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  • 1.
    Blomqvist, Jenny
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ulfsdotter Gunnarsson, Katarina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Operations management NSV. Dept Med Specialist, Sweden.
    Bendtsen, Marcus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Effects of a text messaging smoking cessation intervention amongst online help-seekers and primary health care visitors: findings from a randomised controlled trial2023In: BMC Medicine, E-ISSN 1741-7015, Vol. 21, no 1, article id 382Article in journal (Refereed)
    Abstract [en]

    Background Smoking continues to be a leading risk factor for several diseases globally. We hypothesised that an intervention delivered via text messages could help individuals who were looking to quit.Methods A two-arm, parallel-groups, randomised controlled trial was employed. Both groups received treatment as usual, with the intervention group also receiving a 12-week text messaging intervention. Participants were adult, weekly or more frequent smokers, recruited online and in primary health care centres. Research personnel were blinded, while participants were not. Primary outcomes were prolonged abstinence and point prevalence of abstinence, 3 and 6 months post-randomisation. All randomised participants were included in analyses.Results Between 18 September 2020 and 16 June 2022, we randomised 1012 participants (intervention: 505, control: 507). Outcome data was available for 67% (n = 682) of participants at 3 months and 64% (n = 643) at 6 months. At 3 months, the odds ratio (OR) of prolonged abstinence was 2.15 (95% compatibility interval [CoI] = 1.51; 3.06, probability of effect [POE] > 99.9%, p < 0.0001), and for point prevalence of abstinence, it was 1.70 (95% CoI = 1.18; 2.44, POE = 99.8%, p = 0.0034) in favour of the text messaging intervention. At 6 months, the OR of prolonged abstinence was 2.38 (95% CoI = 1.62; 3.57, POE > 99.9%, p = < 0.0001), and for point prevalence, it was 1.49 (95% CoI = 1.03; 2.14, POE = 98.3%, p = 0.0349) in favour of the text messaging intervention. Analyses with imputed data were not markedly different.Conclusions Amongst general population help-seekers-who on average had smoked for 25 years-access to a 12-week text messaging intervention produced higher rates of self-reported smoking abstinence in comparison to treatment as usual only. The intervention could be part of the societal response to the burden which smoking causes; however, findings are limited by risk of bias due to attrition, self-reported outcomes, and lack of blinding.

  • 2.
    Shorter, G. W.
    et al.
    Queens Univ Belfast, North Ireland; Queens Univ Belfast, North Ireland.
    Campbell, K. B. D.
    Queens Univ Belfast, North Ireland; Queens Univ Belfast, North Ireland.
    Miller, N. M.
    Univ West London, England.
    Epton, T.
    Univ Manchester, England.
    OHara, L.
    Queens Univ Belfast, North Ireland; Queens Univ Belfast, North Ireland.
    Millen, S.
    Queens Univ Belfast, North Ireland; Queens Univ Belfast, North Ireland.
    Ulfsdotter Gunnarsson, Katarina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Berry, E.
    Queens Univ Belfast, North Ireland.
    Bendtsen, Marcus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Few Interventions Support the Affected Other on Their Own: a Systematic Review of Individual Level Psychosocial Interventions to Support Those Harmed by Others Alcohol Use2023In: International Journal of Mental Health and Addiction, ISSN 1557-1874, E-ISSN 1557-1882Article, review/survey (Refereed)
    Abstract [en]

    Over 100 million individuals worldwide experience negative outcomes as a function of a family member or loved ones substance use. Other reviews have summarized evidence on interventions; however, success often depends on the behavior of the individual causing harm, and they may not be ready or able to change. The aim of this study was to identify and describe evaluations of psychosocial interventions which can support those affected by alcohol harm to others independent of their drinking relative or friend. A systematic review/narrative synthesis of articles from 11 databases pre-registered on PROSPERO (CRD42021203204) was conducted. Those experiencing the harm were spouses/partners or adult children/students who have parents with alcohol problems. Studies (n = 7) were from the UK, the USA, Korea, Sweden, Mexico, and India. Most participants were female (71-100%). Interventions varied from guided imagery, cognitive behavioral therapy, motivational interviewing, and anger management. Independent interventions may support those affected by anothers alcohol use, although there was considerable variation in outcomes targeted by the intervention design. Small-scale studies suggest psychosocial interventions ease suffering from alcohols harm to others, independent of the drinking family member. Understanding affected others experience and need is important given the impact of alcohols harm to others; however, there is a lack of quality evidence and theoretical underpinning informing strategies to support these individuals.

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  • 3.
    Ulfsdotter Gunnarsson, Katarina
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    McCambridge, Jim
    Univ York, England.
    Bendtsen, Marcus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Reactions to being allocated to a waiting list control group in a digital alcohol intervention trial2023In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 107, article id 107572Article in journal (Refereed)
    Abstract [en]

    Objective: To study reactions of control group participants allocated to two different presentations of basic health information in a digital alcohol intervention trial.Method: Control participants were randomised to wait with one of two different presentations of basic health information. Multiple choice questions and free-text comments assessed reactions, four months post random-isation. Effects of differential health information on responses were estimated, as were associations between responses, baseline characteristics and change in alcohol consumption.Result: Of 1066 control group participants, 572 (54%) responded to the questionnaire. Contrasting two different presentations of basic health information revealed no statistically significant differences. Responses revealed that 38% were interested sufficiently to look at the information while 42% felt frustration, irritation, or disap-pointment about having to wait. Approximately 55% responded that they decided to reduce their drinking whilst 17% stated that they continued to drink as usual, and 11% gave up on the idea of reducing their drinking. The two latter groups reported markedly higher alcohol consumption at follow-up in comparison to the former (probability of association >99.9%).Conclusion: Being made to wait may invite negative research participation effects. Practice implication: Comparator guidance should be updated to reflect the potentially negative consequences which are under researched.

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  • 4.
    Bendtsen, Marcus
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ulfsdotter Gunnarsson, Katarina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    McCambridge, Jim
    Univ York, England.
    Effects of a waiting list control design on alcohol consumption among online help-seekers: protocol for a randomised controlled trial2021In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 8, article id e049810Article in journal (Refereed)
    Abstract [en]

    Introduction Sparse attention has been given to the design of control conditions in trials, despite their important role as contrasts for novel treatments, and thus as a key determinant of effect sizes. This undermines valid inferences on effect estimates in trials, which are fundamentally comparative in nature. Such challenges to understanding also makes generalisation of effect estimates complex, for example, it may not be clear to what degree real-world alternatives to the novel treatments in pragmatic trials are similar to the control conditions studied. The present study aims to estimate the effects of being allocated to a waiting list control condition. Methods and analysis Individuals searching online for help to reduce their drinking will be invited to take part in a study. Individuals aged 18 years or older, who in the past month consumed six or more drinks on one occasion, or consumed 10 or more drinks the past week, will be eligible to participate. Both groups will receive identical feedback and advice on behaviour change; however, one group will be informed that they have to wait 1 month for the intervention materials. One month postrandomisation, participants will receive an email with the follow-up questionnaire measuring the primary outcomes: (1) frequency of heavy episodic drinking (defined as at study entry) in the past month; and (2) overall past week alcohol consumption. Differences between groups will be analysed using negative binomial regression models estimated using Bayesian inference. Recruitment will begin in October 2021. A Bayesian group sequential design will be employed to determine when to end enrolment (expected to be between 500 and 1500 individuals). Ethics and dissemination The study was approved by the Swedish Ethical Review Authority on 2021-01-25 (Dnr 2020-06267). Findings will be disseminated in open access peer-reviewed journals no later than 2023.

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