Internet-based interventions — messages that click

Dr. Peter Tossmanndelphi-Gesellschaft für Forschung, Beratung und Projektentwicklung mbH, Berlin

EMCDDA ConferenceIdentifying Europe’s information needs for effective drug policyLisbon, 6–8 May 2009

Initial situation

EIAA Mediascope Europe, 2008

178 Million people in Europe have access to the internet

55% of all internet users in Europe are online daily

42% of all internet users in Europe are looking for health information via the internet

Internet and health communication

Informational websites

Forums for discussion and self help / blogs

Interactive tests

Counselling via Chat, E-Mail

Structured intervention programmes

The objective of this review is

to give an overview of existing internet-based drug treatment interventions in the EU Member States and

to describe examples of good practice

EMCDDA-Study (2008): Review on Internet-based drug treatment interventions

..... a specifically elaborated or adapted, structured and scheduled drug treatment intervention, offered on and communicated over the World Wide Web.

What is an “Internet-based drug treatment intervention” ?

Definition:

Methods

Survey within the Reitox network30 National Focal Points: Are you aware of internet-based drug treatment interventions in your country

Literature investigationSearch-terms: ‘internet-based’, ‘web-based’, ‘treatment’,

‘programme’, ‘drug’, ‘cocaine’, ‘cannabis’

Internet-based drug treatment intervention in EU member states: Four programmes focusing cannabis users

Results

Live Onlinebehandeling Cannabis

Initiation Date: Dec 2004

Type of programme: free self-help programme

Recommended/Scheduled duration of the intervention: 4 - 6 Weeks

Programme elements: craving and smoking diary tailored feedback relapse prevention („emergency plan“) information

Evaluation:

year visitors users signed in users competed

2006 33,464 1,419 125 (8.8%)

2007 52,801 1,558 138 (8.9%)

Live Onlinebehandeling Cannabis

Initiation Date: May 2008

Type of programme:

Recommended/Scheduled duration of the intervention: 10 Weeks

fee-based programme including scheduled contact with counsellor

Live Onlinebehandeling Cannabis

identification of personal risk situations

forum

personal goal setting

tailored feedback

smoking and craving diary

exercise: how to cope with craving and peer pressure?

Programme elements:

Initiation Date: Jan 2008

Type of programme: fee-based programme including scheduled contact with counsellor

Recommended/Scheduled duration of the intervention: 3 month

Programme elements: craving diary Pros & Cons Balance risk analysis development of a personal treatment plan working with risk situation emergency plan

From January 2008 until May 2008, 400 participants.

Evaluation:

Initiation Date: Aug 2004

Type of programme: free programme including scheduled contact with counsellor

Recommended/Scheduled duration of the intervention: 50 days

Programme elements: initial chat session with a counsellor (50 mins) diary weekly feedback from the counsellor final chat session

Number of participants 2008: 524Number of participants since Aug 2004: 2,145

Evaluation:

Structure of the survey

Start-up-questionnaire

• Socio-demographics• Cannabis consumption (quantity, freq.)• Psychological well-being• Motives for / against consumption • Consumption-related self-efficacy

Delay-conditionParticipation at the programme

3 M

onth

s

Follow-up

• Cannabis consumption (quantity, freq.)• Psychological well-being• Consumption-related self-efficacy• Receiving of other treatment

Evaluation of the „quit the shit“ Programme

Study Population: N=206 participants

Cannabis: Consumption & dependence• On average on 27 days during the last 30 days• On average 15 grams during the last 30 days

(high variance)• 95% are addicted to cannabis (DSM IV)

Retention rate• 44% of the participants completed the programme regularly

Socio-demographic data• Significantly more male participants (74%)• Average age: 25 yrs. (MD) (youngest: 14 yrs.; oldest: 59 yrs.)• Relatively high education: 49% attend Gymnasium (lycée) or have

reached Abitur (bac)

Evaluation of the „quit the shit“ Programme

T(187,02)=6,593; p<.001; d = 0,98

Results: Days of consumption within the past 30 days

T(166,969)=5,174; p<.001; d = 0,74

Consumed amount (grams) within the past 30 daysResults:

Summary

The internet is a quite new area for preventing and treating drug use

Most of the EU member states provide informational websites.

All of the existing programmes target cannabis users who want to reduce or quit

There remains a lack of experience with these programmes

Some initial results seem to be promising

Further evaluation work needs to be done

Thank you!

Dr. Peter Tossmanntossmann@delphi-gesellschaft.de