{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:04:50Z","timestamp":1782846290549,"version":"3.54.5"},"reference-count":79,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Brief alcohol interventions aim at motivating individuals to reduce their drinking and encompass a multitude of activities with limited duration or frequency such as counseling or individualized feedback. Brief interventions are effective in alcohol users who exceed the low-risk drinking limits. Considering the health risks associated with alcohol consumption below these limits, brief interventions should be targeted at all alcohol users to maximize their public health impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study aimed (1) to test the long-term effects of a brief alcohol intervention consisting of computer-generated individualized feedback letters among individuals who consume alcohol, irrespective of how much; and (2) to explore how intervention effects may be moderated by alcohol use severity and school education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the waiting area of the municipal registry office in Greifswald, Mecklenburg-Western Pomerania, Germany, a general population sample of 1646 adults (n=920, 55.89% women; mean age 31.0, SD 10.8 y) who reported alcohol use at least once in the past year were randomized to an intervention (n=815, 49.51%) or a control group (n=831, 50.49%). The intervention comprised up to 3 computer-generated individualized feedback letters based on the transtheoretical model of behavior change at baseline and after 3 and 6 months. The control group received assessment only at the same time points and no feedback. The outcome was a change in self-reported number of drinks per week from baseline to follow-up after 36 and 48 months. Moderators of intervention efficacy were self-reported alcohol use severity (low risk vs at-risk drinking) and school education (&lt;12 y vs \u226512 y) at baseline. Data were analyzed using latent growth modeling with full-information maximum likelihood estimation, ensuring an intention-to-treat analysis. Bayes factors (BFs) were calculated to estimate the sensitivity of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Unadjusted and adjusted models revealed no group difference after 36 months (incidence rate ratio 1.05, 95% CI 0.87\u20101.27; BF=0.37). After 48 months, a decrease in weekly alcohol consumption was observed in the control group and no change in the intervention group (incidence rate ratio 1.29, 95% CI 1.05\u20101.57; BF=0.16\n                      <jats:italic>),<\/jats:italic>\n                      indicating strong evidence against the hypothesized intervention effect. Intervention efficacy was not moderated by alcohol use severity or school education at baseline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a randomized controlled trial, no evidence for the efficacy of individualized feedback letters was found after 3 and 4 years. Unexpectedly, drinking reductions in the control group and no change in the intervention group were observed 4 years after the study start. Intervention strategies effective in at-risk drinkers may necessitate adaptation for applicability to alcohol users as a whole.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/77921","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:45:07Z","timestamp":1760125507000},"page":"e77921-e77921","source":"Crossref","is-referenced-by-count":0,"title":["Four-Year Effects of a Computer-Based Brief Alcohol Intervention Targeting Alcohol Users in the General Population: Randomized Controlled Trial"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9905-1999","authenticated-orcid":false,"given":"Andreas","family":"Staudt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-5298","authenticated-orcid":false,"given":"Ulrich","family":"John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4827-8760","authenticated-orcid":false,"given":"Jennis","family":"Freyer-Adam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0432-5497","authenticated-orcid":false,"given":"Gallus","family":"Bischof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3684-0664","authenticated-orcid":false,"given":"Maria","family":"Zeiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7697-4923","authenticated-orcid":false,"given":"Sophie","family":"Baumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004148.pub4","article-title":"Effectiveness of brief alcohol interventions in primary care populations","volume":"2","author":"Kaner","journal-title":"Cochrane Database Syst Rev"},{"issue":"18","key":"R2","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1001\/jama.2018.16789","article-title":"Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults","volume":"320","author":"Curry","journal-title":"JAMA"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1111\/add.15613","article-title":"Efficacy of brief intervention for harmful and hazardous alcohol use: a systematic review and meta-analysis of studies from low middle-income countries","volume":"117","author":"Ghosh","journal-title":"Addiction"},{"issue":"2","key":"R4","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1093\/ageing\/afx132","article-title":"Interventions to prevent and reduce excessive alcohol consumption in older people: a systematic review and meta-analysis","volume":"47","author":"Kelly","journal-title":"Age Ageing"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1111\/add.15674","article-title":"Effects of brief substance use interventions delivered in general medical settings: a systematic review and meta-analysis","volume":"117","author":"Tanner-Smith","journal-title":"Addiction"},{"issue":"12","key":"R6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002714","article-title":"Effectiveness and treatment moderators of internet interventions for adult problem drinking: an individual patient data meta-analysis of 19 randomised controlled trials","volume":"15","author":"Riper","journal-title":"PLoS Med"},{"issue":"9","key":"R7","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011479.pub2","article-title":"Personalised digital interventions for reducing hazardous and harmful alcohol consumption in community-dwelling populations","volume":"9","author":"Kaner","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/10859","article-title":"Technology-based alcohol interventions in primary care: systematic review","volume":"21","author":"Ramsey","journal-title":"J Med Internet Res"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1037\/hea0000556","article-title":"In-person alcohol counseling versus computer-generated feedback: Results from a randomized controlled trial","volume":"37","author":"Freyer-Adam","journal-title":"Health Psychol"},{"issue":"11","key":"R10","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1111\/add.12677","article-title":"Does stage tailoring matter in brief alcohol interventions for job-seekers? 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