Examining an Online Self-Assessment Tool for Substance Use
Problematic substance use is an issue of significant public health concern, yet help-seeking remains low, due to barriers such as stigma and exclusion and a lack of information and knowledge about services. Increasingly, people are seeking help online, which provides substance users with an opportunity to gather information with protection from stigma and exclusion. Online substance use self-assessments with personalised feedback and referral options are showing promise in filling the treatment gap as well as engaging those who might not otherwise seek help, and allowing them to self-select an appropriate treatment pathway. They also could have the potential to highlight particular at-risk subgroups. An online self-assessment for substance use was made available on two prominent Australian AOD service websites with minimal marketing or promotion. Over 3,200 people voluntarily completed the online self-assessment from December 2012 until June 2015. This thesis examined characteristics of online help-seekers and their perceptions of helpfulness of the tool. We then identified predictors of a reported transition from enhancement motives for substance use to the more problematic coping motives. Finally, we examined intentions for future help-seeking following the feedback. The sample was generally high in substance use severity, but appeared to be high functioning, indicating an early-intervention population. The majority found the tool to be helpful, and reported that the tool confirmed their suspicions that their substance use was problematic, and provided them with new levels of insight. The transition from enhancement to coping was three times more common than the reverse direction. Significant predictors of this transition were being female (p = .02) and under 25 (p = .03), with high levels of psychological distress (p < .001). Almost all participants intended to take some sort of action (95.9%) following the screen. Intention to do ‘nothing’ was low (4.1%) and had an inverse relationship to AOD symptom severity, indicating that those concerned about their substance use were sufficiently relieved by the feedback to cease unnecessary help-seeking. Women were more likely to intend to seek anonymous forms of help (e.g. online), and men were more likely to intend to seek help face-to-face, which supports existing evidence that women experience increased stigma and exclusion in AOD treatment. These findings can help inform the development of such online tools, and highlight their importance as a cost-effective early-intervention and referral to treatment for those who might not otherwise seek help.