Biomedical subjects

Martine L Cashell-Smith

Publications and source records attributed to Martine L Cashell-Smith.

3 recordsLinked to original sources

PubMed2007

Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinking.

CONTEXT: The concept that assessment of a person's health status without subsequent intervention has beneficial effects in itself has stimulated much interest in underlying psychological mechanisms, methodological implications and its public health potential. There have, however, been few experimental studies of assessment effects. AIM: To test the hypothesis that assessment in itself produces a reduction in hazardous drinking. DESIGN AND SETTING: Two conditions (group A, leaflet only and group B, leaflet and assessment but no intervention) of a four-arm randomized controlled trial with enrollment in March-April 2003. PARTICIPANTS: A total of 975 students (17-29 years) attending a primary health-care clinic completed a web-based Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Of 599 who scored >or= 8576 consented to follow-up and were included in the full four-arm trial, of whom 293 (153 women) were assigned to groups A and B. INTERVENTION: Group A received an information leaflet at baseline. Group B received the information leaflet and 10 minutes of web-based assessment 4 weeks later. MEASUREMENTS: Drinking frequency, typical quantity, heavy episode frequency, personal problems and academic problems. FINDINGS: Baseline mean AUDIT scores were 15.0 (SD = 5.4) and 14.9 (SD = 5.0) in groups A and B, respectively. Twelve months after baseline, relative to group A, group B reported lower overall consumption (geometric means ratio 0.82, 95% CI: 0.68-0.98), fewer heavy drinking episodes (0.66, 0.47-0.91), fewer problems (0.81, 0.67-0.99) and lower AUDIT scores (beta = -1.63, -0.62 to -2.65). CONCLUSIONS: Brief assessment appeared to reduce hazardous drinking. Controlled trials that rely on assessment may therefore underestimate treatment effects. Limitations include the possibility of measurement artefact due to social desirability bias.

Adolescent↗

PubMed2004

An internet-based survey method for college student drinking research.

The purpose of this study was to describe and assess the utility of an Internet-based survey method for characterizing the alcohol consumption of college students. After extensive pilot research, a random sample of 1910 students aged 16-29 years was invited to complete a questionnaire, consisting of a series of web-pages linked to a relational database on a secure web-site. A branch structure allowed for tailoring of survey items by age and gender. The students received up to nine contacts, including a pre-notice letter with a token gift and an e-mail invitation (Phase 1), a reminder letter and e-mail message (Phase 2), and then telephone reminders and replacement access codes (Phase 3). Non-computer-users were offered a pen-and-paper alternative, making this a mixed-mode survey. The overall response to the survey was 82% (n = 1564). The median completion time was 16.7 min. Participants' comments showed high levels of satisfaction with the survey. Comparison of web (n = 1501) versus pen-and-paper completions (n = 63) revealed no modality effects. Technical problems addressed during the course of implementation included web-browser-operating system incompatibilities, and periodic network errors, although these resulted in little lost participation. Internet-based surveys are feasible for college student research and with carefully managed recruitment, can yield a high response.

Adolescent↗

PubMed2004

Web-based screening and brief intervention for hazardous drinking: a double-blind randomized controlled trial.

BACKGROUND: Strong evidence exists for the efficacy of screening and brief intervention for reducing hazardous drinking. However, problems have been highlighted with respect to its implementation in health-care systems, not least of which is a reluctance of some doctors to discuss alcohol proactively with their patients. AIMS: To determine the efficacy of a novel web-based screening and brief intervention (e-SBI) to reduce hazardous drinking. DESIGN: A double-blind randomized controlled trial. SETTING: A university student health service. PARTICIPANTS: A total of 167 students (17-26 years) were recruited in the reception area and completed a 3-minute web-based screen including the Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Of these, 112 tested positive, and 104 (52 females) who consented to follow-up were included in the trial. MEASUREMENTS: Drinking frequency, typical occasion quantity, total volume, heavy episode frequency (females > 80 g ethanol, males > 120 g ethanol), number of personal problems, an academic problems score. INTERVENTION: Participants were randomized to 10-15 minutes of web-based assessment and personalized feedback on their drinking (intervention, n = 51) or to a leaflet-only control group (n = 53). FINDINGS: Mean baseline AUDIT scores for control and intervention groups were 16.6 (SD = 6.0) and 16.6 (SD = 5.7). At 6 weeks, participants receiving e-SBI reported significantly lower total consumption (geometric mean ratio = 0.74; 95% confidence interval: 0.56-0.96), lower heavy episode frequency (0.63; 0.42-0.92) and fewer personal problems (0.70; 0.54-0.91). At 6 months personal problems remained lower (0.76; 0.60-0.97), although consumption did not differ significantly. At 6 months, academic problems were lower in the intervention group relative to controls (0.72; 0.51-1.02). CONCLUSIONS: e-SBI reduced hazardous drinking among university students, to an extent similar to that found for practitioner-delivered brief interventions in the general population. e-SBI offers promise as a strategy to reduce alcohol-related harm in a way that is non-intrusive, appealing to the target group, and capable of being incorporated into primary care. Research is required to replicate the findings, to determine the duration of intervention effects, and to investigate the mechanisms by which the intervention operates.

Adolescent↗