Improving Help-seeking Propensity Through a Micro-intervention Targeting Common Concerns Among Individuals With Alcohol Problems: A Randomized Controlled Experiment

In Sweden, 4% suffer from alcohol dependency, and up to one-third of all adults have risky consumption of alcohol. This does not only cause suffering for the individual with the problem, but also for their relatives as well as contribute to significant costs for the Swedish society. Moreover, only a small proportion of those with problematic use or dependence of alcohol actually seek-, and receive help. This can be explained by both internal factors, such as feelings of shame and the belief that "one should be able to overcome dependence on their own," as well as external factors like low availability of appealing interventions.

The addiction care in Sweden is unique in that it is a shared responsibility between the regional health care system and the municipalities' social services. The distribution of responsibilities varies significantly across different parts of Sweden, which means that the interventions available to individuals seeking help vary depending on where they live. Previous research has shown that only about 5% of people with alcohol problems wish to seek help through social services, which suggests that in parts of Sweden where social services are the primary treatment option, fewer people may receive help for their issues.

Also, in a previous study that investigated barriers to seek help at social service, fear of consequences and having the problems documented, was identified as one of the largest barriers, with a suggestion that more transparency on how the social service works would reduce this.

Therefore, this study aims to investigate whether more people with problematic alcohol use and alcohol dependency can be encouraged to seek help from social services if they first receive a micro-intervention addressing common barriers to seeking help from social services. The intervention will be based on results from the study mentioned above, targeting the barriers revealed in the results.

The research project will be integrated as an intervention on the already existing website alcoholhjälpen.se, a site and forum run by Region Stockholm that is directed at people with alcohol problems and their relatives throughout Sweden. All users on alcoholhjälpen are anonymous. A new feature will be introduced here: "What help is available locally for me?", which will serve as the entry point to the study. Pre-measurements, consent, phone numbers and email addresses, and the participant's municipality will be collected, as well as asking the participant what is preventing him or her to seek help today. Then the participant will be randomized into either the intervention or control group. The intervention group will receive the micro-intervention, with both information about what is offered in his or her municipality, as well as information about the barriers that the participant has stated. For instance, if the participant has written that fear of losing custody of his or her child, information about how the process goes, and what rights one has as a parent etc will be presented. The control group will receive a referral to their municipality, saying that this is where they seek help. One month later, follow-ups will be conducted to measure the likelihood that the participant will seek help from social services, which is the primary outcome measure.

Inclusion criteria

• Hazardous alcohol use according to AUDIT-C (a score of 3 or more)

Exclusion criteria

• Ongoing care contact at a municipal or regional addiction clinic.