While safety-belt use markedly reduces morbidity and mortality, many young adults in the U.S. do not buckle-up 100% of the time. Following a series of community-level interventions on a university campus, this dissertation project focused on promoting individual-level safety-belt use. More specifically, a targeted web-based assessment and brief motivational intervention for individuals with lower rates of safety-belt use was developed and tested. A Pilot Study conducted prior to the Main Study developed self-reported assessment measures for safety-belt use and motivation. Recruitment, baseline assessment, intervention, and follow-up assessment were conducted via the Internet. Student drivers who buckled-up less than 70% of the time and who met other eligibility requirements were enrolled in a within subjects, randomized, attention-controlled design. At baseline, each participant completed an assessment of: (1) demographics; (2) driving behaviors; and (3) social cognitive and motivational variables including knowledge, perceived importance, confidence (self-efficacy), and readiness to buckle-up. Participants were then randomly assigned to one of two groups: (1) an attention-control group receiving emailed general nutrition information or (2) a motivational interviewing-consistent feedback group receiving emailed personalized feedback. Dependent variables were re-assessed approximately ten days after feedback/general nutrition information were emailed via follow-up assessment. Outcomes analyses using non-parametric statistics were conducted twice. First, an analysis of “completers” was conducted using data from those who completed follow-up. Second, a more conservative intent-to-treat analysis was conducted after carrying the last observation forward for those who did not complete follow-up, assuming no change among those who did not complete follow-up. Overall, results suggest this web-based assessment and brief motivational intervention was feasible and acceptable to participants. Overall, results from both analyses found statistically significant increases in median driver and passenger belt use between baseline and follow-up among participants in both groups. Further, effect sizes suggest the magnitude of change was greater among those in the intervention group versus those in the attention-control group. Participants were then categorized according to whether or not they increased driver belt use by at least one instance between baseline and follow-up. Those who received the intervention were not significantly more likely than those who received general nutrition information (i.e., assessment only) to increase driver safety-belt use by at least one instance. No statistical differences were found in either the completer or intent-to-treat analyses. Yet, when participants were categorized according to whether or not they increased passenger belt use by at least one instance between baseline and follow-up, those who received the intervention were 1.75 times more likely than those who received general nutrition information (i.e., assessment only) to increase passenger safety-belt use by at least one instance. This difference was not found in the intent-to-treat analysis. In general, study participation was associated with increased ratings of motivation (i.e., importance, confidence, and readiness) at follow-up. Results were interpreted with caution given psychometric weaknesses including high intercorrelations found between constructs of motivation in the Pilot Study. However, median change in one construct, readiness, was investigated in post-hoc analyses. Using the intent-to-treat sample, it was found that participants who were categorized as having increased driver safety-belt use by at least one instance also reported statistically significant median changes in readiness to buckle-up as a driver. Those categorized as having increased passenger safety-belt use by at least one instance also reported statistically significant median changes in readiness to buckle-up as a passenger. Further, although there was a trend for participants in the intervention group to be more likely than those in the attention-control group to commit to buckling-up and asking others to do the same at follow-up, there were no significant differences in commitment between groups. However, regardless of group assignment, change in median readiness was associated with: (1) commitment to buckle-up as a driver; (2) commitment to buckle-up as a passenger; (3) commitment to ask others to buckle-up while acting as a driver; and (4) commitment to ask others to buckle-up while acting as a passenger. Overall, these studies found the Internet to be an acceptable and promising venue for assessment and brief motivational intervention to promote safety-belt use among university students. Further, safety-belt use and motivational constructs such as importance, confidence, and readiness may be measured via self-report methodology. Results suggest participation in the study was associated with improvement in safety-belt use and some levels of motivation. While there were trends for those in the intervention group to report greater increases, there were no statistically significant differences between the groups in the ITT analyses. In the completer analyses, it was found that those in the intervention group were significantly more likely to report increased passenger safety-belt use. Future research may elucidate more specific psychometric properties of new measures used. In particular, readiness may be a proxy motivational variable that appears to relate to change in safety-belt use among drivers and passengers as well as commitment to buckle-up and ask others to do the same. The simple process of assessment may be sufficient to produce changes in readiness related to behavior change. / Ph. D.

BACKGROUND: Tobacco use remains the leading cause of morbidity and mortality in the US. Effective tobacco cessation aids are widely available, yet underutilized. Tobacco cessation brief interventions (BIs) increase quit rates. However, BI training has focused on conventional medical providers, overlooking other health practitioners with regular contact with tobacco users. The 2007 National Health Interview Survey found that approximately 20% of those who use provider-based complementary and alternative medicine (CAM) are tobacco users. Thus, CAM practitioners potentially represent a large, untapped community resource for promoting tobacco cessation and use of effective cessation aids. Existing BI training is not well suited for CAM practitioners' background and practice patterns, because it assumes a conventional biomedical foundation of knowledge and philosophical approaches to health, healing and the patient-practitioner relationship. There is a pressing need to develop and test the effectiveness of BI training that is both grounded in Public Health Service (PHS) Guidelines for tobacco dependence treatment and that is relevant and appropriate for CAM practitioners. METHODS/DESIGN: The CAM Reach (CAMR) intervention is a tobacco cessation BI training and office system intervention tailored specifically for chiropractors, acupuncturists and massage therapists. The CAMR study utilizes a single group one-way crossover design to examine the CAMR intervention's impact on CAM practitioners' tobacco-related practice behaviors. Primary outcomes included CAM practitioners' self-reported conduct of tobacco use screening and BIs. Secondary outcomes include tobacco using patients' readiness to quit, quit attempts, use of guideline-based treatments, and quit rates and also non-tobacco-using patients' actions to help someone else quit. DISCUSSION: CAM practitioners provide care to significant numbers of tobacco users. Their practice patterns and philosophical approaches to health and healing are well suited for providing BIs. The CAMR study is examining the impact of the CAMR intervention on practitioners' tobacco-related practice behaviors, CAM patient behaviors, and documenting factors important to the conduct of practice-based research in real-world CAM practices.

O uso de álcool na gestação traz sérios riscos à saúde da mãe e do bebê. As prevalências do uso de risco de álcool entre gestantes encontradas em estudos nacionais giram em torno de 20%. Nos EUA, estudos sobre avaliação das intervenções breves têm mostrado uma na redução do uso de álcool em gestantes. O objetivo deste estudo foi elaborar um protocolo de intervenção breve (IB) para gestantes e avaliar sua eficácia na redução do consumo de álcool comparativamente ao recebimento de um folheto informativo sobre os riscos do uso de álcool na gestação. Foi realizado um ensaio clínico, cego, comparativo e prospectivo, com distribuição randômica das participantes em dois grupos (IB e folheto), com dois tempos de coleta de dados (T1 e T2). Foram recrutadas 86 gestantes em serviços de saúde de Ribeirão Preto e Araraquara com uso de risco de álcool utilizando o instrumento T-ACE (pontuação maior ou igual a dois). As gestantes eram maiores de 18 anos e possuíam até 16 semanas de gestação. Todas responderam a um questionário incluindo avaliação do padrão de uso de álcool e receberam IB ou um folheto informativo sobre os riscos do uso de álcool na gestação. Foram excluídas gestantes com diagnóstico prévio de dependência de álcool ou drogas, as que pontuaram acima de 20 no instrumento AUDIT, as que declararam uso, nos últimos três meses, de outras drogas, exceto tabaco e aquelas incapazes de compreender e fornecer informações aos pesquisadores. No segundo tempo da pesquisa (a partir da 25ª semana gestacional) compuseram a amostra 80 gestantes, sendo 39 do grupo folheto e 41 do grupo IB. As gestantes do grupo IB apresentaram menor média de doses consumidas e maior prevalência de abstinentes. Contudo, não foram observadas diferenças estatisticamente significativas entre os grupos em relação ao padrão de consumo de álcool. A avaliação intra-grupos também não detectou diferenças no padrão de consumo de álcool entre T1 e T2 seja para o grupo folheto ou para o grupo IB. Apesar disso, a autoavaliação das gestantes tanto no grupo folheto quanto no grupo IB sobre a mudança no comportamento de consumo de bebidas alcoólicas indicou uma diminuição estatisticamente significativa do consumo (Grupo folheto, Wilcoxon, Z=-2,74; p<0,01; r=0,31) (Grupo IB, Wilcoxon, Z=-4,43; p<0,001; r=0,49). / Alcohol use during pregnancy causes serious health risks to the mother and baby. National studies indicate prevalence around 20% of risky drinking by pregnant women. In the U.S., researches on evaluation of brief interventions have shown a reduction in alcohol consumption among pregnants. A prospective, blind and randomized clinical trial was developed to evaluate the efficacy of a brief intervention (BI) protocol in reducing alcohol use among pregnant women. Participants were randomized by opaque and sealed envelopes in two groups (IB and brochure), with two periods of data collection (T1 and T2). We recruited 86 risky drinking and pregnant women in health care services using T-ACE (score more than two points). Women were older than 18 years and had up to 16 weeks of gestation. All completed a questionnaire including evaluation of standard alcohol and received IB (IB group) or information leaflet about the risks of alcohol use during pregnancy (brochure group). We excluded women with (1) a previous diagnosis of alcohol or drugs dependence, (2) those scored above 20 points in AUDIT instrument, (3) those reported drugs use (except tobacco) in the past three months, and (4) those unable to understand and provide information to researchers. In T2 period (up 24 weeks gestation), 80 participants remained in the study (39 brochure group and 41 IB group). IB group presented a lower average doses consumed and a higher prevalence of abstinent. However, there were no statistically significant differences between the groups in relation to the pattern of alcohol consumption. Intra-group evaluation also did not detect differences in the pattern of alcohol consumption between T1 and T2 in both groups. Nevertheless, self-assessment of pregnant women about the change in drinking behavior indicated a statistically significant decrease of alcohol consumption in brochure group (Wilcoxon, Z= -2.74, p <0, 01, r = 0.31) and IB group (Wilcoxon, Z= -4.43, p <0.001, r = 0.49).

INTRODUCTION: While research indicates that Motivational Interviewing (MI) is effective for reducing substance use, little is known about whether brief MI-based interventions reduce drug use in a primary care setting, or what processes impact outcomes. Mixed findings in MI process studies have led investigators to call for research exploring alternative process variables that may predict outcomes. The current study is a secondary data analysis using coded audio-recordings from a randomized controlled trial that tested the efficacy of two brief MI-based interventions as part of the `Assessing Screening Plus brief Intervention's Resulting Efficacy to stop drug use' (ASPIRE) trial. It was hypothesized that skill in affirming clients and enhancing self-efficacy (also assessed as a composite self-enhancement variable) would be associated with lower frequency of drug use at 6 weeks and 6 months after controlling for baseline drug use and indicators of general MI proficiency. METHODS: Audio-recordings from two intervention conditions [Enhanced Motivational Intervention (EMI; N=176) and Brief Negotiated Interview (BNI; N=174)] were coded with behavior counts and global interventionist skill ratings using an established coding system for MI and a study-specific coding manual. A series of negative binomial regression models were conducted that were stratified by intervention due to the different goals and characteristics of the two interventions. Secondary and tertiary analyses examined moderators including MI Spirit and patient baseline ratings of self-efficacy. RESULTS: There were no significant findings for the main effects models (Incidence Rate Ratio range .71-1.29). Only patient self-efficacy moderated the relationship between self-enhancement composite and 6 week outcome in the BNI condition; Self-enhancement composite was associated with lower frequency of drug use at 6 weeks in the BNI condition for those with low self-efficacy at baseline. Discussion: Overall, the results provided little support for the view that therapist skill in affirmation or enhancing self-efficacy was predictive of drug use outcomes in one-session interventions in primary care. The restricted range of interventionist skill ratings may account, in part, for these intervention process findings. Future work should explore the role of these interventionist variables on proximal indicators of change (i.e., intention) and drug use in MI-based interventions with demonstrated efficacy.

O uso de álcool na gestação traz sérios riscos à saúde da mãe e do bebê. As prevalências do uso de risco de álcool entre gestantes encontradas em estudos nacionais giram em torno de 20%. Nos EUA, estudos sobre avaliação das intervenções breves têm mostrado uma na redução do uso de álcool em gestantes. O objetivo deste estudo foi elaborar um protocolo de intervenção breve (IB) para gestantes e avaliar sua eficácia na redução do consumo de álcool comparativamente ao recebimento de um folheto informativo sobre os riscos do uso de álcool na gestação. Foi realizado um ensaio clínico, cego, comparativo e prospectivo, com distribuição randômica das participantes em dois grupos (IB e folheto), com dois tempos de coleta de dados (T1 e T2). Foram recrutadas 86 gestantes em serviços de saúde de Ribeirão Preto e Araraquara com uso de risco de álcool utilizando o instrumento T-ACE (pontuação maior ou igual a dois). As gestantes eram maiores de 18 anos e possuíam até 16 semanas de gestação. Todas responderam a um questionário incluindo avaliação do padrão de uso de álcool e receberam IB ou um folheto informativo sobre os riscos do uso de álcool na gestação. Foram excluídas gestantes com diagnóstico prévio de dependência de álcool ou drogas, as que pontuaram acima de 20 no instrumento AUDIT, as que declararam uso, nos últimos três meses, de outras drogas, exceto tabaco e aquelas incapazes de compreender e fornecer informações aos pesquisadores. No segundo tempo da pesquisa (a partir da 25ª semana gestacional) compuseram a amostra 80 gestantes, sendo 39 do grupo folheto e 41 do grupo IB. As gestantes do grupo IB apresentaram menor média de doses consumidas e maior prevalência de abstinentes. Contudo, não foram observadas diferenças estatisticamente significativas entre os grupos em relação ao padrão de consumo de álcool. A avaliação intra-grupos também não detectou diferenças no padrão de consumo de álcool entre T1 e T2 seja para o grupo folheto ou para o grupo IB. Apesar disso, a autoavaliação das gestantes tanto no grupo folheto quanto no grupo IB sobre a mudança no comportamento de consumo de bebidas alcoólicas indicou uma diminuição estatisticamente significativa do consumo (Grupo folheto, Wilcoxon, Z=-2,74; p<0,01; r=0,31) (Grupo IB, Wilcoxon, Z=-4,43; p<0,001; r=0,49). / Alcohol use during pregnancy causes serious health risks to the mother and baby. National studies indicate prevalence around 20% of risky drinking by pregnant women. In the U.S., researches on evaluation of brief interventions have shown a reduction in alcohol consumption among pregnants. A prospective, blind and randomized clinical trial was developed to evaluate the efficacy of a brief intervention (BI) protocol in reducing alcohol use among pregnant women. Participants were randomized by opaque and sealed envelopes in two groups (IB and brochure), with two periods of data collection (T1 and T2). We recruited 86 risky drinking and pregnant women in health care services using T-ACE (score more than two points). Women were older than 18 years and had up to 16 weeks of gestation. All completed a questionnaire including evaluation of standard alcohol and received IB (IB group) or information leaflet about the risks of alcohol use during pregnancy (brochure group). We excluded women with (1) a previous diagnosis of alcohol or drugs dependence, (2) those scored above 20 points in AUDIT instrument, (3) those reported drugs use (except tobacco) in the past three months, and (4) those unable to understand and provide information to researchers. In T2 period (up 24 weeks gestation), 80 participants remained in the study (39 brochure group and 41 IB group). IB group presented a lower average doses consumed and a higher prevalence of abstinent. However, there were no statistically significant differences between the groups in relation to the pattern of alcohol consumption. Intra-group evaluation also did not detect differences in the pattern of alcohol consumption between T1 and T2 in both groups. Nevertheless, self-assessment of pregnant women about the change in drinking behavior indicated a statistically significant decrease of alcohol consumption in brochure group (Wilcoxon, Z= -2.74, p <0, 01, r = 0.31) and IB group (Wilcoxon, Z= -4.43, p <0.001, r = 0.49).

Alcohol and drug abuse are strong predictors of suicide. While screening methods have proven effective at identifying and treating substance abuse in non-treatment-seeking users (e.g., screening and brief intervention [SBI]), less attention has been given to the co-occurrence of suicidality among this population, including its correlates and etiology. The current study addresses this gap by presenting data from early adult emergency department (ED) patients (mean age = 27; N = 505), screened for substance abuse and suicidal ideation. Prevalence of past year ideation was high (15%). Results demonstrated a significant and positive indirect effect of cocaine use severity on likelihood of suicidal ideation, mediated through family support. The implications for SBI practices in the ED and suicide etiology among non-treatment-seeking substance abusers are discussed.

Riskbruk av alkohol är ett stort problem i dagens samhälle. Sjuksköterskan beskrivs ha goda möjligheter att upptäcka och behandla riskbruk av alkohol i det dagliga arbetet. Studier tyder på att korta interventioner är av stor nytta till sjuksköterskan i sitt hälsofrämjande arbete. Dock visar forskningen att sjuksköterskans aktivitet inom detta område måste utvecklas och att det finns många faktorer som kan påverka uppgiften. Syftet med arbetet var att belysa faktorer som påverkar sjuksköterskans hälsofrämjande arbete gällande individer med ett riskbruk av alkohol. Arbetet utfördes som en litteraturstudie där 13 vetenskapliga artiklar valdes ut, granskades, analyserades samt kodades för att finna påverkande faktorer. De mest återkommande faktorerna som framkom delades in i fyra kategorier. Dessa var sjuksköterskans uppfattning om sin roll, utbildning och kunskap gällande riskbruk av alkohol, organisationens roll och motivationens betydelse samt sjuksköterskans känslor och attityder inför individer med riskbruk av alkohol. Osäkerhet vad det gäller tillvägagångssättet av korta interventioner och dess effektivitet beskrevs av sjuksköterskor i flertalet studier. Rädsla för att utlösa negativa reaktioner hos patienten samt den höga arbetsbelastningen har visat sig vara stora barriärer till utförandet av korta interventioner. Tydliggörandet av sjuksköterskans roll samt mer utbildning inom ämnet behövs för att öka aktiviteten inom området. Vidare forskning bör fokusera på sjukhusmiljö och fler kvalitativa studier behövs för att få en djupare förståelse för svårigheterna att implementera korta interventioner. / Hazardous use of alcohol is a large problem in today’s society. The nurse is described as having good opportunities to detect and treat hazardous use of alcohol in their daily work. Studies show that brief interventions are of great use to the nurse in their health promotion work. However, research shows that the nurses' activity in this area must be improved and that there are many factors that can affect this task. The purpose of this study was to illustrate factors that affect the nurses' health promotion work with regards to individuals with a hazardous use of alcohol. The work was carried out as a literature study where 13 scientific articles were selected, examined, analyzed and coded in order to find important factors. The most recurring factors that arose were divided into four categories. These were the nurses' perception of their role, education and knowledge about hazardous alcohol use, the organization’s role and the importance of motivation and the nurses’ feelings and attitudes towards individuals with hazardous alcohol use. Uncertainty about the approach to use with regards to brief interventions and their efficiency was described by nurses in several studies. Fear of triggering negative reactions in the patient and even the high workload has proved to be large barriers in carrying out brief interventions. Clarification of the nurses' role and more education on the subject is needed in order to increase the activity in the area. Further research should focus on the hospital environment and more qualitative studies are needed in order to get a deeper understanding of the difficulties in implementing brief interventions.

Anxiety sensitivity (AS; fear of anxiety-related bodily sensations) is a risk factor for anxiety and related psychological disorders. Preliminary evidence also associates high AS with reduced levels of physical exercise and fitness. The primary objectives of the five studies comprising this dissertation were 1) to further explore the relationships between AS levels and exercise/fitness levels, and 2) to evaluate outcomes and processes of a brief group cognitive behaviour therapy (CBT) that included a novel exercise-based interoceptive exposure (IE; exposure to feared anxiety-related sensations) component of running, with female undergraduate students. High AS female undergraduate participants endorsed more barriers to exercise than low AS participants, and these accounted for the inverse relationships between AS group and exercise/fitness levels (Study 1). The brief CBT/IE led to decreases in AS levels (Studies 2 and 4) and in symptoms of stress, depression, and anxiety (Study 4) for high AS participants. Processes involved in the brief CBT’s therapeutic effects were explored by examining cognitive (i.e., catastrophic thoughts), affective (i.e., feelings of anxiety), and somatic (i.e., physical sensations) reactions to the running IE component with an existing measure, the hyperventilation questionnaire (HVQ; Study 2), and a brief version of the measure, the HVQ-B, developed and validated in Study 3 (Study 5). Changes in cognitive and affective reactions to running were most closely associated with the brief CBT/IE’s therapeutic benefits, underlying the importance of changing the meaning of and emotional reaction to physiological arousal. Surprisingly, a health education control (HEC) intervention consisting of an interactive discussion on exercise, nutrition and sleep for health, including problem-solving barriers to health behaviours, also led to decreases in AS levels and in symptoms of depression and anxiety (Study 4). Physical exercise, the common link between the two interventions, may be partially driving the interventions’ therapeutic benefits. More specifically, perhaps both interventions addressed barriers to exercise, either by altering the meaning of and emotional reaction to exercise (CBT/IE), or through problem-solving (HEC). Encouraging physical exercise in high AS individuals by acknowledging and addressing barriers to exercise might help decrease these individuals’ AS levels and improve their overall mental health

Although alcohol plays an important role in psychiatric morbidity, there is a general lack of strategies within psychiatric care to intervene at alcohol problems in an early stage (secondary prevention). The aim of this thesis was to increase knowledge of adequate forms of secondary alcohol prevention in psychiatric care.   The capacity of three brief screening instruments was investigated in a psychiatric outpatient sample (n=1811). The results indicate that the HED (heavy episodic drinking) screener, strongly recommended for health care settings, is not sufficiently sensitive in a psychiatric setting. Instead, the full AUDIT (Alcohol Use Disorders Identification Test) is recommended. The knowledge and attitudes of psychiatric staff members to problem-drinking patients were studied and the effects of a three-hour training course were investigated. Confidence in self-perceived capacity to intervene in more severe alcohol problems was raised among all staff after training. Awareness of early signs of problem drinking was raised among psychologists and social workers. The therapeutic attitude of the psychiatric staff was higher when compared with primary care staff. Two forms of brief intervention were delivered by clinical psychiatric staff. At 12 months, 29% of all participants had improved their drinking habits, moving from hazardous to non-hazardous level (21%) or from harmful to hazardous level (8%). In the improved group, mean AUDIT score was reduced from 11.0 points at baseline to 5.5 points. Differences in outcome between the two interventions could not be identified. Nine high-risk drinking young female psychiatric patients were interviewed, focusing on reasons for excessive drinking and factors facilitating a change in drinking habits. Alcohol played an important role in the lives of the young women. It made them feel social and helped them deal with unbearable emotions. It was also used as a means of self-harm, representing the first stage in an escalating self-harm process. They expressed a need for help from their caregivers in addressing the underlying reasons for drinking. Secondary alcohol prevention strategies including appropriate screening methods, staff training and the elaboration of tailored interventions are urgently needed in psychiatric care. The findings of this thesis can be used when forming such strategies.

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-01-11T10:58:07Z No. of bitstreams: 1 leonardofernandesmartins.pdf: 6640473 bytes, checksum: 1868d371e9d620e74b01b7f3e3fed832 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-01-23T13:12:17Z (GMT) No. of bitstreams: 1 leonardofernandesmartins.pdf: 6640473 bytes, checksum: 1868d371e9d620e74b01b7f3e3fed832 (MD5) / Made available in DSpace on 2018-01-23T13:12:17Z (GMT). No. of bitstreams: 1 leonardofernandesmartins.pdf: 6640473 bytes, checksum: 1868d371e9d620e74b01b7f3e3fed832 (MD5) Previous issue date: 2017-06-02 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / As consequências negativas associadas como o consumo excessivo de álcool contribuem para o surgimento de diversos prejuízos para a saúde. Estratégias de prevenção oferecidas por internet para redução de consumo de álcool podem ser efetivas neste contexto. Objetivo: Desenvolver e avaliar uma intervenção por internet de código aberto e de sessão única para redução do consumo de álcool. Método: Para tanto, foi realizada uma breve revisão narrativa da literatura descrevendo o contexto de uso de ferramentas de e-saúde, as quais incluem as intervenções por internet, para abordar problemas relacionados ao consumo de substâncias. Após esta apresentação geral do campo, descreve-se o processo de desenvolvimento da intervenção, seguindo um conjunto de passos que articula quatro fases (pré-alfa, alfa, beta e divulgação final) relacionadas à construção dos conteúdos ativos da intervenção. Através de um grupo focal as opiniões de potenciais usuários foram consideradas em cada uma destas etapas, assim como a avaliação de especialistas da área. A versão final da intervenção teve o seu código fonte disponibilizado para acesso gratuito. Em um segundo momento, através de um estudo piloto, a versão final do programa foi avaliada por meio de um estudo descritivo que investigou as estratégias de recrutamento, perfil de uso e adesão à intervenção. As estratégias de recrutamento adotadas foram capazes de atrair 30.158 visitantes, destes, um total de 22.258 iniciaram sua avaliação do consumo de álcool, sendo que 94,2% faziam consumo de bebidas alcoólicas. Atendiam aos critérios de inclusão inicial um total de 14.263 participantes que receberam o retorno dos seus resultados e foram convidados à utilizarem a intervenção. Um total 610 participantes aceitaram participar. Dados demográficos, padrão de consumo de álcool e uso dos componentes da intervenção são apresentados. Conclusões: Os resultados indicam que a intervenção foi adequada para realização de rastreio dos problemas relacionados ao consumo de álcool, atingindo um importante contingente populacional. O interesse em mudar o comportamento de beber entre estes participantes parece ser baixo, dado a grande taxa de desistência após o convite. O potencial de aprimoramento e uso desta intervenção para estudos futuros que visem avaliar a sua efetividade é discutido. Conclui-se que as etapas de desenvolvimento e avaliação permitiram preencher a lacuna reconhecida na literatura, mas que avanços precisam ser feitos a partir dos resultados aqui encontrados. / The negative consequences associated with heavy alcohol consumption contribute to the appearance of several health problems. Prevention strategies delivered on the internet to reduce alcohol consumption can be effective in this context. Objective: To develop and evaluate an open source and single session web-based intervention to reduce alcohol consumption. Method: A brief narrative review of the literature was carried out describing the context of using e-health tools, which include web-based interventions, to address substance abuse related problems. After this general presentation of the field, the process of development of the intervention is described, following a set of steps that articulate four phases (pre-alpha, alpha, beta and final disclosure) related to the construction of the active contents of the intervention. Through a focus group the opinions of potential users were considered in each of these stages, as well as the evaluation of specialists in the field. The final version of the intervention had its source code made available for free access. In a second moment, through a pilot study, the final version of the program was evaluated through a descriptive study that investigated the strategies of recruitment, use profile and adherence to the intervention. The recruitment strategies adopted were able to attract 30,158 visitors, of whom, a total of 22,258 started their evaluation of alcohol consumption, with 94.2% consume alcoholic beverages. A total of 14,263 participants who received the return of their results and were invited to use the intervention met the initial inclusion criteria. A total of 610 participants agreed to attend. Demographic data, pattern of alcohol consumption and use of intervention components are presented. Conclusions: The results indicate that the intervention was adequate for the screening of problems related to alcohol consumption, reaching an important population contingent. The interest in changing drinking behavior among these participants seems to be low given the high dropout rate after the invitation. The potential for improvement and use of this intervention for future studies aimed at evaluating its effectiveness is discussed. It is concluded that the stages of development and evaluation have made it possible to fill the gap recognized in the literature, but that advances must be made from the results found here.