Web-Based Coping Skills Training and Coach Support for Women Living With a Partner With an Alcohol Use Disorder: Randomized Controlled Trial (Preprint)

Author:

Rychtarik Robert GORCID,Danaher Brian GORCID,McGillicuddy Neil BORCID,Tyler Milagra SORCID,Barrick ChristopherORCID,Leong FlorenceORCID,Kosty Derek BORCID

Abstract

BACKGROUND

Individuals living with a partner with an alcohol use disorder (AUD) can experience significant psychological distress and use health care more than those without a partner with an AUD. However, the prevailing treatment system’s focus on the partner and personal barriers limit these individuals from getting help for themselves. Preliminary work on a self-directed, web-based coping skills training program, <i>Stop Spinning My Wheels</i> (SSMW), shows promise in broadening available treatments for this population. In this study, we conducted a robust evaluation of SSMW primary outcomes.

OBJECTIVE

The study aims to test whether women with a partner with an AUD assigned to SSMW experienced a greater reduction in negative affect (depression and anger) (1) than a usual web care (UWC) control and (2) with brief phone coach support (SSMW+coach) rather than without (SSMW only) and (3) whether baseline negative affect moderated treatment effects.

METHODS

Women (mean age 45.7, SD 10.8 years; Black: 17/456, 3.7%; White: 408/456, 89.5%) were randomized to SSMW only, SSMW+coach, or UWC. Depression (Beck Depression Inventory–II) and anger (State-Trait Anger Expression Inventory 2–State Anger) were assessed at baseline, 12-week posttest, and 6- and 12-month follow-ups.

RESULTS

Participants in all conditions decreased in depression from baseline to posttest and from baseline to follow-up; SSMW-only and SSMW+coach participants decreased in anger, but UWC participants did not. Compared to UWC participants, SSMW-only participants experienced greater anger reduction (<i>P</i>=.03), and SSMW+coach participants experienced a greater reduction in depression (<i>P</i>&lt;.001) from baseline to posttest. However, from baseline to follow-up, only a greater, but not statistically significant (<i>P</i>=.052), reduction in anger occurred in SSMW+coach compared to UWC. Although the SSMW conditions did not differ from each other in negative affect outcomes (<i>P=</i>.06-.57), SSMW+coach had higher program engagement and satisfaction (all <i>P</i>&lt;.004). Baseline negative affect did not moderate effects, although remission from baseline clinically relevant depressive symptoms (Beck Depression Inventory≥14) was higher in SSMW only (33/67, 49%; odds ratio 2.13, 95% CI 1.05-4.30; <i>P=</i>.03) and SSMW+coach (46/74, 62%; odds ratio 3.60, 95% CI 1.79-7.23; <i>P</i>&lt;.001) than in UWC (21/67, 31%); remission rates did not differ between the SSMW conditions (<i>P=</i>.12).

CONCLUSIONS

The results partially supported the hypotheses. The SSMW conditions had earlier effects than UWC, but positive change in UWC mitigated the hypothesized long-term SSMW-UWC differences. The results highlight the importance of incorporating active controls in web-based clinical trials. Although SSMW+coach showed benefits over SSMW only on engagement and satisfaction measures and in the number needed to treat (5.6 for SSMW only; 3.2 for SSMW+coach), the SSMW conditions were comparable and superior to UWC on depressive symptom remission levels. Overall, SSMW with or without a coach can reduce clinically meaningful distress and add to available treatment options for this large, underserved group.

CLINICALTRIAL

ClinicalTrials.gov NCT02984241; https://www.clinicaltrials.gov/study/NCT02984241

Publisher

JMIR Publications Inc.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3