Enhancing a brief online intervention to reduce alcohol consumption

ISRCTN ISRCTN18317328
DOI https://doi.org/10.1186/ISRCTN18317328
Secondary identifying numbers Sponsor’s research project number: 149152
Submission date
06/02/2017
Registration date
17/02/2017
Last edited
07/09/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims:
Excessive alcohol consumption is associated with a range of negative health (e.g. liver disease, high blood pressure) and social outcomes (e.g., physical assaults, crime). In England, 23% of men and 16% of women drink at a level that puts them at an increased or higher risk of harm (2013 figures). There is therefore an important need to design interventions that can help people reduce how much alcohol they consume. Brief interventions (programs) that give people feedback on their alcohol consumption, health risk information and advice to cut down have been found to effective in primary care. There is great potential to expand the reach of these interventions through the use of digital (online) technologies; however, current approaches have fallen short of this promise. This study will test the effects of two potential enhancements to a brief online alcohol intervention. First, online interventions can be free-roaming such that users can view material in any order or tunnelled such that users view the material in a predetermined order. Second, alcohol interventions typically suggest strategies for reducing consumption. However, research has shown that such strategies are more effective when they are linked to specific high-risk situations through the use of if-then plans (e.g. If I am out with heavy drinking friends, then I will not have a drink until I’ve eaten). The aim of this study is to test whether the type of planning task (choosing strategies or making if-then plans to cut down) influences the effectiveness of the intervention.

Who can participate?
All members of staff at University of Sheffield who are part of a list of research volunteers.

What does the study involve?
Participants who consent to take part are asked to complete an online questionnaire which asks them to report on their typical alcohol consumption. They are then be randomly allocated to receive one of four versions of the DBIU online program and asked to view the information presented in the website. The first version involves viewing information pages in a set order which includes strategies to cut down alcohol consumption. The second version involves viewing information pages in a set order which includes plans to cut down alcohol consumption. The third version involves being able to access all of the pages relevant to them and their risk level in any order with strategies to cut down. The fourth version involves being able to access all of the pages relevant to them and their risk level in any order with plans to cut down. In all groups, the strategies to cut down involve being presented with a list of ten strategies for cutting down taken from the Australian “Drink-Less” programme. Participants are instructed to select up to three strategies to cut down by dragging them into boxes (or to write their own strategies in the boxes). The plans to cut down involve being presented with a list of ten high-risk situations for heavy episodic drinking as well as the ten strategies for cutting down used in the strategies conditions. Participants are then instructed to form up to three if-then plans by dragging situations and strategies into boxes to form if-then plans (or to write their own if-then plans in the boxes). All participants are asked to complete further online questionnaires after one and six months to assess their alcohol consumption.

What are the possible benefits and risks of participating?
Reducing alcohol consumption can decrease the risk of both short-term alcohol-related problems and long-term negative health outcomes. It is hoped that the intervention will help people to reduce their levels of alcohol consumption. There are no major risks or discomfort are anticipated.

Where is the study conducted?
The study is run from the University of Sheffield and takes place online (UK)

When is study starting and how long is it expected to run for?
January 2017 to December 2017

Who is funding the study?
Alcohol Research UK (UK)

Who is the main contact?
Professor Paul Norman
p.norman@sheffield.ac.uk

Contact information

Prof Paul Norman
Public

Department of Psychology
University of Sheffield
Cathedral Court
1 Vicar Lane
Sheffield
S1 2LT
United Kingdom

ORCiD logoORCID ID 0000-0002-5892-0470
Phone +44 114 2226505
Email p.norman@sheffield.ac.uk

Study information

Study design2 x 2 factorial randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Internet/virtual
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleAssessing the effects of website structure (free-roam versus tunnelled) and planning activities (choosing strategies versus forming if-then plans) on alcohol consumption in a brief online intervention
Study objectives1. The tunnelled version of the intervention will lead to increased engagement (pages visited, time spent of website) and greater reductions in alcohol consumption than the free-roam version
2. Asking participants to form specific if-then plans will lead greater reductions in alcohol consumption than asking them to choose general strategies
3. There will be an interaction between the structure of the intervention and the type of plan participants are asked to make, such that the effect of making if-then plans will be augmented in the tunnelled structure
Ethics approval(s)University of Sheffield, Department of Psychology Research Ethics Committee, 01/02/2017, ref: 012635
Health condition(s) or problem(s) studiedAlcohol consumption
InterventionParticipants will complete a baseline online questionnaire to assess their typical alcohol consumption. The randomisation function in Qualtrics will then be used to randomly allocate participants to one of four versions of the “Don’tBottleItUp” (DBIU) website to provide a 2 (structure: tunnelled vs. free-roam) × 2 (planning: strategies vs. if-then plans) between-participants factorial design. The four versions that will be compared are therefore: tunnelled version with strategies to cut down, (tunnelled version with plans to cut down, free-roam version with strategies to cut down, and free-roam version with plans to cut down.

All participants, when they enter the DBIU website, will be asked to complete the AUDIT measure that will categorise them into low, increasing, higher and high/possible dependent risk categories. All participants will receive feedback on their AUDIT score (i.e. their risk category) and will be provided with information on the government’s recommendations for weekly alcohol consumption.

Tunnelled versions:
Participants who receive tunnelled versions of the DBIU website will be asked to view the following pages in a set order – i.e. information on what units mean, information on the risks of drinking (tailored to their risk category), and comparisons with national drinking levels. The next page for lower risk drinkers will comprise advice that they do not need to cut down and that they should continue to drink within recommended limits. The next page for increasing risk drinkers will include advice on strategies or plans to cut down (see below for further details). The next page for higher risk/possibly dependent drinkers will provide information on alcohol dependence and advice to consult a health professional. The final page will comprise advice on strategies or plans to cut down (see below for further details). The next page for high risk/possibly dependent drinkers will provide information on alcohol dependence and advice to consult a health professional. This will be followed by a page providing information on alcohol support services that also includes a short advice video about high risk drinking.

Free-roam versions:
Participants who receive the free-roam versions of the DBIU website, will be able to access all the pages relevant to their risk category (as described above) in any order by clicking on links to each page.

Choosing strategies to cut down:
Participants categorised as increasing and higher risk drinkers who are randomly allocated to the strategies conditions will be presented with a list of ten strategies for cutting down taken from the Australian “Drink-Less” programme (Gomel et al., 1994). Participants will be instructed to select up to three strategies to cut down by dragging them into boxes (or to write their own strategies in the boxes).

Making plans to cut down:
Participants categorised as increasing and higher risk drinkers who are randomly allocated to the planning conditions will be presented with a list of ten high-risk situations for heavy episodic drinking taken from Maddock et al. (2000) as well as the ten strategies for cutting down used in the strategies conditions. Participants will be instructed to form up to three if-then plans by dragging situations and strategies into boxes to form if-then plans (or to write their own if-then plans in the boxes).
Intervention typeBehavioural
Primary outcome measureEngagement with the intervention:
1. Number of pages visited on the intervention website is measured by reviewing web-usage data (i.e. from a backend database that logs each user's activity on the DBIU website) after completion of the intervention
2. Total time spent on the intervention website is measured by reviewing web-usage data (i.e. from a backend database that logs each user's activity on the DBIU website) after completion of the intervention

Alcohol consumption:
Number of units of alcohol consumed in a typical week is measured using a retrospective seven-day alcohol diary at 6 months.
Secondary outcome measuresEngagement with the intervention:
1. Number of strategies/if-then plans made (by increasing risk and higher risk drinkers) is measured by reviewing web-usage data (i.e. from a backend database that logs each user's activity on the DBIU website) after completion of the intervention
2. Viewing an advice video (by high risk/possible dependent drinkers) versus not is measured by reviewing web-usage data (i.e. from a backend database that logs each user's activity on the DBIU website) after completion of the intervention

Alcohol consumption:
1. Number of units of alcohol consumed in a typical week is measured using a retrospective seven-day alcohol diary at 1 month
2. Number of days drinking in a typical week is measured using a retrospective seven-day alcohol diary at 1 and 6 months
3. Mean units of alcohol consumed on a drinking day is measured using a retrospective seven-day alcohol diary at 1 and 6 months
4. Peak daily consumption is measured using a retrospective seven-day alcohol diary at 1 and 6 months
5. Frequency of binge drinking is measured using a retrospective seven-day alcohol diary at 1 and 6 months
6. Hazardous drinking is measured by the AUDIT questionnaire at 6 months
Overall study start date01/01/2017
Completion date31/12/2017

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsAt least 632 participants at baseline and 506 at six-month follow-up (as determined by an a priori power analysis)
Total final enrolment286
Key inclusion criteria1. Members of staff at the University of Sheffield
2. Aged 18 years and over
Key exclusion criteriaNo exclusion criteria.
Date of first enrolment28/02/2017
Date of final enrolment31/05/2017

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of Sheffield
Western Ban
Sheffield
S10 2GW
United Kingdom

Sponsor information

University of Sheffield
University/education

Research & Innovation Services
New Spring House
231 Glossop Road
Sheffield
S10 2GW
England
United Kingdom

Phone +44 114 22 27444
Email ri-contracts@sheffield.ac.uk
Website http://www.shef.ac.uk/ris/index
ROR logo "ROR" https://ror.org/05krs5044

Funders

Funder type

Charity

Alcohol Research UK
Private sector organisation / Other non-profit organizations
Location
United Kingdom

Results and Publications

Intention to publish date31/12/2018
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planIt is planned that the results of the trial will be disseminated in the following ways:
1. A brief “Alcohol Insight” report for the ARUK website (2018)
2. Presentation at the Alcohol Research UK Annual Conference (2018)
3. Submission of a paper to a peer-reviewed journal (2018)
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Paul Norman (p.norman@sheffield.ac.uk)

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 25/11/2019 07/09/2020 Yes No

Editorial Notes

07/09/2020: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
21/02/2017: Verified study information with principal investigator