 0000-0001-5161-2638
authors.initials: D
authors.lastname: Rosenbloom
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000453:epidemiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology*