Abstract
Ziel: Überprüfung der Effektivität einer auf Motivational Interviewing (MI) basierenden Intervention im Online-Chat unter jungen Alkohol- und Cannabiskonsumenten mit ambivalenter Änderungsmotivation. Methodik: Randomisiert-kontrollierte Online-Studie mit Nachbefragungen nach einem und nach drei Monaten. Die Rekrutierung erfolgte über die Selbsttests auf der Website drugcom.de und schloss nur Personen mit problematischem Alkohol- oder Cannabiskonsum ein. Teilnehmer der Interventionsgruppe nahmen am privaten MI-Chat teil. Mitglieder der Kontrollgruppe erhielten im Chat lediglich Sachinformationen über den zuvor genutzten Selbsttest. Ergebnisse: 302 Personen wurden randomisiert und in die ITT-Auswertung einbezogen. Es zeigten sich keine Gruppenunterschiede im Konsum von Alkohol (p ≥ 0.224), Cannabis (p = 0.537) oder in der Änderungsmotivation nach RCQ (p = 0.469). Beide Gruppen senkten ihren Alkoholkonsum im Studienverlauf signifikant und zeigten Verbesserungen der Änderungsbereitschaft. Schlussfolgerungen: Die beschriebene Chat-Intervention erzielt keine Verhaltensänderung bei ambivalent eingestellten Konsumenten. Online-Interventionen für diese Zielgruppe sollten womöglich länger und verbindlicher gestaltet werden.
Aims: To evaluate a one-session online-intervention based on Motivational Interviewing (MI) among young alcohol and cannabis users who are ambivalent about behavior change. Methods: Randomized controlled online trial (RCT) with follow up surveys after one and three months. Participants were recruited via self-tests on the addiction prevention website www.drugcom.de. Recruitment only included individuals with problematic alcohol or cannabis use. Participants either received a MI-based intervention (intervention group) or technical information (control group) in a private online chat. Results: 302 individuals were randomized and included in the intent-to-treat-analysis. The follow up data revealed no group differences in the use-related measures of alcohol (p ≥ 0.224), cannabis (p = 0.537) or the readiness to change according to RCQ (p = 0.469). In both groups, there was a significant time-effect in alcohol use and the readiness to change. Conclusions: A one-session text based online-intervention possibly is not effective in motivating young substance abusers who are ambivalent about change. Online-interventions aiming at this group should be longer and more binding.
Literatur
2011). Internet therapy versus internet self-help versus no treatment for problematic alcohol use: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 79, 330 – 341. doi: 10.1037/a0023498
(2010). Missing data approaches in eHealth research: simulation study and a tutorial for nonmathematically inclined researchers. Journal of Medical Internet Research, 12(5), e54. doi: 10.2196/jmir.1448
(2000). Effects of a brief motivational intervention with college student drinkers. Journal of Consulting and Clinical Psychology, 68, 728 – 733. doi: 10.1037/0022 – 006X.68.4.728
(2010). A review of motivational interviewing-based interventions targeting problematic drinking among college students. Alcoholism Treatment Quarterly, 28, 63 – 77. doi: 10.1080/07347320903436276
(2008). Happy Ending: a randomized controlled trial of a digital multi-media smoking cessation intervention. Addiction, 103, 478 – 484. doi: 10.1111/j.1360 – 0443.2007.02119.x
(2003). Handbook of the Medical Consequences of Alcohol and Drug Abuse. London: Routledge.
(2001). Motivational interviewing to enhance treatment initiation in substance abusers: an effectiveness study. The American Journal on Addictions, 10, 335 – 339. doi:10.1080/aja.10.4.335.339
(1988). Statistical Power Analysis for the Behavioral Sciences. New York: Erlbaum.
(2006). Access to the Internet among drinkers, smokers and illicit drug users: Is it a barrier to the provision of interventions on the World Wide Web? Medical Informatics and the Internet in Medicine, 31, 53 – 58.
(2010). Annual Report 2010. The State of the Drug Problem in Europe. Lissabon: EMCDDA.
(2005). The law of attrition. Journal of Medical Internet Research, 7(1), e11.
(2004). The readiness to change questionnaire: reliability and validity of a Swedish version and a comparison of scoring methods. British Journal of Health Psychology, 9, 335 – 346. doi: 10.1348/1359107041557084
(1995). The Severity of Dependence Scale (SDS): Psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90, 607 – 614. doi: 10.1111/j.1360 – 0443.1995.tb02199.x
(2003). Der Fragebogen zur Änderungsbereitschaft bei Alkoholkonsum (RCQ-G). In , Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES, Version 3.00). Mannheim: Zentrum für Umfragen, Methoden und Analysen.
(2002). The readiness to change questionnaire in subjects with hazardous alcohol consumption, alcohol misuse and dependence in a general population survey. Alcohol and Alcoholism, 37, 362 – 369. doi: 10.1093/alcalc/37.4.362
(1997). The Validity of Self-Reported Drug Use: Improving the Accuracy of Survey Estimates (NIDA Research Monograph 167 [Electronic version]). Rockville: U. S. Department of Health and Human Services. Retrieved 22. 11. 2011, from archives.drugabuse.gov/pdf/monographs/monograph167/download167.html
(2005). Motivational Interviewing. Annual Review of Clinical Psychology, 1, 91 – 111. doi:10.1146/annurev.clinpsy.1.102803.143833
(2009). Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: a randomized controlled trial of clinical efficacy. Addiction, 104, 378 – 388. doi: 10.1111/j.1360 – 0443.2008.02444.x
(2010). A meta-analysis of motivational interviewing: Twenty-five years of empirical studies. Research on Social Work Practice, 20, 137 – 160. doi: 10.1177/1049731509347850
(2004). The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial. Addiction, 99, 39 – 52.
(2008). Randomized controlled trial of motivational interviewing compared with drug information and advice for early intervention among young cannabis users. Addiction, 103, 1809 – 1818. doi: 10.1111/j.1360 – 0443.2008.02331.x
(2009). Motivierende Gesprächsführung. Freiburg im Breisgau: Lambertus.
(2003). Motivational interviewing in drug abuse services: a randomized trial. Journal of Consulting and Clinical Psychology, 71, 754 – 763. doi: 10.1037/0022 – 006X.71.4.754
(2011). Accuracy of self-reported drinking: observational verification of ‘last occasion’ drink estimates of young adults. Alcohol and Alcoholism, 46, 709 – 713. doi: 10.1093/alcalc/agr138
(2010). Substanzkonsum und substanzbezogene Störungen. Ergebnisse des epidemiologischen Suchtsurveys 2009. SUCHT, 56, 327 – 336.
(2007). Auswirkungen von Cannabiskonsum und -missbrauch. Lengerich: Pabst Science Publishers.
(1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38 – 48.
(2011). Reliability and validity of young adults anonymous online reports of marijuana use and thoughts about use. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0026201
(2008). Web-based self-help for problem drinkers: a pragmatic randomized trial. Addiction, 103, 218 – 227.
(2003). Deutsche Version des Alcohol Use Disorders Identification Test (AUDIT-G-L). In A. Glöckner-Rist, F. Rist & H. Küfner (Hrsg.), Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES, Version 3.00). Mannheim: Zentrum für Umfragen, Methoden und Analysen.
(1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption: II. Addiction, 88, 791 – 804. doi: 10.1111/j.1360 – 0443.1993.tb02093.x
(2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147 – 177. doi: 10.1037/1082 – 989X.7.2.147
(2009). Stata Statistical Software: Release 11. College Station, TX: StataCorp LP.
(2010). Allgemeinbildende Schulen: Absolventen/Abgänger nach Abschlussarten, Abgangsjahr 2009. Wiesbaden: Statistisches Bundesamt Deutschland. Zugriff am 14. 4. 2011. Verfügbar unter www.webcitation.org/5xwSPBPGO
(2008). Severity of dependence scale: Establishing a cut-off point for cannabis dependence in the German adult population. SUCHT, 54(Suppl. 1), 57 – 63.
(2011). A controlled trial of an Internet-based intervention program for cannabis users. Cyberpsychology, Behavior, and Social Networking, 14, 673 – 679. doi: 10.1089/cyber.2010.0506.
(2010). Fast 50 Millionen Deutsche online – Multimedia für alle? Ergebnisse der ARD/ZDF-Onlinestudie 2010. Media Perspektiven, 7 – 8, 334 – 349. Zugriff am 1. 7. 2011. Verfügbar unter: www.ard-zdf-onlinestudie.de/fileadmin/Online10/07 – 08 – 2010_van_Eimeren.pdf
(2010). Online alcohol interventions: a systematic review. Journal of Medical Internet Research, 12(5), e62.
(2007). Evaluation of an Internet virtual world chat room for adolescent smoking cessation. Addictive Behaviors, 32, 1769 – 1786. doi: 10.1016/j.addbeh.2006.12.008
(