{"doi":"10.2196/56119","title":"Web-Based Coping Skills Training and Coach Support for Women Living With a Partner With an Alcohol Use Disorder: Randomized Controlled Trial","abstract":"BACKGROUND: Individuals living with a partner with an alcohol use disorder (AUD) can experience significant psychological distress and use health care more than those without a partner with an AUD. However, the prevailing treatment system's focus on the partner and personal barriers limit these individuals from getting help for themselves. Preliminary work on a self-directed, web-based coping skills training program, Stop Spinning My Wheels (SSMW), shows promise in broadening available treatments for this population. In this study, we conducted a robust evaluation of SSMW primary outcomes. OBJECTIVE: The study aims to test whether women with a partner with an AUD assigned to SSMW experienced a greater reduction in negative affect (depression and anger) (1) than a usual web care (UWC) control and (2) with brief phone coach support (SSMW+coach) rather than without (SSMW only) and (3) whether baseline negative affect moderated treatment effects. METHODS: Women (mean age 45.7, SD 10.8 years; Black: 17/456, 3.7%; White: 408/456, 89.5%) were randomized to SSMW only, SSMW+coach, or UWC. Depression (Beck Depression Inventory-II) and anger (State-Trait Anger Expression Inventory 2-State Anger) were assessed at baseline, 12-week posttest, and 6- and 12-month follow-ups. RESULTS: Participants in all conditions decreased in depression from baseline to posttest and from baseline to follow-up; SSMW-only and SSMW+coach participants decreased in anger, but UWC participants did not. Compared to UWC participants, SSMW-only participants experienced greater anger reduction (P=.03), and SSMW+coach participants experienced a greater reduction in depression (P<.001) from baseline to posttest. However, from baseline to follow-up, only a greater, but not statistically significant (P=.052), reduction in anger occurred in SSMW+coach compared to UWC. Although the SSMW conditions did not differ from each other in negative affect outcomes (P=.06-.57), SSMW+coach had higher program engagement and satisfaction (all P<.004). Baseline negative affect did not moderate effects, although remission from baseline clinically relevant depressive symptoms (Beck Depression Inventory≥14) was higher in SSMW only (33/67, 49%; odds ratio 2.13, 95% CI 1.05-4.30; P=.03) and SSMW+coach (46/74, 62%; odds ratio 3.60, 95% CI 1.79-7.23; P<.001) than in UWC (21/67, 31%); remission rates did not differ between the SSMW conditions (P=.12). CONCLUSIONS: The results partially supported the hypotheses. The SSMW conditions had earlier effects than UWC, but positive change in UWC mitigated the hypothesized long-term SSMW-UWC differences. The results highlight the importance of incorporating active controls in web-based clinical trials. Although SSMW+coach showed benefits over SSMW only on engagement and satisfaction measures and in the number needed to treat (5.6 for SSMW only; 3.2 for SSMW+coach), the SSMW conditions were comparable and superior to UWC on depressive symptom remission levels. Overall, SSMW with or without a coach can reduce clinically meaningful distress and add to available treatment options for this large, underserved group. TRIAL REGISTRATION: ClinicalTrials.gov NCT02984241; https://www.clinicaltrials.gov/study/NCT02984241.","journal":"Journal of Medical Internet Research","year":2024,"id":473948,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9549,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02984241"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1309792,"name":"Brian G. Danaher","orcid":"0000-0001-8234-0479","position":1,"is_corresponding":false},{"id":1310220,"name":"Neil B. McGillicuddy","orcid":null,"position":2,"is_corresponding":false},{"id":1309793,"name":"Milagra S Tyler","orcid":"0000-0003-3207-6248","position":3,"is_corresponding":false},{"id":1309794,"name":"Christopher Barrick","orcid":"0000-0002-2672-0810","position":4,"is_corresponding":false},{"id":1309795,"name":"Florence W. Leong","orcid":"0009-0006-6895-5657","position":5,"is_corresponding":false},{"id":1076920,"name":"Derek Kosty","orcid":"0000-0002-9792-3383","position":6,"is_corresponding":false},{"id":1309791,"name":"Robert G. Rychtarik","orcid":"0009-0009-4256-4019","position":0,"is_corresponding":true}],"reference_count":48,"raw_metadata":null,"created_at":"2026-07-19T02:06:04.967429Z","pmid":"39208412","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}