Online alcohol interventions : a systematic review

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. Objectives: 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 post treatment 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.

An innovative online intervention: The Steering Clear First Offender Drink Driving Program

Drink driving remains a substantial public health issue warranting investigation. First offender drink drivers are seen to be less risky than repeat offenders, though the majority of first offenders report drink driving prior to detection, and many continue to drink drive following conviction. Few first offenders are offered treatment programs, and as such there is a need to address drink driving behaviour at this stage. A comprehensive approach including first offender treatment is needed to address the problem. Online interventions have demonstrated effectiveness in reducing risky behaviours such as harmful substance use. Such interventions allow for personalised tailored content to be delivered to individuals targeting specific mechanisms of behavioural change. This method also allows for targeting screening to ensure relevance of content on an individual level. However, there have been no research based online programs to date aimed at reducing repeat drink driving by first offenders. The Steering Clear First Offender Drink Driving Program is a self-guided, research based online program aimed at reducing recidivism by first time drink driving offenders. It includes a specialised web app to track drinks and build plans to prevent future drink driving. This allows for elongation of learning and encouragement of sustained behavioural change using self-monitoring after initial program completion. An outline of the program is discussed and the qualitative experience of the program on a sample of first offenders recruited at the time of court appearance is described.

Reflections on teaching and learning online: quality program design, delivery and support issues from a cross-global perspective

This reflective paper began with a discussion of the online program design and delivery experiences of three senior faculty members at the University of Calgary (Canada) and Deakin University (Australia), which was recorded at Deakin University. After drawing on this recording in their research and practice, one faculty member from each institution decided to review and expanded upon their intervening experiences in terms of issues of quality program design, delivery, and support issues when teaching, and learning in different cultural contexts. The authors discovered that these issues are as important today as they were when they met to record the interview, and have concluded their discussion here with thoughts about the teaching, student, and administrative supports that institutions engaged in online program delivery cross-culturally must address in order to successfully deliver quality online programs worldwide.

The potential for a web based intervention to improve young adult passenger safety

Young drivers aged 17-24 are consistently overrepresented in motor vehicle crashes. Research has shown that a young driver’s crash risk increases when carrying similarly aged passengers, with fatal crash risk increasing two to three fold with two or more passengers. Recent growth in access to and use of the internet has led to a corresponding increase in the number of web based behaviour change interventions. An increasing body of literature describes the evaluation of web based programs targeting risk behaviours and health issues. Evaluations have shown promise for such strategies with evidence for positive changes in knowledge, attitudes and behaviour. The growing popularity of web based programs is due in part to their wide accessibility, ability for personalised tailoring of intervention messages, and self-direction and pacing of online content. Young people are also highly receptive to the internet and the interactive elements of online programs are particularly attractive. The current study was designed to assess the feasibility for a web based intervention to increase the use of personal and peer protective strategies among young adult passengers. An extensive review was conducted on the development and evaluation of web based programs. Year 12 students were also surveyed about their use of the internet in general and for health and road safety information. All students reported internet access at home or at school, and 74% had searched for road safety information. Additional findings have shown promise for the development of a web based passenger safety program for young adults. Design and methodological issues will be discussed.

A qualitative exploration of Internet-based treatment for comorbid depression and alcohol misuse

Background Many Internet-based treatments for depression and for alcohol misuse have a positive impact, yet little is known about how these treatments work. Most research on web-based interventions involves efficacy trials which, while important, offer little explanation about how people perceive and use online programs. Objective This study aimed to undertake a qualitative exploration of participants' experience, perceived impact and use of an integrated web-based program for comorbid depression and alcohol misuse. Specifically, it explored users' perspectives on the intensity of their treatment and the level of support they received. Methods Interviewees were drawn from participants in a randomised controlled trial of the OnTrack web-based treatment for depression and alcohol misuse, which compared Brief Self-Guided, Comprehensive Self-Guided and Comprehensive Therapist-Assisted versions of the program. Twenty-nine people (9–11 from each condition) completed semi-structured telephone interviews asking about their impressions and experiences with the program. Interview transcriptions were subject to a 6-step thematic analysis, employing a conceptual matrix to identify thematic differences across groups. Results Positive experiences and outcomes were more pronounced among participants receiving the comprehensive treatments than the brief one, but other responses were relatively consistent across conditions. A major theme was a wish for more individualisation and human contact, even in participants receiving emailed assistance. Some confused follow-up research assessments with therapist support. There was little correspondence between the perceived impact of the program and the amount reportedly completed, and some participants said they used strategies offline or completed exercises mentally. Conclusions This study highlighted discrepancies between how web-based treatments are intended to be used and how people actually engage with them. A challenge for the next wave of these interventions is the provision of individualised responses and coaching that retains an emphasis on self-management and constrains cost.

A new screen face for public service broadcasting

The contemporary broadcasting industry is characterised by technological and social change, it is increasingly competitive, and the media industry is fragmenting. New services need not necessarily compete with existing free-to-air broadcasting but could act as further incentive for audiences to invest in new equipment. New equipment will be necessary in the future as set out under the Television Broadcasting Services (Digital Conversion) Act 2000 (Cth), before the planned switch-off of analogue broadcasts planned for this year but now likely to be 2013. By then, however, audiences might already have migrated to the online environment for television and radio content as well as other services. Those that produce and deliver programs via free-to-air broadcasting need to consider what audiences do with new media in order to engage them. This will be an ongoing process as technology and audience expectations continue to change. Against such a background, this article examines how Australia’s public broadcasters are responding to the new media environment. It will consider their interactive online programs and services with specific analysis of ABC’s new ‘iView’ and ‘ABC Fora’ which offer content on-demand. It will also examine SBS online initiatives. I wish to argue that the new media offer public broadcasters new prospects to provide forums and spaces for education, entertainment, public discussion and interaction online.

Can eLearning provide tools for capacity-building to improve performance in the nonprofit sector?

Can E-learning 2.0 provide a platform for improving performance in nonprofit organizations? It is argued that Web 2.0 technologies provide the tools that today’s students rely on in the learning environment. As such they may be the means to attract and retain learners in training and education programs designed to improve performance. E-learning delivered through a blended learning model has proven to be effective in corporate training and higher education. Can the interactive, collaborative model offered in E-learning 2 prove to be as effective? This paper reviews the literature on blended learning and capacity-building as background for a discussion of the potential that e-learning models enhanced by web 2.0 technologies have for expanding access to education and training and facilitating implementation of skills and knowledge gained in the workplace. We suggest that increasing training opportunities for staff and making nonprofit management education more accessible through online programs is not enough to meet the challenge. What is needed at this point is practicable education and training delivered in today’s user’s environment, that is online and “on the go.”

Web-based counseling for problem gambling: exploring motivations and recommendations

Background:

A randomized head to head trial of MoodSwings.net.au: an internet based self-help program for bipolar disorder.

Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design.

e-Mental health for mood and anxiety disorders in general practice

Background Australia is a world leader in the development of internetdelivered programs for the prevention and management of mood and anxiety disorders. Despite a strong evidence base of time- and cost-effectiveness, as well as clinical efficacy, the uptake of these programs in general practice remains low. Objective To familiarise general practitioners (GPs) with the range of online programs in Australia that have demonstrated efficacy and are currently available for use by patients with mental health problems. Discussion E-mental health programs provide an efficacious and accessible form of mental healthcare and have the potential to fill the gap for those for whom such care is inaccessible, unaffordable or unacceptable. Clinicians can also use it in a stepped-care manner to augment existing healthcare services. There are a number of online resources currently available to Australians who have mood or anxiety disorders. These resources have strong evidence to support their effectiveness. Online portals facilitate access to these programs. Recently the Australian Federal Government has funded an education program (eMHPrac) for GPs and mental health professionals, to outline what is available, indicate situations where recommending such resources is appropriate, and suggest ways in which they can be incorporated into general practice.

Main maximum power point tracking strategies intended for photovoltaics

This paper presents evaluations among the most usual MPPT techniques, doing meaningful comparisons with respect to the amount of energy extracted from the photovoltaic panel (PV) (Tracking Factor - TF) in relation to the available power, PV voltage ripple, dynamic response and use of sensors. Using MatLab/Simulink® and DSpace platforms, a digitally controlled boost DC-DC converter was implemented and connected to an Agilent Solar Array E4350B simulator in order to verify the analytical procedures. The main experimental results are presented and a contribution in the implementation of the IC algorithm is performed and called IC based on PI. Moreover, the dynamic response and the tracking factor are also evaluated using a Friendly User Interface, which is capable of online program power curves and compute the TF. Finally, a typical daily insulation is used in order to verify the experimental results for the main PV MPPT methods. © 2011 IEEE.

Evaluation of the main MPPT techniques for photovoltaic applications

This paper presents evaluations among the most usual maximum power point tracking (MPPT) techniques, doing meaningful comparisons with respect to the amount of energy extracted from the photovoltaic (PV) panel [tracking factor (TF)] in relation to the available power, PV voltage ripple, dynamic response, and use of sensors. Using MatLab/Simulink and dSPACE platforms, a digitally controlled boost dc-dc converter was implemented and connected to an Agilent Solar Array E4350B simulator in order to verify the analytical procedures. The main experimental results are presented for conventional MPPT algorithms and improved MPPT algorithms named IC based on proportional-integral (PI) and perturb and observe based on PI. Moreover, the dynamic response and the TF are also evaluated using a user-friendly interface, which is capable of online program power profiles and computes the TF. Finally, a typical daily insulation is used in order to verify the experimental results for the main PV MPPT methods. © 2012 IEEE.

Unlocking the "reminder" potential when viewers pause programs : results from a laboratory test of a new online medium

The branded pause advertisement is a recently developed online television-advertising format that displays a full-screen still-image banner ad whenever a viewer pauses a streaming-video program. This study used a controlled lab experiment to compare the effectiveness of branded pause advertisements with normal online television advertisements. The results demonstrate that branded pause advertisements are effective but only when combined with a long-exposure advertisement for the same brand. Despite their short exposure time, pause advertisements function as effective reminders, building awareness through repeat exposure. The findings of the current study were similar regardless of whether pause advertisements were activated as a result of viewers’ pausing at a time of their own choosing or whether viewers were interrupted.

The ACA effect: Examining how current affairs programs shape victim understandings and responses to online fraud

In recent years, numerous current affairs stories on online fraud victimisation have been broadcast on Australian television. These stories typically feature highly organised, international ‘sting’ operations, in which alleged offenders are arrested and investigated by law enforcement. These portrayals of police responses influence the expectations that some online fraud victims have about how their individual cases will be handled by law enforcement. Based on interviews with 80 online fraud victims, this article argues that a narrow media portrayal of online fraud by television current affairs programs — termed the ‘ACA effect’ — informs victims’ understandings of online fraud and their responses to it. In particular, current affairs programs influence what victims of online fraud expect from police. The article further demonstrates that current affairs programs present themselves as de facto law enforcement agencies, to which victims who receive an unsatisfactory response from police might turn. Overall, the article highlights the importance of current affairs programs portraying a more realistic image of official responses to online fraud.