Parlier-Ahmad AB, Boss N, Eglovitch M, et al. Within Sex Differences from a Clinical Trial of Digital Cognitive Behavioral Therapy for Alcohol Use Disorder Among a Nontreatment Sample. Womens Health Rep (New Rochelle). 2026;7:26884844261465225. doi:10.1177/26884844261465225
This exploratory analysis examined whether the effectiveness, usability, and acceptability of CBT4CBT, a validated digital intervention for alcohol use disorder (AUD), differed by sex. The analysis included data from 160 adults with lifetime AUD and current heavy drinking who were not seeking treatment. The sample included 83 females and 39 males assigned to CBT4CBT, and 26 females and 12 males assigned to the control group. Effectiveness was measured by a decrease in heavy drinking days, usability was determined by program initiation and the number of CBT4CBT modules completed, and acceptability was determined based on user-reported satisfaction with the intervention. Contrary to the hypothesis, female participants were not more likely than male participants to initiate CBT4CBT, and there were no significant sex differences among program initiators. Overall satisfaction was high across sexes, although women reported some concerns. Half of female participants gave negative ratings regarding the intervention’s fit, and significantly fewer women than men said they would refer a friend to the intervention. Both female and male study completers reduced their alcohol use during the study period regardless of intervention group. However, within-sex differences were also observed. Among female completers, those receiving CBT4CBT had a significantly lower percentage reporting any heavy drinking days at postintervention and greater reductions in drinking days over time than controls. Among male completers, the CBT4CBT group had a significantly lower percentage reporting any heavy drinking days at the 1-month follow-up. Female, but not male, CBT4CBT completers also had significantly better recovery scores than controls. The findings highlight differences in how CBT4CBT was experienced and its effects across sexes, supporting the need for further research on which digital interventions work for whom.