# Investigating the added effects of guidance in digital psychological self-care for alcohol problems (ALVA)—protocol for a randomized factorial optimization trial

## TL;DR

This study explores how adding guidance to a digital self-care program for alcohol problems affects its effectiveness and efficiency.

## Contribution

The study introduces a factorial trial to optimize guidance methods in digital psychological self-care for alcohol use.

## Key findings

- A feasibility study showed ALVA had promising effects on alcohol consumption without guidance.
- The trial will compare mid-treatment interviews and weekly messages as guidance methods.
- Results will be evaluated based on alcohol reduction and clinician time spent.

## Abstract

The continual development and implementation of effective digital interventions is one important strategy that may serve to bridge the well-known treatment gap related to problematic alcohol use. Research suggests that clinician guidance, provided in different ways during the digital intervention (i.e., written weekly messages, phone calls etc.), can boost intervention engagement and effects. Digital psychological self-care (DPSC) is a new delivery format wherein an unguided digital intervention is provided within the framework of a structured care process that includes initial clinical assessment and follow-up interviews. In a recent feasibility study, a DPSC intervention for problematic alcohol use, ALVA, provided without any extra guidance, was found safe and credible and to have promising within-group effects on alcohol consumption. The aim of the current study is to gather information on the effects and efficiency of different forms of guidance added to ALVA, in order to optimize the intervention.

This protocol describes a randomized factorial trial where the effects of two different ways of providing guidance (mid-treatment interview, weekly written messages, respectively) in DPSC for problematic alcohol use are investigated. Optimization criteria will be applied to the results regarding how effective the intervention is at reducing alcohol consumption measured by the number of standard drinks per week together with the clinician time spent on guidance.

This study will investigate the added benefit of different forms of guidance to DPSC for problematic alcohol use. These added effects will be compared to the added cost of guidance, according to pre-defined optimization criteria.

Clinicaltrials.gov: NCT05649982. Registered on 06 December 2022. Prospectively registered.