An Alcohol-Free Start to Twenty Twenty-Three: A Brief Internet-Delivered Intervention Targeting Individuals with Mild to Moderate Alcohol Use Disorder (AUD), Assisted by Goal Coaches

Abstract

Background: Alcohol use disorder (AUD) is a psychiatric condition that impairs control, has social repercussions, and causes dependency. AUD is a relapsing disorder that affects 5.1% of the global population. Furthermore, just 9% of New Zealanders seek professional treatment. Brief internet-delivered therapies for mild to moderate AUD have been successful in recent years, and are more convenient, removing barriers like accessibility. Nonetheless, while internet-delivered AUD therapies are effective, they garner poor engagement and are highly attritional. The inclusion of social support has the potential to address these difficulties but is yet to be fully explored. Aim: This study investigates how a brief, lived experience-based intervention affects alcohol use and related issues in mild to moderate AUD. This study also evaluates goal coach social support for study engagement and retention. Methods: This study uses a pre-post exploratory design. Data was collected on Day 0 and Day 28 using Qualtrics. Questionnaires measured the intervention's impact on alcohol reduction by assessing participants' alcohol use, severity, drinking motives, volitional state, and selfefficacy. During the intervention, goal setting, plan formulation, feedback response, and notetaking were measured for participant engagement, whilst post-intervention assessments measured retention. The Alcohol Habit Hacker PALS (HHPALS) intervention is part of a series of self-help programmes for addictive behaviours. This study extends previous work by exploring engagement methods, such as incorporating goal coaches and hosting the challenge as a New Year’s Resolution challenge, leveraging intrinsic motivation. HHPALS uses the Health Action Process Approach (HAPA) and Self-Determination Theory (SDT) as underpinning theories, and Behavioural Change Technique (BCT) components such as goal setting, action and coping planning, and self-monitoring. Participants established their own alcohol intake and frequency goals for the challenge. Additionally, they were instructed to design a plan using a strategy from those provided and to create a coping plan for obstacles. Results: This research recruited 86 volunteers using Facebook advertising and word-of-mouth, with 48 participants completing the post-intervention assessment. Participants reported improvements in post-intervention measures, including a significant decrease in alcohol consumption. Consistent with participant evaluation, the New Year's timing contributed to the success of the intervention for approximately half of the participants. In contrast, others struggled to meet their goals due to social engagements and temptations that complement the season. Conclusion: HHPALS is a successful and beneficial therapy endorsed by significant decreases in AUDIT-C scores, alcohol intake frequency, and large improvement in self-efficacy in resisting alcohol urges. Goal coaches played a crucial role in enhancing the intervention's effectiveness and fostering participant engagement; however, it is recommended that HHPALS sees advancements in technology, social support systems, and content customisation to increase user experience and engagement. HHPALS has made progress in supporting AUD patients, but external social and legislative adjustments are needed.