ICTs such as the internet, websites, online screening tools, and smartphone apps have potential to help reduce alcohol and other drug related harms in Australia. Over 65% of Australian households have internet access and 90% of 16-29 year olds use the internet daily, showing its reach. Current uses of ICTs in AOD include prevention websites, online counseling, and SMS health promotion. ICTs can cost-effectively reach more people, including hard to reach groups, and provide anonymous access to information and treatment. However, ensuring accurate information online and managing potential risks like encouraging harmful behaviors are important challenges.
2. ICT in Australia In 2009 it was estimated that over a quarter of the world’s population used the Internet and that five billion people owned a mobile phone. Over 65 percent of Australian households have internet access and 90 percent of 16–29 year-olds use the internet daily.
3. ICT in Australia Aims of the issues paper: summarise key findings of drug prevention research as it applies to ICT in reducing alcohol and other drug related harms provide examples from the field and practical approaches to usefully inform the work of AOD practitioners
4. Current use of ICT in AOD Prevention focused educational websites, and online screening and assessment Moderated forums, self-directed therapy and online counseling SMS health promotion & smart phone applications Social media & networking for sector and consumer information sharing, and promotion of services and programs
5. ICT opportunities for AOD sector Potential for service providers to cost-effectively reach a much greater population Anonymity of online health information and treatment can reduce barriers to help seeking such as geographic location or stigma Programs are being accessed by previously under-represented groups, such as young people Use of social media and networks to facilitate awareness of services and information sharing in the sector
6. ICT opportunities for AOD sector Counter misinformation and service gaps by providing: accurate and evidence based alcohol and drug relevant information intervention and support, including to new and difficult to reach populations interactivity, tailored content and feedback for consumers including via wireless technologies
7. Potential issues Ill-informed sites and resources can gain a wide audience Social networking and online forums have a potentially powerful influence in terms of the messages they convey (e.g. risk of encouraging harmful or excessive behaviours) Internet as a source of purchasing pharmaceuticals and other drugs
8. Using ICT- Key Informant recommendations Clearly define project objectives and target population Review evidence and consult with target audience Understand the range of expertise required and consider external partnerships Plan funds and resource for ongoing updates Consider and develop risk management strategies Develop online and offline dissemination and marketing strategies
9. Future directions Continue and increase efforts to develop & evaluate ICT based interventions in AOD ICT delivered programs become an established step in health care and treatment response
Editor's Notes
Intro- ContextThe use of information and communication technologies and their application for reducing alcohol and other drug related harms, is an important and timely topic of focus for the ADF Prevention Research Quarterly resource.In Australia, and around the world, we have seen the widespread use and incorporation of information and communication technologies into many aspects of our lives.Over 65% of Australian households have internet access - up to 9 million people use social mediaIncreasing use of ‘smart phones’ - up to 35% of online Australians now using this technology Young people are significant users of the these technologies90% of 16-29 year olds access the internet dailyWide use of ICT for general health promotion, information provision and now treatment
Aims The paper aims to summarise key findings of drug prevention research as it applies to ICT in reducing alcohol and other drug related harms. It includes examples of what is being used in the field and the evidence behind itBy providing practical approaches and case studies, it is hoped that the paper can usefully inform the work of AOD practitioners.
As we will hear today – There are many forms of technology available to deliver programs, to disseminate evidence based information and to communicate with others in the sector, and this technology is changing rapidly. While unable to be all encompassing, it is hoped that this paper can provide a brief snapshot of the range of technologies currently being used and what is known to be effective.- There is now a considerable body of research supporting the efficacy of ICT based treatment of a range of mental health issues including anxiety, depression, and to support smoking cessation. The evidence base for ICT as a tool for the AOD sector is comparatively still developing - but there is a good initial evidence to assist the development of programs.E.g. Strong evidence base for self guided modules and assessmentADDITIONAL NOTES ABOUT DIFFERENT TYPES ICT:wide range of harm reduction and health promotion websites relevant to drug and alcohol use –Sites and resources are progressively incorporating interactive modes of content delivery, using multimedia and ‘social media’ as a means of promoting harm prevention messages.As yet, there is limited evidence of the effects of health promotion websites, however they are shown to have wide dissemination and may attract young help seekers.Websites are also increasingly using validated early screening and brief intervention tools for site users to complete. Use of mobile phones for ICT extends from text reminders for clients, to health promotion messages sent by SMS, to mobile phone applications monitoring substance use and mood. This area is continuing to develop.Preliminary research in smoking cessation treatment and sexual health promotion. - emphasises the potential for low cost and targeted health promotion – and that SMS messages using tailored content and interactivity are likely to improve effect.Early research indicates positive applications of mobile phone and smart phone technologies for self monitoring, receiving harm reduction related feedback and as a support tool for primary care. Moderated forums and communities are online spaces for discussion and advice and are utilised by both clinicians and the community.They may also be a useful adjunct to other treatment such as providing after-care support for face-to-face AOD treatment programs.Initial research suggests that forums may have better outcomes if people who use AOD are encouraged to discuss behaviour-change and strategies rather than focusing on symptoms.Potential risks to be managed - for forums and message boards where submitted comment appears online immediately Online and computer based self-guided programs - are evidence-based treatment modules usually involving assessment, motivational interviewing and/or cognitive behavioural therapy. Often include telephone or email support, or peer-support via moderated forums. Generally, provision of support (by a clinician, coach or administrative staff ) has reported better outcomes than no support.While self-guided interventions are showing efficacy as stand-alone programs, clients perceive support as important,and it may have better long-term outcomes for addictive disorders E-counselling is currently provided by sites via email, or in an immediate “chat” mode. The majority of programs can be accessed anonymously and can provide immediate access to a counsellor (e.g. Kids Help Line or Counselling Online) or by appointmentResearch is yet to demonstrate whether text-based therapy works the same as face-to-face treatments. However, client demographic and usage data suggest that this mode of service delivery is attracting a new cohort of treatment seekers and e-counselling potentially addresses some of the barriers to treatment (e.g. structural factors such as geographic location or individual barriers such as shame or stigma). E-counselling can provide an alternative or adjunct to traditional services.
The anonymity of health information and treatment online resources reduces barriers to help seeking and may be preferred by many consumers, as evidenced by the access to programs by previously under-represented groups such as young people, women and populations with less severe symptoms.
ICT enables significantly expanded opportunities for service providers to cost-effectively reach a much greater population, providing alcohol and drug relevant information that is accurate and evidence based, as well as providing intervention and support. Online and interactive technologies have potential to access new and difficult-to-reach populations, while providing a way to tailor content and feedback. There are a range of issues which are inherent in the context of widespread use of the internet and wireless technologies which are relevant to the AOD sector. Including - ill-informed sites and resources can gain a wide audiencesocial networking and online forums have a potentially powerful influence in terms of the messages they convey – e.g. risk of encouraging harmful or excessive behavioursthe internet as a source of purchasing pharmaceuticals and other drugsThis emphasizes that while the AOD field is still somewhat navigating their role in the many areas of ICT, it is important they continue to use and incorporate these technologies to best provide and disseminate resources and deliver services.
Practitioners and researchers continue to address the gaps in the evidence and develop new initiatives however there are a range of issues for the sector to consider in planning and developing ICT programs. Some practical advice from key experts included These include- -. Making best use of vast array of technologies by developing clear objectives and identification of the target audience-The need to review evidence, consult with the target audience-Consider external partnerships , especially considering the additional expertise that ICT can require to be used effectively.the management of practical, risk and ethical considerations in regard to real-time communication with consumers – such as in forums and social networking
The continued and increased efforts to develop well researched and evaluated ICT based interventions can support a future direction where online and wireless treatment modalities become a recognized part of the health system. Websites and online directories are already an accepted starting point for treatment entry and referral With agency funding and health sector support, it is feasible that ICT delivered programs become a validated and important step in health care and treatment response incorporated as not only a source of information and referral but as adjunct support for primary care. ICT delivered programs become an established step in health care and treatment response -not only a source of information and referral but as adjunct support for primary care.