ABC‐training as a new intervention for hazardous alcohol drinking: Two proof‐of‐principle randomized pilot studies

Abstract

AbstractBackground and AimsABC‐training is a new intervention to encourage health behavior change that targets the automatic activation of adaptive beliefs (i.e. automatic inferences). The aim of this proof‐of‐principle study was to test the effectiveness of web‐based ABC‐training to change outcome expectancies of alcohol drinking in a sample of hazardous drinkers.DesignOne exploratory and one confirmatory experiment with two between‐subject conditions (online ABC‐ and control‐training) and assessments at baseline and 1 week later (after three sessions of training).SettingParticipants recruited on Prolific Academic completed the web‐based study.ParticipantsAdults with self‐reported hazardous alcohol drinking (Experiment 1: 193 adults, United Kingdom, age mean = 46.7 years; Experiment 2: 282 adults, different nationalities, age mean = 38.3 years).Intervention and ComparatorABC‐training involved completing an online task that required choosing personally relevant alternative behaviors to drinking alcohol in personally relevant antecedent contexts to attain personally important outcomes. Comparator was control‐training, in which participants selected both the alternative behaviors and alcohol drinking an equal number of times. Training was completed at baseline, after 3 days and after 1 week.MeasurementsPrimary outcome was change in automatic and self‐reported (negative/positive) outcome expectancies of alcohol drinking from baseline to after 1 week. Secondary outcomes were change in weekly alcohol consumption, self‐efficacy, craving and motivation (and approach‐alcohol associations in Experiment 1). Moderators were baseline outcome scores, motivation, age and alcohol dependency.FindingsFindings of this study are as follows: stronger increase in negative outcome expectancies after ABC‐ than control‐training (Experiment 1: self‐report, 95% confidence interval of difference scores (CIdiff) = [0.04, Inf]; automatic, CIdiff = [0.01, Inf]; Experiment 2: self‐report, CIdiff = [0.16, Inf]; automatic, CIdiff = [0.002, Inf]). Stronger reduction in self‐reported positive outcome expectancies after ABC‐ than control‐training (Experiment 1: CIdiff = [−Inf, −0.01]; Experiment 2: CIdiff = [−Inf, −0.21]) but mixed findings on automatic positive outcome expectancies (Experiment 1: CIdiff = [−Inf, 0.02]; Experiment 2: CIdiff = [−Inf, −0.001]).ConclusionsABC‐training may change outcome expectancies of alcohol consumption, but testing of clinically relevant effects in other samples is warranted.