182 lines
5.9 KiB
YAML
182 lines
5.9 KiB
YAML
abstract: 'Background: Social equity in the efficacy of behavior change
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intervention is much needed. While the efficacy of brief alcohol
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interventions (BAIs), including digital interventions, is well
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established, particularly in health care, the social equity of
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interventions has been sparsely investigated.
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Objective: We aim to investigate whether the efficacy of computer-based
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versus in-person delivered BAIs is moderated by the participants''
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socioeconomic status (ie, to identify whether general hospital patients
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with low-level education and unemployed patients may benefit more or
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less from one or the other way of delivery compared to patients with
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higher levels of education and those that are employed).
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Methods: Patients with nondependent at-risk alcohol use were identified
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through systematic offline screening conducted on 13 general hospital
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wards. Patients were approached face-to-face and asked to respond to an
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app for self-assessment provided by a mobile device. In total, 961 (81\%
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of eligible participants) were randomized and received their allocated
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intervention: computer-generated and individually tailored feedback
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letters (CO), in-person counseling by research staff trained in
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motivational interviewing (PE), or assessment only (AO). CO and PE were
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delivered on the ward and 1 and 3 months later, were based on the
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transtheoretical model of intentional behavior change and required the
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assessment of intervention data prior to each intervention. In CO, the
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generation of computer-based feedback was created automatically. The
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assessment of data and sending out feedback letters were assisted by the
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research staff. Of the CO and PE participants, 89\% (345/387) and 83\%
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(292/354) received at least two doses of intervention, and 72\%
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(280/387) and 54\% (191/354) received all three doses of intervention,
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respectively. The outcome was change in grams of pure alcohol per day
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after 6, 12, 18, and 24 months, with the latter being the primary
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time-point of interest. Follow-up interviewers were blinded. Study group
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interactions with education and employment status were tested as
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predictors of change in alcohol use using latent growth modeling.
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Results: The efficacy of CO and PE did not differ by level of education
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(P=.98). Employment status did not moderate CO efficacy (Ps >=.66). Up
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to month 12 and compared to employed participants, unemployed
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participants reported significantly greater drinking reductions
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following PE versus AO (incidence rate ratio 0.44, 95\% CI 0.21-0.94;
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P=.03) and following PE versus CO (incidence rate ratio 0.48, 95\% CI
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0.24-0.96; P=.04). After 24 months, these differences were statistically
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nonsignificant (Ps >=.31).
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Conclusions: Computer-based and in-person BAI worked equally well
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independent of the patient''s level of education. Although findings
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indicate that in the short-term, unemployed persons may benefit more
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from BAI when delivered in-person rather than computer-based, the
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findings suggest that both BAIs have the potential to work well among
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participants with low socioeconomic status.'
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affiliation: 'Freyer-Adam, J (Corresponding Author), Univ Med Greifswald, Inst Med
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Psychol, Walther Rathenau Str 48, D-17475 Greifswald, Germany.
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Freyer-Adam, Jennis; Goeze, Christian, Univ Med Greifswald, Inst Med Psychol, Walther
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Rathenau Str 48, D-17475 Greifswald, Germany.
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Freyer-Adam, Jennis; John, Ulrich, German Ctr Cardiovasc Res DZHK, Greifswald, Germany.
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Baumann, Sophie; Staudt, Andreas, Univ Med Greifswald, Inst Community Med, Dept
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Methods Community Med, Greifswald, Germany.
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Bischof, Gallus, Med Univ Lubeck, Dept Psychiat \& Psychotherapy, Lubeck, Germany.
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Staudt, Andreas, Tech Univ Dresden, Inst \& Policlin Occupat \& Social Med, Fac
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Med, Dresden, Germany.
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Gaertner, Beate, Robert Koch Inst Berlin, Dept Epidemiol \& Hlth Monitoring, Berlin,
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Germany.
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John, Ulrich, Univ Med Greifswald, Inst Community Med, Dept Prevent Res \& Social
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Med, Greifswald, Germany.'
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article-number: e31712
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author: Freyer-Adam, Jennis and Baumann, Sophie and Bischof, Gallus and Staudt, Andreas
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and Goeze, Christian and Gaertner, Beate and John, Ulrich
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author-email: Jennis.Freyer-Adam@med.uni-greifswald.de
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author_list:
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- family: Freyer-Adam
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given: Jennis
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- family: Baumann
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given: Sophie
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- family: Bischof
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given: Gallus
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- family: Staudt
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given: Andreas
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- family: Goeze
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given: Christian
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- family: Gaertner
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given: Beate
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- family: John
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given: Ulrich
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da: '2023-09-28'
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doi: 10.2196/31712
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files: []
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issn: 2368-7959
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journal: JMIR MENTAL HEALTH
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keywords: 'brief alcohol intervention; electronic; eHealth; digital; motivational
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interviewing; socioeconomic status; equity; social inequality;
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transtheoretical model; moderator; mental health; public health; alcohol
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interventions; digital intervention; digital health intervention;
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alcohol use'
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keywords-plus: 'DISORDERS IDENTIFICATION TEST; SOCIOECONOMIC-STATUS; MENTAL-HEALTH;
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LIFE
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EXPECTANCY; TEST AUDIT; CONSUMPTION; MORTALITY; VALIDITY; DETERMINANTS;
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MODERATORS'
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language: English
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month: JAN 24
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number: '1'
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number-of-cited-references: '58'
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orcid-numbers: 'Baumann, Sophie/0000-0002-7697-4923
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Staudt, Andreas/0000-0001-9905-1999
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Freyer-Adam, Jennis/0000-0002-4827-8760
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John, Ulrich/0000-0003-0587-5298
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Gaertner, Beate/0000-0002-5785-3341'
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papis_id: 71e62cefbbaf0ee1e139589dfcb84d5c
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ref: Freyeradam2022socialequity
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researcherid-numbers: 'Baumann, Sophie/IXN-7491-2023
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Gaertner, Beate/F-8197-2011
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'
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times-cited: '2'
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title: 'Social Equity in the Efficacy of Computer-Based and In-Person Brief Alcohol
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Interventions Among General Hospital Patients With At-Risk Alcohol Use: A Randomized
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Controlled Trial'
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type: article
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unique-id: WOS:000749560800001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '9'
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web-of-science-categories: Psychiatry
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year: '2022'
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