Addressing the Booming Booze Culture in Middle-Aged Women: Effect of an Online Intervention on Alcohol Consumption

The underlying theory for the present online intervention is based on the assumptions of the Integrated Behavioural Model (Fishbein, 2000) and the Transtheoretical Model of Change (Prochaska, 1979). The Integrated Behavioural Model (Fishbein, 2000) posits that the most important determinant of behaviour is the intention to perform the behaviour, informed by individuals’ attitudes, perceived norms and personal agency. However, within this model, intention to perform a behaviour is modified by four key factors: knowledge and skills, environmental constraints; the salience of the behaviour to the individual and the role of habits. The Transtheoretical Model of Change (Prochaska, 1979) provides an integrative framework for understanding and intervening with human intentional behaviour change. The theory posits that individuals move through six stages of change, and for each stage, different behavioural change strategies will be effective. The intervention operationalises principles from both theories and integrates concepts from the alcohol-specific behavioural literature to develop a comprehensive approach to changing alcohol consumption. The intervention is also based on the outcomes of interactive focus group workshops that were run by the research team with women aged 40-65. The core features of the intervention include: (1) Goal setting: Enabling participants to set goals at the start of the intervention period, and amend throughout, for the reduction of their alcohol consumption; (2) Tracking of alcohol consumption: Based on the data collected in their twice-weekly assessments, participants will see a live graph of their alcohol consumption which will update after each assessment is completed; (3) Four modules of content: (a) The Low-Risk Drinking Module, which will provide the most up to date evidence of the harms associated with alcohol consumption, information about what a standard drink is, an online calculator that will allow participants to measure their current level of consumption and receive feedback on the associated costs and harms; (b) The Mindful Drinking module which will contain information about drinking motives, and provide participants with skills to both learn to consume alcohol mindfully, as well as apply the broader technique of mindfulness to their lives to reduce the common antecedents of alcohol consumption (such as stress); (c) The Social Drinker module, will explore the social influences on drinking, including facts about how people influence each other both consciously and unconsciously, encourage participants to reflect on where alcohol currently fits into their social lives, and help build participant’s skills to talk about their alcohol consumption with others, and (d) the Alcohol is Everywhere module, which will look at the broader factors that influence alcohol consumption, including information about the normativity of alcohol in Australian society and how alcohol availability and outlet density impact on consumption, the ways in which the alcohol industry specifically target women, how alcohol advertising impacts on children, and the broader alcohol industry tactics used to promote their products; and (4) Challenges associated with each module: One to two challenges will be available at the end of each module, allowing participants to operationalise their learnings in the real world. Participants in the intervention group will have six weeks to complete the modules, which they can access and complete in any order. The interventions back-end system will record the number of times in which participants log on to view the intervention content, and the time they spend on the website each time they login. It will also record whether participants complete the requested number of follow-up Ecological Momentary Assessments (EMA). This data (number of visits, time spent on website, number of EMA’s completed) will be extracted from the system to assist in assessing the fidelity of the implementation of the intervention.