Table 7 Summary results of included systematic reviews, for digital interventions
Intervention | Population | Comparator | Outcome | Timeframe | Effect size (method: effect (95% CI)) | I2 | Publication bias | Number of RCTs | Quality assessment of RCTs |
|---|---|---|---|---|---|---|---|---|---|
Mobile text messaging [32] | Risky drinker | Minimal/no contact, basic health information up to once a week, referral to information sources or primary health care with reminders up to once a week, or intervention not focussed on alcohol consumption | Weekly alcohol consumption (grams) | 1–15 months | MD: -18.62 (-39.61, 2.38) | 66% | No | 5 | Low |
Heavy episode drinking per month | 1–15 months | MD: -0.33 (-0.79, 0.12) | 41% | Yes (very small) | 7 | Low | |||
Computer-delivered intervention [102] | College or university students | No treatment control | Alcohol consumption per week/ month |  ≤ 13 weeks | WMD: 0.14 (0.03, 0.24) | 80% | NR | 28 | Moderate |
14–26 weeks | WMD: 0.13 (− 0.01, 0.27) | 0% | NR | 8 | Moderate | ||||
 ≥ 27 weeks | WMD: 0.08 (− 0.09, 0.26) | 0% | NR | 5 | Moderate | ||||
Frequency of heavy drinking days |  ≤ 13 weeks | WMD: 0.13 (0.02, 0.24) | 67% | NR | 17 | Moderate | |||
14–26 weeks | WMD: 0.17 (− 0.05, 0.39) | 0% | NR | 4 | Moderate | ||||
 ≥ 27 weeks | WMD: 0.13 (− 0.01, 0.26) | 0% | NR | 5 | Moderate | ||||
e-interventions (including CD-ROM-based, web-based, IVR, or mobile applications [35] | Adults at high risk of AUD or a diagnosis of AUD | Inactive controls | Weekly alcohol consumption (grams) | 6Â months | MD: -25.0 (-59.3, 9.3) | 54.5% | No | 6 | Low |
12Â months | MD: -8.6 (-53.7, 36.5) | 73% | No | 5 | Low | ||||
Control | Abstinence | NR | OR: 1.94 (1.14, 3.31) | NR | No | 3 | Low | ||
College students at high risk of AUD or a diagnosis of AUD | Inactive controls | Weekly alcohol consumption (grams) | 6Â months | MD: -12.4 (-26.6, 1.9) | 41% | No | 8 | Low | |
Binge drinking episodes | 6Â months | MD: -0.1 (-1.0, 0.9) | 45.5% | No | 4 | Moderate | |||
BI web-based [36] | Military and veterans | Control | Self-reported alcohol consumption | 6 – 20 months | WMD: 1.81 (-0.06, 3.68) | 79.4% | NR | 6 | Mean quality rating score: 20 out of 32 |
Death | 6Â months | RR: 0.42 (0.19, 0.94) | NR | NR | 9 | ||||
1Â year | RR: 0.60 (0.40, 0.91) | NR | NR | 9 | |||||
Electronic screening and brief intervention (eSBI) (brief intervention comprised of a single session, ranging from 5–45 min in duration, and up to a maximum of 4 sessions) [37] | Hazardous alcohol consumption | Control condition (care as usual, assessment only, non-intervention) | Weekly alcohol consumption (grams) | 0–3 months | MD: -32.74 (-56.80, -8.68) | 53.5% | No | 9 | Moderate |
3–6 months | MD: -17.33 (-31.82, -2.84) | 30.4% | No | 8 | NR | ||||
6–12 months | MD: -14.91 (-25.56, -4.26) | 26.7% | No | 10 | NR | ||||
 >  = 12 months | MD: -7.46 (-25.34, 10.43) | 41.1% | No | 7 | NR | ||||
Social norms interventions delivered via web/ computer feedback [41] | University and college students | No intervention (assessment only or alcohol information or alternative (non-normative) intervention) | Number of drinking days per week | 4 + months | SMD: -0.12 (-0.18, -0.05) | 38% | Suspected | 9 | Moderate |
Technology-based interventions (TBIs) such as website, text messages, and tablet [108] | Women of childbearing age (18 to 45 years old), any level of drinking behaviour | Inactive (no treatment, waitlist control, treatment as usual) or active (non–TBIs) controls | Combined outcomes of alcohol consumption | Min: 4 weeks; Max: 6 months | SMD: 0.13 (-0.03, 0.29) | NR | No | 11 | Moderate |
Alcohol misuse prevention course (AlcoholEdu) [43] | College students with any drinking behaviour | No intervention | Quantity of alcohol use | 0–3 months | SMD: -0.13 (- 0.22,—0.04) | NR | Yes | 52 | Low |
3–6 months | SMD: -0.07 (- 0.55, 0.42) | NR | Yes | 52 | Low | ||||
Frequency of alcohol use | 0–3 months | SMD: -0.04 (-0.15, 0.06) | NR | Yes | 52 | Low | |||
Brief Alcohol Screening and Intervention for College Students (BASICS) [43] | College students with any drinking behaviour | No intervention | Quantity of alcohol use | 0–3 months | SMD: -0.26 (-0.36, -0.16) | NR | Yes | 52 | Low |
3–6 months | SMD: -0.23 (-0.44, -0.02) | NR | Yes | 52 | Low | ||||
Frequency of alcohol use | 0–3 months | SMD: -0.36 (-0.55, -0.18) | NR | Yes | 52 | Low | |||
Electronic CHECKUP TO GO (e-CHUG): Personalized prevention intervention to motivate individuals to reduce alcohol or marijuana consumption [43] | College students with any drinking behaviour | No intervention | Quantity of alcohol use | 0–3 months | SMD: -0.25 (-0.45, -0.05) | NR | Yes | 52 | Low |
3–6 months | SMD:—0.12 (-0.39, 0.16) | NR | Yes | 52 | Low | ||||
Frequency of alcohol use | 0–3 months | SMD: -0.15 (-0.44, -0.14) | NR | Yes | 52 | Low | |||
Tertiary Health Research Intervention Via Email (THRIVE) [43] | College students with any drinking behaviour | No intervention | Quantity of alcohol use | 0–3 months | SMD:—0.47 (- 0.60,—0.33) | NR | Yes | 52 | Low |
3–6 months | SMD:—0.47 (-0.95, 0.02) | NR | Yes | 52 | Low | ||||
Frequency of alcohol use | 0–3 months | SMD:—0.15 (-0.44, 0.14) | NR | Yes | 52 | Low | |||
Personalised digital intervention (including web-based, mobile phone text messaging, smartphone apps, social networking, or standalone computer-based technologies [45] | People living in the community | No or minimal intervention | Quantity of drinking (g/week) | 1 to 12Â months | MD: -22.84 (-30.31, -15.36) | 78% | Yes | 41 | Moderate |
Frequency of drinking | 1 to 12Â months | MD: -0.16 (-0.24, -0.09) | 39% | NR | 16 | Moderate | |||
Frequency of binge drinking | 1 to 12Â months | MD: -0.24 (-0.35, -0.13) | 53% | NR | 15 | Moderate | |||
Binge drinkers | 1 to 12Â months | MD: 0.98 (0.97, 1.0) | 0% | NR | 9 | NR | |||
Intensity of drinking | 1 to 12Â months | MD: -4.63 (-8.01, -1.23) | 83% | NR | 15 | Moderate | |||
Face-to-face intervention | Quantity of drinking (g/week) | 1 to 24Â months | MD: 0.52 (-24.59, 25.63) | NA | NR | 5 | Low | ||
Frequency of binge drinking | 1 to 24Â months | MD: 0.04 (-0.15, 0.22) | 0% | NR | 3 | Low | |||
Distance-based alcohol moderation [50] | Cancer survivors, drank alcohol in the past week | No intervention or brochures | Combined outcomes (days of drinking, AUDIT score, consumption) | NR (mean: 10Â months) | SMD: 0.12 (-0.08, 0.31) | 0% | NR (inadequate studies) | 3 | Risk of bias concerns for all RCTs, especially in selection of the reported result |
Personalised feedback [54] | College students and the adult population | Control condition (e.g., assessment only, waitlist, or minimal intervention) | Alcohol-drinking behaviour (e.g., frequency or quantity) | 1.6Â weeks to 9Â months | SMD: 0.22 (0.16, 0.29) | 0% | No | 14 | NR |
Internet-based alcohol interventions (iAIs) including internet and CD-ROM [110] | Alcohol use disorders | Control conditions (information, assessment-only, waiting list) | Alcohol consumption | 4Â weeks to 9Â months | Hedges g: 0.44 (0.17, 0.71) | 81.08% | No | 9 | All studies used well-validated alcohol consumption measures and well-described, theoretically based interventions. Dropout rates differed from 0 to 42% |
Low-intensity self-help intervention, performed on computer or mobile phone, with or without guidance from a professional [111] | Alcohol drinkers who exceeded local guidelines for low-risk drinking | Assessment only, waitlisted or alcohol information brochure control condition | Quantity consumed (mixture of subjective and objective) | 0Â months (post-test) | SMD: 0.2 (0.13, 0.27) | 27% | Yes | 16 | The risk of bias varied among studies |
6–12 months | SMD: 0.06 (-0.14, 0.25) | NR | NR | 8 | NR | ||||
Internet-based alcohol interventions (iAIs) including internet, SMS, phone, CD-ROM [112] | Regular drinker and problem drinkers (exclude students and pregnant women) | Control condition (e.g., assessment only, waitlist, or minimal intervention) | Mean weekly alcohol consumption | 1–12 month | MD: -5.02 (-7.57, -2.48) | 90% | Yes | 19 | High |
Computer-delivered intervention [113] | No specific population | Active comparison (cognitive-behavioural therapy: CBT), attention/placebo (assessment only, placebo, and treatment as usual) | Combined outcomes of alcohol consumptions | 1–156 weeks | SMD 0.22 (0.14,0.29) | NR | NR | 28 | Non-significant Pearson correlations between treatment effect and methodological quality score (r = 0.13, P = 0.40) |
Personalised normative feedback (able to be delivered remotely) [53] | Hazardous alcohol use | Passive control | Number of drinking days last month | 12–23 months | SMD: -0.02 (-0.15, 0.11) | 0% | NR | 2 | Low |
Symptom severity (RAPI score) | 12–23 months | SMD: 0.13 (-0.01, 0.26) | 0% | NR | 2 | Low | |||
Personalised normative feedback combined with other self-directed interventions [53] | Hazardous alcohol use | Passive control | Number of drinking days last month | 12–23 months | SMD: -0.01 (-0.14, 0.12) | 0% | NR | 2 | Low |
Symptom severity (RAPI score) | 12–23 months | SMD: 0.24 (0.11, 0.37) | 0% | NR | 2 | Low | |||
Computer assessment and feedback [55] | At risk drinking | Counsellor assessment and feedback | Alcohol consumption | 0–6 months | SMD: -0.1 (-0.3, 0.11) | 51% | NR | 6 | Very low |
Alcohol consumption |  > 6 months | SMD: -0.11 (-0.53, 0.32) | 81% | NR | 2 | Very low |