Brief or extended online alcohol intervention: does more content mean better results?

What is it about?

Brief internet-based interventions for problem drinking have an established evidence base, but little is known about whether offering a more extended online programme produces greater reductions in alcohol consumption. This randomised controlled trial recruited 490 problem drinkers aged 18 and over through online advertising in Canada and randomised them to either a brief intervention (CheckYourDrinking.net, a single-session personalised feedback tool) or a more extended multi-component programme (AlcoholHelpCentre.net). Participants were followed up at 6, 12 and 24 months, with a primary analysis at 12 months using AUDIT-C scores and secondary outcomes including typical weekly drinks and maximum drinks on a single occasion. The follow-up rate at 12 months was 83%. Analyses found no statistically significant differences between the two interventions on any outcome measure, suggesting that adding more programme content did not produce additional reductions in drinking beyond what the brief intervention achieved.

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Why is it important?

The finding that a brief single-session online tool produced comparable outcomes to a far more extensive programme has direct implications for how digital alcohol interventions are designed and resourced. From a public health perspective, if brief interventions are equally effective, they are also far more scalable, cheaper to deliver and lower in participant burden, which matters considerably when the goal is population-level reach among people who drink at risky levels and are unlikely to seek formal treatment. The study contributes to an ongoing evidence base on the optimal dose and format of digital behaviour change interventions for alcohol, and its null finding on extended content challenges assumptions that more intensive digital delivery is always preferable. It remains a relevant reference point for decisions about the design of online alcohol brief intervention programmes.