Online Community Reinforcement and Family Training (CRAFT) for Concerned Significant Others in Rural Australia: A Randomized Controlled Trial

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Abstract

AIMS: To evaluate the effectiveness of an online delivery of Community Reinforcement and Family Training (CRAFT) in a rural Australian context. DESIGN: A randomized controlled trial (RCT) using a parallel-group, two-arm, superiority design, with a baseline assessment, and two follow-up assessments. SETTING: Rural Australians PARTICIPANTS/CASES: 126 participants were enrolled and randomly assigned to either the CRAFT intervention (_n_ = 64) or Waitlist (_n_ = 62). At baseline, the mean age of participants was 51.08 years (_SD_ = 10.88). Females comprised of 92.06% of the study. Most participants (86.4%) were born in Australia and 87.9% identified as White/Caucasian. INTERVENTION AND COMPARATOR: Participants were randomized (1:1) into the CRAFT or Waitlist groups. The CRAFT intervention consisted of 6 sessions of 60 minutes each, conducted over 6 weeks. Participants randomised to the waitlist received reading resources from the Center for Motivation and Change. MEASUREMENTS: The primary outcome was the psychological well-being of the participant. Psychological well-being scales included the DASS-21, SWLS, FS, and Brief-COPE. FINDINGS: Post-intervention scores found a statistically significant difference between the intervention and waitlist groups. This included in the intervention group, a decrease in depression scores (DASS-21), with an adjusted mean difference of -2.71 (95% CI: -5.36 to -0.06) between interventions and waitlist group, a significant increase in Satisfaction with Life scores (SWLS), with an adjusted mean difference of 1.98 (95% CI: 0.45 to 3.50) and a significant increase in the use of problem-focused coping with an adjusted mean difference of 2.92 (95% CI: 1.33 to 4.51). CONCLUSIONS: Online CRAFT for rural Australians decreased depression, increased life satisfaction and increased problem-focused coping.
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