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@ARTICLE{McDermott:276760,
      author       = {K. T. McDermott and C. Noake and R. Wolff and C. Espina and
                      J. Foucaud and K. Steindorf$^*$ and J. Schüz and M. A.
                      Thorat and M. Weijenberg and L. Bauld and J. Kleijnen},
      title        = {{D}igital interventions to moderate alcohol consumption in
                      young people: a {C}ancer {P}revention {E}urope overview of
                      systematic reviews.},
      journal      = {Frontiers in digital health},
      volume       = {5},
      issn         = {2673-253X},
      address      = {Lausanne},
      publisher    = {Frontiers Media},
      reportid     = {DKFZ-2023-01141},
      pages        = {1178407},
      year         = {2023},
      abstract     = {Strategies to reduce alcohol consumption would contribute
                      to substantial health benefits in the population, including
                      reducing cancer risk. The increasing accessibility and
                      applicability of digital technologies make these powerful
                      tools suitable to facilitate changes in behaviour in young
                      people which could then translate into both immediate and
                      long-term improvements to public health.We conducted a
                      review of systematic reviews to assess the available
                      evidence on digital interventions aimed at reducing alcohol
                      consumption in sub-populations of young people [school-aged
                      children, college/university students, young adults only
                      (over 18 years) and both adolescent and young adults (<25
                      years)].Searches were conducted across relevant databases
                      including KSR Evidence, Cochrane Database of Systematic
                      Reviews (CDSR) and Database of Abstracts of Reviews of
                      Effects (DARE). Records were independently screened by title
                      and abstract and those that met inclusion criteria were
                      obtained for full text screening by two reviewers. Risk of
                      bias (RoB) was assessed with the ROBIS checklist. We
                      employed a narrative analysis.Twenty-seven systematic
                      reviews were included that addressed relevant interventions
                      in one or more of the sub-populations, but those reviews
                      were mostly assessed as low quality. Definitions of 'digital
                      intervention' greatly varied across systematic reviews.
                      Available evidence was limited both by sub-population and
                      type of intervention. No reviews reported cancer incidence
                      or influence on cancer related outcomes. In school-aged
                      children eHealth multiple health behaviour change
                      interventions delivered through a variety of digital methods
                      were not effective in preventing or reducing alcohol
                      consumption with no effect on the prevalence of alcohol use
                      [Odds Ratio (OR) = 1.13, $95\%$ CI: 0.95-1.36, review rated
                      low RoB, minimal heterogeneity]. While in adolescents and/or
                      young adults who were identified as risky drinkers, the use
                      of computer or mobile device-based interventions resulted in
                      reduced alcohol consumption when comparing the digital
                      intervention with no/minimal intervention (-13.4 g/week,
                      $95\%$ CI: -19.3 to -7.6, review rated low RoB, moderate to
                      substantial heterogeneity).In University/College students, a
                      range of E-interventions reduced the number of drinks
                      consumed per week compared to assessment only controls
                      although the overall effect was small [standardised mean
                      difference (SMD): -0.15, $95\%$ CI: -0.21 to -0.09].
                      Web-based personalised feedback interventions demonstrated a
                      small to medium effect on alcohol consumption (SMD: -0.19,
                      $95\%$ CI: -0.27 to -0.11) (review rated high RoB, minimal
                      heterogeneity). In risky drinkers, stand-alone Computerized
                      interventions reduced short (SMD: -0.17, $95\%$ CI: -0.27 to
                      -0.08) and long term (SMD: -0.17, $95\%$ CI: -0.30 to -0.04)
                      alcohol consumption compared to no intervention, while a
                      small effect (SMD: -0.15, $95\%$ CI: -0.25 to -0.06) in
                      favour of computerised assessment and feedback vs.
                      assessment only was observed. No short-term (SMD: -0.10,
                      $95\%$ CI: -0.30 to 0.11) or long-term effect (SMD: -0.11,
                      $95\%$ CI: -0.53 to 0.32) was demonstrated for computerised
                      brief interventions when compared to counsellor based
                      interventions (review rated low RoB, minimal to considerable
                      heterogeneity). In young adults and adolescents, SMS-based
                      interventions did not significantly reduce the quantity of
                      drinks per occasion from baseline (SMD: 0.28, $95\%$ CI:
                      -0.02 to 0.58) or the average number of standard glasses per
                      week (SMD: -0.05, $95\%$ CI: -0.15 to 0.05) but increased
                      the risk of binge drinking episodes (OR = 2.45, $95\%$ CI:
                      1.32-4.53, review rated high RoB; minimal to substantial
                      heterogeneity). For all results, interpretation has
                      limitations in terms of risk of bias and
                      heterogeneity.Limited evidence suggests some potential for
                      digital interventions, particularly those with feedback, in
                      reducing alcohol consumption in certain sub-populations of
                      younger people. However, this effect is often small,
                      inconsistent or diminishes when only methodologically robust
                      evidence is considered. There is no systematic review
                      evidence that digital interventions reduce cancer incidence
                      through alcohol moderation in young people. To reduce
                      alcohol consumption, a major cancer risk factor, further
                      methodologically robust research is warranted to explore the
                      full potential of digital interventions and to form the
                      basis of evidence based public health initiatives.},
      subtyp        = {Review Article},
      keywords     = {alcohol consumption (Other) / digital health, cancer
                      (Other) / evidence assessment (Other) / evidence synthesis
                      (Other) / public health (Other) / systematic reviews
                      (Other)},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37288171},
      pmc          = {pmc:PMC10243367},
      doi          = {10.3389/fdgth.2023.1178407},
      url          = {https://inrepo02.dkfz.de/record/276760},
}