A systematic review and behaviour change technique analysis of remotely delivered alcohol and/or substance misuse interventions for adults

Neil Howlett, Jaime García-iglesias, Charis Bontoft, Gavin Breslin, Suzanne Bartington, Imogen Freethy, Monica Huerga-malillos, Julia Jones, Nigel Lloyd, Tony Marshall, Stefanie Williams, Wendy Wills, Katherine Brown

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)
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There has been a lack of systematic exploration of remotely delivered intervention content and their effectiveness for behaviour change outcomes. This review provides a synthesis of the behaviour change techniques (BCT) contained in remotely delivered alcohol and/or substance misuse approaches and their association with intervention promise.

Searches in MEDLINE, Scopus, PsycINFO (ProQuest), and the Cochrane Library, included studies reporting remote interventions focusing on alcohol and/or substance misuse among adults, with a primary behaviour change outcome (e.g., alcohol levels consumed). Assessment of risk of bias, study promise, and BCT coding was conducted. Synthesis focussed on the association of BCTs with intervention effectiveness using promise ratios.

Studies targeted alcohol misuse (52 studies) or substance misuse (10 studies), with predominantly randomised controlled trial designs and asynchronous digital approaches. For alcohol misuse studies, 16 were very promising, 17 were quite promising, and 13 were not promising. Of the 36 eligible BCTs, 28 showed potential promise, with seven of these only appearing in very or quite promising studies. Particularly promising BCTs were ‘Avoidance/reducing exposure to cues for behaviour’, ‘Pros and cons’ and ‘Self-monitoring of behaviour’. For substance misuse studies, three were very promising and six were quite promising, with all 12 BCTs showing potential promise.

This review showed remotely delivered alcohol and substance misuse interventions can be effective and highlighted a range of BCTs that showed promise for improving services. However, concerns with risk of bias and the potential of promise ratios to inflate effectiveness warrant caution in interpreting the evidence.
Original languageEnglish
Article number109597
JournalDrug and Alcohol Dependence
Early online date8 Aug 2022
Publication statusPublished (in print/issue) - 1 Oct 2022

Bibliographical note

Funding Information:
This work is part of the NIHR-funded Project “New models of remote delivery, in drug and alcohol services, introduced during Covid-19″ (Award number: NIHR133206 ), conducted by the PHIRST (Public Health Intervention Responsive Studies Team) funded by NIHR Public Health Research funding stream (Award number: NIHR131573 ). WW is also part funded by the NIHR Applied Research Collaboration for the east of England . The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The funders have not had a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 The Authors

Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.


  • Remote delivery
  • Substance misuse
  • Intervention promise
  • Behaviour change
  • Behaviour change techniques
  • Alcohol misuse
  • Humans
  • Adult
  • Behavior Therapy/methods
  • Alcoholism/therapy


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