scholarly journals Effects of Treatment Length and Chat-Based Counseling in a Web-Based Intervention for Cannabis Users: Randomized Factorial Trial (Preprint)

2017 ◽  
Author(s):  
Benjamin Jonas ◽  
Marc-Dennan Tensil ◽  
Peter Tossmann ◽  
Evelin Strüber
Keyword(s):  
Real Time ◽  
Working Alliance ◽  
Treatment Satisfaction ◽  
Positive Impact ◽  
Controlled Trial ◽  
Cannabis Use ◽  
Synchronous Communication ◽  
Design Factor ◽  
Web Based ◽  
Timeline Followback

BACKGROUND Digital interventions show promise in reducing problematic cannabis use. However, little is known about the effect of moderators in such interventions. The therapist-guided internet intervention Quit the Shit provides 50 days of chat-based (synchronous) and time-lagged (asynchronous) counseling. OBJECTIVE In the study, we examined whether the effectiveness of Quit the Shit is reduced by shortening the program or by removing the chat-based counseling option. METHODS We conducted a purely Web-based randomized experimental trial using a two-factorial design (factor 1: real-time-counseling via text-chat: yes vs no; factor 2: intervention duration: 50 days vs 28 days). Participants were recruited on the Quit the Shit website. Follow-ups were conducted 3, 6, and 12 months after randomization. Primary outcome was cannabis-use days during the past 30 days using a Timeline Followback procedure. Secondary outcomes were cannabis quantity, cannabis-use events, cannabis dependency (Severity of Dependence Scale), treatment satisfaction (Client Satisfaction Questionnaire), and working alliance (Working Alliance Inventory-short revised). RESULTS In total, 534 participants were included in the trial. Follow-up rates were 47.2% (252/534) after 3 months, 38.2% (204/534) after 6 months, and 25.3% (135/534) after 12 months. Provision of real-time counseling (factor 1) was not significantly associated with any cannabis-related outcome but with higher treatment satisfaction (P=.001, d=0.34) and stronger working alliance (P=.008, d=0.22). In factor 2, no significant differences were found in any outcome. The reduction of cannabis use among all study participants was strong (P<.001, d≥1.13). CONCLUSIONS The reduction of program length and the waiver of synchronous communication have no meaningful impact on the effectiveness of Quit the Shit. It therefore seems tenable to abbreviate the program and to offer a self-guided start into Quit the Shit. Due to its positive impact on treatment satisfaction and working alliance, chat-based counseling nevertheless should be provided in Quit the Shit. CLINICALTRIAL International Standard Randomized Controlled Trial Number ISRCTN99818059; http://www.isrctn.com/ISRCTN99818059 (Archived by WebCite at http://www.webcitation.org/6uVDeJjfD)

scholarly journals Guided web-based treatment program for reducing cannabis use: a randomized controlled trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Kristina Sinadinovic ◽  
Magnus Johansson ◽  
Ann-Sofie Johansson ◽  
Thomas Lundqvist ◽  
Philip Lindner ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Treatment Program ◽  
Controlled Trial ◽  
Cannabis Use ◽  
Control Group ◽  
Web Based ◽  
Randomized Controlled ◽  
Intervention Adherence ◽  
Group Effects

Abstract Background The aim of this study was to investigate the effects of a web-based treatment program with therapist guidance for adults and adolescents with regular cannabis use from the general population. Methods A double blinded randomized controlled trial with a parallel group design was conducted (intervention group n = 151, wait-list control group n = 152). Follow-up 12 weeks from treatment commencement of a 13-module intervention. The primary outcome was frequency of cannabis use. Time by group interaction effects were modeled using generalized estimated equations and the instrumental variable approach was used to estimate the effect of intervention adherence. Results At follow-up, the intention to treat (ITT) analyses did not show any significant time by group effects. A significant association between intervention adherence and scores on the cannabis abuse screening test (CAST) was found. Secondary analysis excluding participants who had received other professional help revealed time by group effects for secondary outcomes gram cannabis consumed past week, number of dependency criteria and CAST score. Due to methodological limitations, these latter results should be interpreted with caution. Conclusions In this study we did not find a web-based treatment program with therapist guidance to be more effective than a waiting-list in reducing frequency of cannabis use. Trial registration The trial was pre-registered at ClinicalTrials.gov (NCT02408640) April 3, 2015

scholarly journals Effects of a Brief Web-Based “Social Norms”-Intervention on Alcohol, Tobacco and Cannabis Use Among German University Students: Results of a Cluster-Controlled Trial Conducted at Eight Universities

2021 ◽  
Vol 9 ◽  
Author(s):  
C. R. Pischke ◽  
S. M. Helmer ◽  
H. Pohlabeln ◽  
S. Muellmann ◽  
S. Schneider ◽  
...  
Keyword(s):  
Substance Use ◽  
University Students ◽  
Social Norms ◽  
Controlled Trial ◽  
Cannabis Use ◽  
Intervention Effects ◽  
Web Based ◽  
Peer Substance Use ◽  
Peer Use

Background and Aim: “Social norms” (SN)-interventions are aimed at changing existing misperceptions regarding peer substance use by providing feedback on actual norms, thereby affecting personal substance use. It is unknown whether SN-intervention effects previously demonstrated in US students can be replicated in German students. The aim of the INSIST-study was to examine the effects of a web-based SN-intervention on substance use.Design: Cluster-controlled trial.Setting: Eight Universities in Germany.Participants and Measurements: Students were recruited at four intervention vs. four delayed intervention control Universities. 4,463 students completed baseline, 1,255 students (59% female) completed both baseline and 5-months follow-up web-based surveys on personal and perceived peer substance use. Intervention participants received feedback contrasting personal and perceived peer use with previously assessed use and perceptions of same-sex, same-university peers. Intervention effects were assessed via multivariable mixed logistic regression models.Findings: Relative to controls, reception of SN-feedback was associated with higher odds for decreased alcohol use (OR: 1.91, 95% CI 1.42-2.56). This effect was most pronounced in students overestimating peer use at baseline and under or accurately estimating it at follow-up (OR: 6.28, 95% CI 2.00-19.8). The OR was 1.33 (95% CI 0.67-2.65) for decreased cannabis use in students at intervention Universities and was statistically significant at 1.70 (95% CI 1.13-2.55) when contrasting unchanged and decreased with increased use. Regarding tobacco use and episodes of drunkenness, no intervention effects were found.Conclusions: This study was the first cluster-controlled trial suggesting beneficial effects of web-based SN-intervention on alcohol and cannabis use in a large sample of German University students.Clinical Trial Registration: The trial registration number of the INSIST-study is DRKS00007635 at the “German Clinical Trials Register.”

scholarly journals ICan, an Internet-based intervention to reduce cannabis use: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marleen I. A. Olthof ◽  
Matthijs Blankers ◽  
Margriet W. van Laar ◽  
Anna E. Goudriaan
Keyword(s):  
Randomized Controlled Trial ◽  
Substance Use ◽  
Brief Intervention ◽  
Controlled Trial ◽  
Cannabis Use ◽  
Substance Use Treatment ◽  
Professional Help ◽  
Web Based ◽  
Randomized Controlled ◽  
Internet Based Intervention

Abstract Background Heavy cannabis use is associated with adverse physical and mental health effects. Despite available effective treatments, the majority of heavy cannabis users does not seek professional help. Web-based interventions can provide an alternative for cannabis users who are reluctant to seek professional help. Several web-based cannabis interventions are effective in reducing cannabis use; however, the effect sizes are typically small and attrition rates are typically high. This suggests that web-based programs can be an effective cannabis use intervention for some, while others may need additional substance use treatment after completing a web-based intervention. Therefore, it is important that web-based interventions do not solely focus on reducing cannabis use, but also on improving attitudes towards substance use treatment. The Screening Brief Intervention and Referral to Treatment (SBIRT) approach appears to be well suited for the purpose of reducing cannabis use and improving substance use treatment utilization. Based on the SBIRT approach—and based on cognitive behavioral therapy (CBT) and motivational interviewing (MI)—we developed the Internet-based cannabis reduction intervention ICan. Methods/design This protocol paper presents the design of a randomized controlled trial (RCT) in which we evaluate the effectiveness of the ICan intervention compared to four online modules of educational information on cannabis in a sample of Dutch frequent cannabis users. The primary outcome measure is frequency of cannabis use. Secondary outcome measures include the quantity of cannabis used (grams), the attitudes towards seeking help and the number of participants who enter specialized treatment services for cannabis use-related problems. Discussion To the best of our knowledge, ICan is the first Internet-based intervention for cannabis users that combines screening, a brief intervention—based on CBT and MI—and referral to treatment options. Trial registration The study is registered in the Netherlands Trial Register; identifier NL7668. Registered on 17 April 2019.

scholarly journals A Web-Based Program for Cannabis Use and Psychotic Experiences in Young People (Keep It Real): Protocol for a Randomized Controlled Trial

10.2196/15803 ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. e15803
Author(s):  
Leanne Hides ◽  
Amanda Baker ◽  
Melissa Norberg ◽  
Jan Copeland ◽  
Catherine Quinn ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Substance Use ◽  
Cost Effectiveness ◽  
Young People ◽  
Controlled Trial ◽  
Cannabis Use ◽  
Psychotic Experiences ◽  
Web Based ◽  
Randomized Controlled ◽  
The Past

Background Young Australians (16-25 years) have the highest rates of past-month cannabis use in the world. Cannabis use increases the risk of alcohol and other drug disorders and depressive disorders, and has a robust dose-response association with psychotic experiences (PEs) and disorders. PEs are subthreshold positive psychotic symptoms, including delusions and hallucinations, which increase the risk of substance use, depressive or anxiety disorders, and psychotic disorders. Access to effective web-based early interventions targeting both cannabis use and PEs could reduce such risk in young people. Objective The objective of this study is to determine the efficacy and cost-effectiveness of the Keep it Real web-based program compared to an information-only control website among young cannabis users (16-25 years) with PEs. Methods Participants are recruited online, and consenting individuals meeting inclusion criteria (aged 16-25 years, who have used cannabis in the past month and experienced PEs in the past 3 months) are automatically randomized to either the Keep it Real web-based program (n=249) or an information-only control website (n=249). Both websites are self-guided (fully automated). The baseline and follow-up assessments at 3, 6, 9, and 12 months are self-completed online. Primary outcome measures are weekly cannabis use, PEs, and the relative cost-effectiveness for quality-adjusted life years. Secondary outcomes include other substance use and related problems, PE-related distress, cannabis intoxication experiences, severity of cannabis dependence, depression/anxiety symptoms, suicidality, and mental well-being and functioning. Results Recruitment commenced in February 2019, and the results are expected to be submitted for publication in mid-2021. Conclusions This study protocol describes a large randomized controlled trial of a new web-based program for young cannabis users experiencing PEs. If effective, the accessibility and scalability of Keep it Real could help reduce growing public health concerns about the significant social, economic, and health impacts of cannabis use. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618001107213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374800 International Registered Report Identifier (IRRID) DERR1-10.2196/15803

scholarly journals The Effects of Social Presence on Adherence-Focused Guidance in Problematic Cannabis Users: Protocol for the CANreduce 2.0 Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Manuel Amann ◽  
Severin Haug ◽  
Andreas Wenger ◽  
Christian Baumgartner ◽  
David D Ebert ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Social Presence ◽  
Outcome Measurement ◽  
Common Mental Disorder ◽  
Controlled Trial ◽  
Cannabis Use ◽  
Web Based ◽  
Related Disorder ◽  
Randomized Controlled ◽  
Self Help

BACKGROUND In European countries, including Switzerland, cannabis is the most commonly used illicit drug. Offering a Web-based self-help tool could potentially reach users who otherwise would not seek traditional help. However, such Web-based self-help tools often suffer from low adherence. OBJECTIVE Through adherence-focused guidance enhancements, the aim of this study was to increase adherence in cannabis users entering a Web-based self-help tool to reduce their cannabis use and, in this way, augment its effectiveness. METHODS This paper presents the protocol for a three-arm randomized controlled trial (RCT) to compare the effectiveness of (1) an adherence-focused, guidance-enhanced, Web-based self-help intervention with social presence; (2) an adherence-focused, guidance-enhanced, Web-based self-help intervention without social presence; and (3) a treatment-as-usual at reducing cannabis use in problematic users. The two active interventions, each spanning 6 weeks, consist of modules designed to reduce cannabis use and attenuate common mental disorder (CMD) symptoms, including depression, anxiety, and stress-related disorder symptoms based on the approaches of motivational interviewing and cognitive behavioral therapy. With a target sample size of 528, data will be collected at baseline, 6 weeks, and 3 months after baseline. The primary outcome measurement will be the number of days of cannabis use on the preceding 7 days. Secondary outcomes will include the quantity of cannabis used in standardized cannabis joints, the severity of cannabis dependence, changes in CMD symptoms, and adherence to the program. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models. RESULTS The project commenced in August 2016; recruitment is anticipated to end by December 2018. First results are expected to be submitted for publication in summer 2019. CONCLUSIONS This study will provide detailed insights on if and how the effectiveness of a Web-based self-help intervention aiming to reduce cannabis use in frequent cannabis users can be improved by theory-driven, adherence-focused guidance enhancement. CLINICALTRIAL International Standard Randomized Controlled Trial Number Registry: ISRCTN11086185; http://www.isrctn.com/ISRCTN11086185 (Archived by WebCite at http://www.webcitation.org/6wspbuQ1M)

scholarly journals Instructional Video and Medical Student Surgical Knot-Tying Proficiency: Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Katarzyna Bochenska ◽  
Magdy P Milad ◽  
John OL DeLancey ◽  
Christina Lewicky-Gaupp
Keyword(s):  
Medical Student ◽  
Positive Impact ◽  
Controlled Trial ◽  
Instructional Video ◽  
Knot Tying ◽  
Web Based ◽  
Checklist Score ◽  
Scale Range ◽  
Unlimited Access ◽  
Video Group

BACKGROUND Many senior medical students lack simple surgical and procedural skills such as knot tying. OBJECTIVE The aim of this study was to determine whether viewing a Web-based expert knot-tying training video, in addition to the standard third-year medical student curriculum, will result in more proficient surgical knot tying. METHODS At the start of their obstetrics and gynecology clerkship, 45 students were videotaped tying surgical knots for 2 minutes using a board model. Two blinded female pelvic medicine and reconstructive surgery physicians evaluated proficiency with a standard checklist (score range 0-16) and anchored scoring scale (range 0-20); higher numbers represent better skill. Students were then randomized to either (1) expert video (n=26) or (2) nonvideo (n=24) groups. The video group was provided unlimited access to an expert knot-tying instructional video. At the completion of the clerkship, students were again videotaped and evaluated. RESULTS At initial evaluation, preclerkship cumulative scores (range 0-36) on the standard checklist and anchored scale were not significantly different between the nonvideo and video groups (mean 20.3, SD 7.1 vs mean 20.2, SD 9.2, P=.90, respectively). Postclerkship scores improved in both the nonvideo and video groups (mean 28.4, SD 5.4, P<.001 and mean 28.7, SD 6.5, P=.004, respectively). Increased knot board practice was significantly correlated with higher postclerkship scores on the knot-tying task, but only in the video group (r=.47, P<.05). CONCLUSIONS The addition of a Web-based expert instructional video to a standard curriculum, coupled with knot board practice, appears to have a positive impact on medical student knot-tying proficiency.

A national effectiveness trial of an eHealth program to prevent alcohol and cannabis misuse: responding to the replication crisis

2020 ◽  
pp. 1-9
Author(s):  
Nicola C. Newton ◽  
Cath Chapman ◽  
Tim Slade ◽  
Louise Birrell ◽  
Annalise Healy ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Cannabis Use ◽  
Heavy Episodic Drinking ◽  
Self Report ◽  
Future Research ◽  
Standard Drink ◽  
Web Based ◽  
Randomised Controlled ◽  
The Web

Abstract Background The burden of disease attributable to alcohol and other drug (AOD) use in young people is considerable. Prevention can be effective, yet few programs have demonstrated replicable effects. This study aimed to replicate research behind Climate Schools: Alcohol and Cannabis course among a large cohort of adolescents. Methods Seventy-one secondary schools across three States participated in a cluster-randomised controlled trial. Year 8 students received either the web-based Climate Schools: Alcohol and Cannabis course (Climate, n = 3236), or health education as usual (Control, n = 3150). Outcomes were measured via self-report and reported here for baseline, 6- and 12-months for alcohol and cannabis knowledge, alcohol, cannabis use and alcohol-related harms. Results Compared to Controls, students in the Climate group showed greater increases in alcohol- [standardised mean difference (SMD) 0.51, p < 0.001] and cannabis-related knowledge (SMD 0.49, p < 0.001), less increases in the odds of drinking a full standard drink[(odds ratio (OR) 0.62, p = 0.014], and heavy episodic drinking (OR 0.49, p = 0.022). There was no evidence for differences in change over time in the odds of cannabis use (OR 0.57, p = 0.22) or alcohol harms (OR 0.73, p = 0.17). Conclusions The current study provides support for the effectiveness of the web-based Climate Schools: Alcohol and Cannabis course in increasing knowledge and reducing the uptake of alcohol. It represents one of the first trials of a web-based AOD prevention program to replicate alcohol effects in a large and diverse sample of students. Future research and/or adaptation of the program may be warranted with respect to prevention of cannabis use and alcohol harms.

scholarly journals A Web-Based Program for Cannabis Use and Psychotic Experiences in Young People (Keep It Real): Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Leanne Hides ◽  
Amanda Baker ◽  
Melissa Norberg ◽  
Jan Copeland ◽  
Catherine Quinn ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Substance Use ◽  
Cost Effectiveness ◽  
Young People ◽  
Controlled Trial ◽  
Cannabis Use ◽  
Psychotic Experiences ◽  
Web Based ◽  
Randomized Controlled ◽  
The Past

BACKGROUND Young Australians (16-25 years) have the highest rates of past-month cannabis use in the world. Cannabis use increases the risk of alcohol and other drug disorders and depressive disorders, and has a robust dose-response association with psychotic experiences (PEs) and disorders. PEs are subthreshold positive psychotic symptoms, including delusions and hallucinations, which increase the risk of substance use, depressive or anxiety disorders, and psychotic disorders. Access to effective web-based early interventions targeting both cannabis use and PEs could reduce such risk in young people. OBJECTIVE The objective of this study is to determine the efficacy and cost-effectiveness of the <i>Keep it Real</i> web-based program compared to an information-only control website among young cannabis users (16-25 years) with PEs. METHODS Participants are recruited online, and consenting individuals meeting inclusion criteria (aged 16-25 years, who have used cannabis in the past month and experienced PEs in the past 3 months) are automatically randomized to either the <i>Keep it Real</i> web-based program (n=249) or an information-only control website (n=249). Both websites are self-guided (fully automated). The baseline and follow-up assessments at 3, 6, 9, and 12 months are self-completed online. Primary outcome measures are weekly cannabis use, PEs, and the relative cost-effectiveness for quality-adjusted life years. Secondary outcomes include other substance use and related problems, PE-related distress, cannabis intoxication experiences, severity of cannabis dependence, depression/anxiety symptoms, suicidality, and mental well-being and functioning. RESULTS Recruitment commenced in February 2019, and the results are expected to be submitted for publication in mid-2021. CONCLUSIONS This study protocol describes a large randomized controlled trial of a new web-based program for young cannabis users experiencing PEs. If effective, the accessibility and scalability of <i>Keep it Real</i> could help reduce growing public health concerns about the significant social, economic, and health impacts of cannabis use. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12618001107213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374800 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15803

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