{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:08:30Z","timestamp":1782846510600,"version":"3.54.5"},"reference-count":112,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Alcohol use disorder (AUD) profoundly affected ethnic minority young adults due to unique stressors, such as acculturation challenges and discrimination. Our prior studies found that experiential avoidance behavior and discrimination significantly contributed to AUD. These findings warranted third-wave interventions, such as acceptance and commitment therapy (ACT). Nonetheless, barriers to engagement with value-based activities may affect ACT efficacy. Behavioral activation (BA) may be an alternative for this shortcoming. Integrating these interventions has shown promise. However, no studies evaluated its effectiveness in this group. Therefore, evaluating the preliminary effectiveness and feasibility of this intervention was needed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the feasibility measures. The secondary objective aimed to examine its effectiveness on cumulative abstinence duration, drinking days, drinks per drinking day, heavy drinking days, alcohol abstinence self-efficacy, readiness to change, psychological flexibility (Acceptance and Action Questionnaire\u2014version II), and everyday discrimination score.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A pilot parallel randomized controlled trial was conducted. Forty young ethnic minorities who can speak English and have AUD based on\n DSM-5<\/jats:italic>\n (\n Diagnostic and Statistical Manual of Mental Disorders<\/jats:italic>\n [Fifth Edition]) criteria were recruited and randomly assigned to either Acceptance and Commitment Therapy with Behavioral Activation (ACT-BA; n=20) or Treatment-as-Usual (TAU; n=20) using a computer-generated random number; assessors were blinded to group assignment. Outcomes were collected at baseline (T0) and postintervention (T1). The analysis included descriptive statistics, independent samples\n t<\/jats:italic>\n test, chi-square test, and generalized estimating equations with multiple imputations. To further supplement findings, a qualitative interview was conducted.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 148 ethnic minority young adults were screened, with an eligibility rate of 38.5% (57\/148). Of these, 85.9% (49\/57) consented, and among them, 81.6% (40\/49) were randomized to either the ACT-BA or TAU. The retention rate was 82.5% (33\/40), of which 75% (30\/40) completed the postintervention assessment (ACT-BA: 16\/20, 80%; TAU: 14\/20, 70%). The adherence rate was 81.7% (4.9\/6 sessions), and participants reported no adverse effects. Finally, 40 participants (20 for each group) were analyzed. The intervention group showed a promising improvement in drinking days (\n B<\/jats:italic>\n =\u22124.12, 95% CI \u22128.10 to \u22120.13;\n P<\/jats:italic>\n =.04,\n d<\/jats:italic>\n =\u22120.57), drinks per drinking day (\n B<\/jats:italic>\n =\u22121.56, 95% CI \u22123.06 to \u22120.07;\n P<\/jats:italic>\n =.04,\n d<\/jats:italic>\n =\u22121.89), alcohol abstinence self-efficacy (\n B<\/jats:italic>\n =11.95, 95% CI 0.10-23.81;\n P<\/jats:italic>\n =.048,\n d<\/jats:italic>\n =0.81), and Acceptance and Action Questionnaire\u2014version II (\n B<\/jats:italic>\n =\u22126.41, 95% CI \u221212.77 to \u22120.06;\n P<\/jats:italic>\n =.04,\n d<\/jats:italic>\n =\u22120.65).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study, unlike existing evidence, presents an innovative integration of ACT and BA delivered via an internet-based self-help format. The findings contribute to the field by providing preliminary evidence that this integrated intervention is feasible and promising for AUD. The main implication in the real world is to conduct a fully powered randomized controlled trial to further examine its effectiveness with longer follow-up to serve as a stand-alone treatment option for ethnic minorities.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/83896","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:26:16Z","timestamp":1779398776000},"page":"e83896-e83896","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Integrated Internet-Based Acceptance and Commitment Therapy and Behavioral Activation Among Ethnic Minority Young Adults With Alcohol Use Disorder in Hong Kong: Pilot Randomized Controlled Trial"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3868-7082","authenticated-orcid":false,"given":"Getaneh Mulualem","family":"Belay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-3719","authenticated-orcid":false,"given":"Katherine Ka Wai","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6348-2498","authenticated-orcid":false,"given":"Qi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-0534","authenticated-orcid":false,"given":"Ting","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6098-1267","authenticated-orcid":false,"given":"Yim Wah","family":"Mak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3953-9065","authenticated-orcid":false,"given":"Ka Yan","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"R1","unstructured":"Understanding alcohol use disorder. National Institute on Alcohol Abuse and Alcoholism. 2022. URL: https:\/\/www.niaaa.nih.gov\/publications\/brochures-and-fact-sheets\/understanding-alcohol-use-disorder [Accessed 29-04-2026]"},{"key":"R2","unstructured":"Substance use in adolescents. MSD MANUAL. 2022. URL: https:\/\/www.msdmanuals.com\/home\/children-s-health-issues\/problems-in adolescents\/substance-use-in-adolescents [Accessed 29-04-2026]"},{"key":"R3","unstructured":"Naar S . The transition from adolescence to adulthood. Psychology Today. 2023. URL: https:\/\/www.psychologytoday.com\/us\/blog\/metamorphosis\/202107\/the-transition-adolescence-adulthood [Accessed 29-04-2026]"},{"key":"R4","unstructured":"What increases the risk for alcohol use disorder? National Institute on Alcohol Abuse and Alcoholism. 2025. URL: https:\/\/www.niaaa.nih.gov\/publications\/brochures-and-fact-sheets\/understanding-alcohol-use-disorder [Accessed 01-01-2026]"},{"issue":"12","key":"R5","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.1111\/j.1530-0277.2008.00806.x","article-title":"Age at first drink and the first incidence of adult-onset DSM-IV alcohol use disorders","volume":"32","author":"Dawson","journal-title":"Alcohol Clin Exp Res"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1002\/wps.20786","article-title":"Alcohol and the developing adolescent brain","volume":"19","author":"Squeglia","journal-title":"World Psychiatry"},{"key":"R7","unstructured":"The global action for measurement of adolescent health (GAMA). World Health Organization. 2022. URL: https:\/\/www.who.int\/groups\/the-global-action-for-measurement-of-adolescent-health [Accessed 29-04-2026]"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1002\/j.2161-1882.2002.tb00213.x","article-title":"Understanding college alcohol abuse and academic performance: selecting appropriate intervention strategies","volume":"5","author":"Sullivan","journal-title":"J of College Counseling"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1590\/0104-1169.3579.2475","article-title":"Problems associated with alcohol consumption by university students","volume":"22","author":"Casta\u00f1o-Perez","journal-title":"Rev Lat Am Enfermagem"},{"issue":"1","key":"R10","first-page":"159","volume":"28","author":"Oluwafemi","journal-title":"IFE PsychologIA Int J"},{"issue":"3","key":"R11","first-page":"291","volume":"56","author":"Sindelar","journal-title":"Minerva Pediatr"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1542\/peds.2008-2176","article-title":"Age of drinking onset, alcohol use disorders, frequent heavy drinking, and unintentionally injuring oneself and others after drinking","volume":"123","author":"Hingson","journal-title":"Pediatrics"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2013.01.008","article-title":"Alcohol- or drug-use disorders and motor vehicle accident mortality: a retrospective cohort study","volume":"53","author":"Callaghan","journal-title":"Accident Analysis & Prevention"},{"issue":"12","key":"R14","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1001\/jama.1938.02790380018006","article-title":"Alcohol in relation to traffic accidents","volume":"111","author":"Holcomb","journal-title":"JAMA"},{"key":"R15","unstructured":"Alcohol, fact sheet. World Health Organization. 2022. URL: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/alcohol [Accessed 29-04-2026]"},{"issue":"11","key":"R16","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.3109\/10826089309056245","article-title":"Ethnic identification and alcohol use among Canadian-born and foreign-born high school students in Toronto","volume":"28","author":"Cheung","journal-title":"Int J Addict"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1007\/0-306-47138-8_23","article-title":"Patterns of alcohol use among ethnic minority adolescent women","volume":"12","author":"Edwards","journal-title":"Recent Dev Alcohol"},{"key":"R18","unstructured":"Statistics CfBH, Quality. Racial\/ethnic differences in substance use, substance use disorders, and substance use treatment utilization among people aged 12 or older (2015-2019). Substance Abuse and Mental Health Services Administration; 2021."},{"key":"R19","unstructured":"The demographics: ethnic groups. Relation Units. 2021. URL: https:\/\/www.had.gov.hk\/rru\/english\/info\/demographics.htm [Accessed 29-04-2026]"},{"key":"R20","unstructured":"Discrimination and mental health\u2014a guide for young people. Cool Minds. 2022. URL: https:\/\/kely.org\/our-work\/mental-health-wellbeing\/coolminds# [Accessed 20-07-2022]"},{"issue":"2","key":"R21","volume":"14","author":"Dominic","journal-title":"J Youth Stud"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1097\/00004583-200101000-00020","article-title":"Natural course of alcohol use disorders from adolescence to young adulthood","volume":"40","author":"Rohde","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1037\/a0025432","article-title":"Perception of racial discrimination and psychopathology across three U.S. ethnic minority groups","volume":"18","author":"Chou","journal-title":"Cultur Divers Ethnic Minor Psychol"},{"key":"R24","unstructured":"Demombynes G . Why is ethnic minority poverty persistent in Vietnam. World Bank Blogs; 2013. URL: https:\/\/blogs worldbank org\/eastasiapacific\/why-ethnic-minority-poverty-persistent-vietnam [Accessed 08-05-2026]"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1037\/cdp0000568","article-title":"Psychological outcomes and culturally relevant moderators associated with events of discrimination among Asian American adults","volume":"30","author":"Liu","journal-title":"Cultur Divers Ethnic Minor Psychol"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1111\/acer.13285","article-title":"Drinking, alcohol use disorder, and treatment access and utilization among U.S. racial\/ethnic groups","volume":"41","author":"Vaeth","journal-title":"Alcohol Clin Exp Res"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1111\/hsc.12892","article-title":"Challenges of healthcare professionals in providing care to South Asian ethnic minority patients in Hong Kong: a qualitative study","volume":"28","author":"Vandan","journal-title":"Health Soc Care Community"},{"key":"R28","unstructured":"Research on social inclusion: employment situations of ethnic minority in Hong Kong. TREATS. 2021. URL: https:\/\/treats.org.hk\/en\/research-on-social-inclusion\/ [Accessed 29-04-2026]"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1560092","article-title":"Reasons and impacts of alcohol use disorder among ethnic minority young adults: a descriptive phenomenological study","volume":"13","author":"Belay","journal-title":"Front Public Health"},{"issue":"8","key":"R30","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1111\/j.1553-2712.2010.00818.x","article-title":"A brief motivational interview in a pediatric emergency department, plus 10-day telephone follow-up, increases attempts to quit drinking among youth and young adults who screen positive for problematic drinking","volume":"17","author":"Bernstein","journal-title":"Acad Emerg Med"},{"issue":"5","key":"R31","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/j.jsat.2014.01.001","article-title":"Phone-delivered brief motivational interventions for mandated college students delivered during the summer months","volume":"46","author":"Borsari","journal-title":"J Subst Abuse Treat"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2015.06.016","article-title":"Motivational interviewing to reduce substance use in adolescents with psychiatric comorbidity","volume":"59","author":"Brown","journal-title":"J Subst Abuse Treat"},{"issue":"8","key":"R33","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015423","article-title":"A randomised controlled pilot trial evaluating feasibility and acceptability of a computer-based tool to identify and reduce harmful and hazardous drinking among adolescents with alcohol-related presentations in Canadian pediatric emergency departments","volume":"7","author":"Newton","journal-title":"BMJ Open"},{"issue":"3","key":"R34","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1590\/s1516-44462011000300004","article-title":"Brief motivational interview and educational brochure in emergency room settings for adolescents and young adults with alcohol-related problems: a randomized single-blind clinical trial","volume":"33","author":"Segatto","journal-title":"Braz J Psychiatry"},{"issue":"6","key":"R35","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1037\/a0036939","article-title":"A randomized controlled trial of guided self-change with minority adolescents","volume":"82","author":"Wagner","journal-title":"J Consult Clin Psychol"},{"issue":"3","key":"R36","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1111\/j.1752-0606.2009.00121.x","article-title":"Comparison of family therapy outcome with alcohol-abusing, runaway adolescents","volume":"35","author":"Slesnick","journal-title":"J Marital Fam Ther"},{"issue":"2","key":"R37","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1111\/acem.13126","article-title":"Short- to midterm effectiveness of a brief motivational intervention to reduce alcohol use and related problems for alcohol intoxicated children and adolescents in pediatric emergency departments: a randomized controlled trial","volume":"24","author":"Arnaud","journal-title":"Acad Emerg Med"},{"issue":"12","key":"R38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0226271","article-title":"Brief group-delivered motivational interviewing is equally effective as brief group-delivered cognitive-behavioral therapy at reducing alcohol use in risky college drinkers","volume":"14","author":"Mart\u00edn-P\u00e9rez","journal-title":"PLoS One"},{"issue":"3","key":"R39","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/j.jpeds.2004.04.057","article-title":"A randomized clinical trial of a brief motivational intervention for alcohol-positive adolescents treated in an emergency department","volume":"145","author":"Spirito","journal-title":"J Pediatr"},{"issue":"3","key":"R40","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/s0376-8716(03)00171-6","article-title":"Integrated family and cognitive-behavioral therapy for adolescent substance abusers: a stage I efficacy study","volume":"71","author":"Latimer","journal-title":"Drug Alcohol Depend"},{"issue":"12","key":"R41","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1097\/CHI.0b013e318189147c","article-title":"Efficacy of outpatient aftercare for adolescents with alcohol use disorders: a randomized controlled study","volume":"47","author":"Kaminer","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"4","key":"R42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003056","article-title":"Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): a randomized controlled trial","volume":"17","author":"Murray","journal-title":"PLoS Med"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1371497","article-title":"Psychosocial treatment options for adolescents and young adults with alcohol use disorder: systematic review and meta-analysis","volume":"12","author":"Belay","journal-title":"Front Public Health"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/bjc.12404","article-title":"The effectiveness of third wave cognitive behavioural therapies for children and adolescents: a systematic review and meta-analysis","volume":"62","author":"Perkins","journal-title":"Br J Clin Psychol"},{"issue":"6","key":"R45","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1097\/YCO.0b013e328358e531","article-title":"The third wave of cognitive behavioural therapies: what is new and what is effective?","volume":"25","author":"Kahl","journal-title":"Curr Opin Psychiatry"},{"issue":"5","key":"R46","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1037\/adb0000883","article-title":"Review of third-wave therapies for substance use disorders in people of color and collectivist cultures: current evidence and future directions","volume":"37","author":"Dela Cruz","journal-title":"Psychol Addict Behav"},{"issue":"4","key":"R47","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1080\/00952990.2016.1199697","article-title":"Cognitive-behavioral therapies for depression and substance use disorders: an overview of traditional, third-wave, and transdiagnostic approaches","volume":"43","author":"Vujanovic","journal-title":"Am J Drug Alcohol Abuse"},{"issue":"4","key":"R48","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/S0005-7894(04)80013-3","article-title":"Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies","volume":"35","author":"Hayes","journal-title":"Behav Ther"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2014.12.028","article-title":"The promise of third-wave behavioral therapies in the treatment of substance use disorders","volume":"2","author":"Stotts","journal-title":"Curr Opin Psychol"},{"issue":"1","key":"R50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.brat.2005.06.006","article-title":"Acceptance and commitment therapy: model, processes and outcomes","volume":"44","author":"Hayes","journal-title":"Behav Res Ther"},{"key":"R51","doi-asserted-by":"crossref","unstructured":"Hayes SC Strosahl KD . A Practical Guide to Acceptance and Commitment Therapy. Springer Science & Business Media; 2004. URL: https:\/\/psycnet.apa.org\/record\/2005-02327-000 [Accessed 29-04-2026]","DOI":"10.1007\/978-0-387-23369-7"},{"key":"R52","doi-asserted-by":"crossref","unstructured":"Forman EM Juarascio AS Martin LM Herbert JD . Acceptance and commitment therapy (ACT). The Encyclopedia of Clinical Psychology; 2014:1-7. [doi: 10.1002\/9781118625392]","DOI":"10.1002\/9781118625392.wbecp101"},{"key":"R53","volume":"28","author":"Sevin\u00e7ok","journal-title":"Psychiatry Clin Psychopharmacol"},{"key":"R54","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.08.004","article-title":"An initial meta-analysis of Acceptance and Commitment Therapy for treating substance use disorders","volume":"155","author":"Lee","journal-title":"Drug Alcohol Depend"},{"issue":"10","key":"R55","doi-asserted-by":"publisher","first-page":"629","DOI":"10.14740\/jocmr4311","article-title":"The use of acceptance and commitment therapy in substance use disorders: a review of literature","volume":"12","author":"Osaji","journal-title":"J Clin Med Res"},{"issue":"1","key":"R56","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1177\/0145445516659645","article-title":"Web-based acceptance and commitment therapy for mental health problems in college students: a randomized controlled trial","volume":"41","author":"Levin","journal-title":"Behav Modif"},{"issue":"2","key":"R57","doi-asserted-by":"publisher","first-page":"191","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_820_23","article-title":"Testing the waters: a pilot trial of acceptance and commitment therapy (ACT) for alcohol use disorder","volume":"66","author":"Khandelwal","journal-title":"Indian J Psychiatry"},{"issue":"8","key":"R58","doi-asserted-by":"publisher","DOI":"10.2196\/18586","article-title":"A web-delivered acceptance and commitment therapy intervention with email reminders to enhance subjective well-being and encourage engagement with lifestyle behavior change in health care staff: randomized cluster feasibility stud","volume":"4","author":"Brown","journal-title":"JMIR Form Res"},{"issue":"2","key":"R59","first-page":"172","volume":"90","author":"Clark","journal-title":"Radiol Technol"},{"key":"R60","unstructured":"Martell CR Dimidjian S Herman-Dunn R . Behavioral activation for depression. In: Barlow DH , editor. Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual. 6th ed. Guilford Press; 339-380. URL: https:\/\/psycnet.apa.org\/record\/2021-54173-009 [Accessed 29-04-2026]"},{"issue":"6","key":"R61","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.cpr.2010.04.001","article-title":"What is behavioral activation? A review of the empirical literature","volume":"30","author":"Kanter","journal-title":"Clin Psychol Rev"},{"key":"R62","doi-asserted-by":"crossref","unstructured":"Santos MM Puspitasari AJ Nagy GA Kanter JW . Behavioral activation. In: Wenzel A , editor. Handbook of Cognitive Behavioral Therapy: Overview and Approaches. American Psychological Association; 2021:235-273. [doi: 10.1037\/0000218-009]","DOI":"10.1037\/0000218-009"},{"issue":"1","key":"R63","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/01454455221083309","article-title":"Is activation the active ingredient of transdiagnostic therapies? A randomized clinical trial of behavioral activation, acceptance and commitment therapy, and transdiagnostic cognitive-behavioral therapy for emotional disorders","volume":"47","author":"Fern\u00e1ndez-Rodr\u00edguez","journal-title":"Behav Modif"},{"issue":"3","key":"R64","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1177\/0145445512465173","article-title":"An open trial of a new acceptance-based behavioral treatment for major depression with psychotic features","volume":"37","author":"Gaudiano","journal-title":"Behav Modif"},{"issue":"2\/3","key":"R65","doi-asserted-by":"publisher","DOI":"10.1108\/ADD-02-2016-0006","article-title":"LETS ACT: a behavioral activation treatment for substance use and depression","volume":"9","author":"Daughters","journal-title":"Adv Dual Diagn"},{"issue":"2-3","key":"R66","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.jad.2012.12.020","article-title":"Internet-based behavioral activation and acceptance-based treatment for depression: a randomized controlled trial","volume":"148","author":"Carlbring","journal-title":"J Affect Disord"},{"key":"R67","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2014.00065","article-title":"Support from the internet for individuals with mental disorders: advantages and disadvantages of e-mental health service delivery","volume":"2","author":"Moock","journal-title":"Front Public Health"},{"issue":"1","key":"R68","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/1467-8721.01214","article-title":"Computer- and internet-based psychotherapy interventions","volume":"12","author":"Taylor","journal-title":"Curr Dir Psychol Sci"},{"issue":"1","key":"R69","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/wps.20083","article-title":"Advantages and limitations of Internet-based interventions for common mental disorders","volume":"13","author":"Andersson","journal-title":"World Psychiatry"},{"issue":"3","key":"R70","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.invent.2015.01.003","article-title":"Developing Internet interventions to target the individual impact of stigma in health conditions","volume":"2","author":"Thomas","journal-title":"Internet Interv"},{"issue":"12","key":"R71","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1111\/j.1360-0443.2009.02726.x","article-title":"A randomized controlled trial of an internet-based intervention for alcohol abusers","volume":"104","author":"Cunningham","journal-title":"Addiction"},{"key":"R72","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.07.006","article-title":"ACT internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: an 18-month follow-up","volume":"61","author":"Lappalainen","journal-title":"Behav Res Ther"},{"issue":"5","key":"R73","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2052","article-title":"Economic evaluation of internet-based interventions for harmful alcohol use alongside a pragmatic randomized controlled trial","volume":"14","author":"Blankers","journal-title":"J Med Internet Res"},{"issue":"1","key":"R74","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1192\/bjp.bp.114.146068","article-title":"Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomised controlled trial","volume":"208","author":"Pots","journal-title":"Br J Psychiatry"},{"key":"R75","unstructured":"Zettle R . ACT for Depression: A Clinician\u2019s Guide to Using Acceptance and Commitment Therapy in Treating Depression. New Harbinger Publications; 2007. URL: https:\/\/books.google.com.hk\/books\/about\/ACT_for_Depression.html?id=4VUp7wlwXH8C&redir_esc=y [Accessed 29-04-2026]"},{"key":"R76","unstructured":"Hayes SC Strosahl KD Wilson KG . Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. Guilford Press; 1999. URL: https:\/\/www.guilford.com\/excerpts\/hayes_ch3.pdf?t=1 [Accessed 29-04-2026]"},{"key":"R77","doi-asserted-by":"crossref","unstructured":"Hayes SC Pierson H . Acceptance and commitment therapy. In: Encyclopedia of Cognitive Behavior Therapy. Springer US; 1999:1-4. [doi: 10.1007\/0-306-48581-8_1]","DOI":"10.1007\/0-306-48581-8_1"},{"issue":"2","key":"R78","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1037\/\/0021-843x.97.2.181","article-title":"Contributions from behavioral theories of choice to an analysis of alcohol abuse","volume":"97","author":"Vuchinich","journal-title":"J Abnorm Psychol"},{"issue":"3","key":"R79","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1111\/add.14049","article-title":"The effect of a behavioral activation treatment for substance use on post-treatment abstinence: a randomized controlled trial","volume":"113","author":"Daughters","journal-title":"Addiction"},{"key":"R80","unstructured":"Population, total\u2014Hong Kong SAR. World Bank. 2022. URL: https:\/\/data.worldbank.org\/indicator\/SP.POP.TOTL?locations=HK [Accessed 29-04-2026]"},{"key":"R81","unstructured":"Alcohol use disorder: a comparison between DSM\u2013IV and DSM\u20135 on alcohol abuse or alcoholism. National Institute on Alcohol Abuse and Alcoholism. 2021. URL: https:\/\/www.niaaa.nih.gov\/publications\/brochures-and-fact-sheets\/alcohol-use-disorder-comparison-between-dsm [Accessed 29-04-2026]"},{"key":"R82","unstructured":"Vespa J . The changing economics and demographics of young adulthood: 1975-2016. US Department of Commerce, Economics and Statistics Administration, US Census Bureau; Apr 7, 2017. URL: https:\/\/hispanicad.com\/wp-content\/uploads\/2017\/04\/p20-579.pdf [Accessed 29-04-2026]"},{"issue":"3","key":"R83","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1080\/17525098.2019.1661073","article-title":"The demography of drug abuse in Hong Kong","volume":"12","author":"Liu","journal-title":"China J Soc Work"},{"issue":"4","key":"R84","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1002\/pst.185","article-title":"Sample size of 12 per group rule of thumb for a pilot study","volume":"4","author":"Julious","journal-title":"Pharm Stat"},{"key":"R85","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcbs.2024.100812","article-title":"Taking ACTion for anxiety and depression: a pilot study of a brief virtual acceptance and commitment therapy group in primary care","volume":"33","author":"Johns","journal-title":"J Contextual Behav Sci"},{"issue":"4","key":"R86","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/BF03395679","article-title":"Treating inpatients with comorbid depression and alcohol use disorders: a comparison of acceptance and commitment therapy versus treatment as usual","volume":"59","author":"Petersen","journal-title":"Psychol Rec"},{"issue":"6","key":"R87","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/j.beth.2015.05.005","article-title":"Acceptance and commitment therapy in the treatment of alcohol use disorder and comorbid affective disorder: a pilot matched control trial","volume":"46","author":"Thekiso","journal-title":"Behav Ther"},{"key":"R88","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcbs.2023.06.002","article-title":"Brief acceptance and commitment therapy added to medication management during acute alcohol detoxification: A pilot randomized controlled effectiveness trial","volume":"29","author":"Weststrate","journal-title":"J Contextual Behav Sci"},{"key":"R89","unstructured":"Understanding alcohol drinking patterns. National Institute on Alcohol Abuse and Alcoholism. 2025. URL: https:\/\/www.niaaa.nih.gov\/alcohols-effects-health\/alcohol-drinking-patterns [Accessed 29-04-2026]"},{"key":"R90","unstructured":"Heather N Rollnick S . Readiness to Change Questionnaire: user\u2019s manual. National Drug and Alcohol Research Centre; 1993. URL: https:\/\/ndarc.med.unsw.edu.au\/sites\/default\/files\/ndarc\/resources\/TR.019.pdf [Accessed 29-04-2026]"},{"issue":"4","key":"R91","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.beth.2011.03.007","article-title":"Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance","volume":"42","author":"Bond","journal-title":"Behav Ther"},{"key":"R92","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-026-04273-3","article-title":"Factors associated with alcohol use disorder among young adults from ethnic minorities: a cross-sectional study","author":"Belay","journal-title":"BMC Psychol"},{"issue":"1","key":"R93","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1017\/S1742058X11000087","article-title":"Racial disparities in health: how much does stress really matter?","volume":"8","author":"Sternthal","journal-title":"Du Bois Rev"},{"issue":"10489","key":"R94","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1016\/S0140-6736(25)00672-5","article-title":"CONSORT 2025 statement: updated guideline for reporting randomised trials","volume":"405","author":"Hopewell","journal-title":"Lancet"},{"issue":"6","key":"R95","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","journal-title":"Int J Qual Health Care"},{"issue":"1","key":"R96","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1111\/nhs.12564","article-title":"Accessing health care: experiences of South Asian ethnic minority women in Hong Kong","volume":"21","author":"Vandan","journal-title":"Nurs Health Sci"},{"key":"R97","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S132255","article-title":"Acceptance and commitment therapy for clients institutionalized for severe substance-use disorder: a pilot study","volume":"8","author":"Svanberg","journal-title":"Subst Abuse Rehabil"},{"issue":"5","key":"R98","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1002\/jts.22322","article-title":"Acceptance and commitment therapy for co-occurring posttraumatic stress disorder and alcohol use disorders in veterans: pilot treatment outcomes","volume":"31","author":"Meyer","journal-title":"J Trauma Stress"},{"issue":"4","key":"R99","first-page":"233","volume":"36","author":"Ghodrati","journal-title":"J Med Counc Iran"},{"key":"R100","unstructured":"Harris R . ACT made simple: an easy-to-read primer on acceptance and commitment therapy. New Harbinger Publications; May 1, 2019. URL: https:\/\/www.actmindfully.com.au\/upimages\/ACT_Made_Simple_Introduction_and_first_two_chapters.pdf [Accessed 29-04-2026]"},{"issue":"6","key":"R101","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1111\/apa.13384","article-title":"Understanding type I and type II errors, statistical power and sample size","volume":"105","author":"Akobeng","journal-title":"Acta Paediatr"},{"issue":"2","key":"R102","doi-asserted-by":"publisher","first-page":"141","DOI":"10.15288\/jsa.1994.55.141","article-title":"The Alcohol Abstinence Self-Efficacy Scale","volume":"55","author":"DiClemente","journal-title":"J Stud Alcohol"},{"issue":"2","key":"R103","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1037\/\/0033-295x.84.2.191","article-title":"Self-efficacy: toward a unifying theory of behavioral change","volume":"84","author":"Bandura","journal-title":"Psychol Rev"},{"issue":"12","key":"R104","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/j.addbeh.2011.07.032","article-title":"The role of self-efficacy in the treatment of substance use disorders","volume":"36","author":"Kadden","journal-title":"Addict Behav"},{"issue":"3","key":"R105","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/0306-4603(82)90051-x","article-title":"The application of Bandura\u2019s self-efficacy theory to abstinence-oriented alcoholism treatment","volume":"7","author":"Rollnick","journal-title":"Addict Behav"},{"issue":"4","key":"R106","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1037\/a0024634","article-title":"Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: depression and alcohol outcomes","volume":"58","author":"Reynolds","journal-title":"J Couns Psychol"},{"issue":"9069","key":"R107","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1016\/S0140-6736(97)04572-8","article-title":"The alcohol withdrawal syndrome","volume":"349","author":"Hall","journal-title":"Lancet"},{"issue":"4","key":"R108","first-page":"348","volume":"31","author":"Becker","journal-title":"Alcohol Res Health"},{"issue":"2","key":"R109","doi-asserted-by":"publisher","first-page":"100","DOI":"10.4103\/0972-6748.132914","article-title":"Clinical management of alcohol withdrawal: a systematic review","volume":"22","author":"Kattimani","journal-title":"Ind Psychiatry J"},{"key":"R110","unstructured":"Wayne W . The transtheoretical model (stages of change). Encyclopedia. 2022. URL: https:\/\/encyclopedia.pub\/entry\/30695 [Accessed 29-04-2026]"},{"issue":"4","key":"R111","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1177\/02537176211021280","article-title":"The ceiling effect, the floor effect, and the importance of active and placebo control arms in randomized controlled trials of an investigational drug","volume":"43","author":"Andrade","journal-title":"Indian J Psychol Med"},{"issue":"5","key":"R112","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1177\/10497315241236966","article-title":"Comparative efficacy of online vs. face-to-face group interventions: a systematic review","volume":"35","author":"Rafieifar","journal-title":"Res Soc Work Pract"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2026\/1\/e83896","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:18:05Z","timestamp":1782843485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e83896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":112,"URL":"https:\/\/doi.org\/10.2196\/83896","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"article-number":"v28i12e83896"}}