Alcohol Misuse
Conditions
Keywords
Chat-based IM, Alcohol brief intervention, AED, AUDIT
Brief summary
This study aims to assess the effectiveness of chat-based intervention on reducing risky alcohol consumption to inform clinical practice for providing ABI to risky drinkers attending AED in Hong Kong.
Detailed description
Alcohol use is a major risk factor for non-communicable diseases and 6th leading cause of death and disability-adjusted life years. The prevalence of alcohol consumption has increased since 2008 after introduction of zero tax on alcohol with strength \<30% (e.g., wine and beer) and due to promoting the city as Asia's wine hub. ABI reduced alcohol intake by about 20g/week at 12-month follow-up in primary healthcare populations. Given the relatively low prevalence of risky alcohol drinkers in Hong Kong, testing ABI in clinics may face difficulties in recruitment. Alcohol use is associated with problems such as injury and violence requiring accident and emergency department (AED) services, thus AEDs in Hong Kong are more feasible places to recruit subjects for delivering ABI. Primary hypothesis: The Intervention group has significantly larger reduction of weekly alcohol consumption compared with the Control group at 12-month follow-up Secondary hypotheses: Compared with the Control group, the Intervention group has lower AUDIT scores, fewer episodes of heavy/binge drinking, lower re-attendence at AED and reduced alcohol-related harms at 6-month and 12-month follow-up.
Interventions
BEHAVIORALAlcohol brief intervention
At baseline, subjects will receive face-to-face or online alcohol brief intervention developed based on the guideline by the World Health Organisation in 5-10 minutes
BEHAVIORAL12-page health warning leaflet
Nurses will provide information about the consequences of drinking using a 12-page health warning booklet. Benefits of reducing and quit drinking will be emphasized by focusing on improving their perception towards the impacts on health, social problems, risky behaviors, academic performance and financial issues.
A total of 26 e-messages will be scheduled: once daily for the first week, 3 time/week for subsequent 4 weeks and 1 time/week for the remaining 7 weeks. The frequency will be adjusted according to IM Apps conversation and subject's requests.
The chat-based IM support is the extension of baseline ABI and regular e-messages, which aims to provide real-time behavioral and psychosocial support to reduce or quit drinking. It will be personalized according to the subjects' characteristics (gender, drinking pattern and alcoholic drinks preferences), intention to drink and specific questions regarding drinking. Through real-time chatting (text and/or voice), drinkers can acquire information on consequences of drinking and gain social support immediately to reduce intention to drink and alcohol consumption.
a diagram explaining drinking behaviour and potential health risks, definitions of alcohol unit and binge drinking, and advise on limiting daily drinking to 2 alcohol units for men and 1 unit for women
Sponsors
The University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* HK resident able to read/communicate in Cantonese/Putonghua. This may exclude potential subjects from other countries with higher alcohol consumption than local Chinese, but quality of the chat-based intervention is important for the research hypothesis, and it will not be feasible to recruit other language speakers (e.g., English) in the present study. * Aged ≥18 with proficiency in using IM Apps (e.g., WhatsApp, WeChat). Those aged \<18 are excluded as other studies suggest they have different patterns of alcohol drinking and reduction from adult drinkers.
Exclusion criteria
* Those unable to understand or receive face-to-face ABI due to severe traumatic injury, unconscious, or drunk patients unable to follow commands * Anticipated to be admitted to in-patient department for \>1 week, which will interfere with the chat-based intervention * Having psychiatric/psychological diseases or receiving regular psychotropic medication * Participating in other alcohol reduction or abstinence programmes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Amount of alcohol consumption per week (gram/week) at 12-month follow-up | 12-month after baseline | Assessed by unit in gram and compare the alcohol consumption between intervention and control group at 12-month after baseline. |
| Compare the primary outcome using intention-to-treat (ITT), per-protocol (PP) and as-treated (AP) analysis with Compliance Average Causal Effect (CACE) analysis | 6-month after baseline | To estimate large, moderate and null (same as the control) treatment effects and check whether ITT, AP and PP analysis estimates are biased compared with CACE estimates (alcohol consumption per week at 6-month follow-up) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of standard drinks (10g of alcohol) per week at 3-, 6-, and 12-month follow-ups | 3, 6 and 12 months after baseline | Assessed by either increase or decrease in standard drinks number and compared between intervention and control group at 3-, 6-, and 12-month |
| Episode of binge drinking in the past 30-day at 3-, 6- and 12-month follow-ups | 3, 6, and 12 months after baseline | Defined by 5 standard drink \[male\] or 4 standard drink \[female\] in one occasion for binge drinking and compared between intervention and control group at 3-, 6-, and 12-month |
| Episode of heavy drinking in the past 30-day at 3-, 6- and 12-month follow-ups | 3, 6, and 12 months after baseline | Defined by 15 standard drink \[male\] or 8 standard drink\[female\] in a week for heavy drinking and compared between intervention and control group at 3-, 6-, and 12-month |
| Amount of alcohol consumption per week (gram/week) at 3- and 6-month follow-ups | 3 and 6 months after baseline | Assessed by unit in gram and compare the alcohol consumption between intervention and control group at 3- and 6-month after baseline. |
| Re-attendance of AED at 3-, 6- and 12-month follow-ups | 3, 6, and 12 months after baseline | Ask for attendance of AED (yes/no) in the past 3 months at 3-, 6- and 12-month follow-ups |
| Health status of participants at 12-month | 12 months after baseline | Measured by EQ-5D-5L. Comprises five dimensions (MOBILITY, SELF-CARE, USUAL ACTIVITIES, PAIN /DISCOMFORT and ANXIETY / DEPRESSION), each dimension has five response levels:no problems, slight problems, moderate problems, severe problems, unable to/extreme problems. The participant is asked to indicate his/her health state by checking the box next to the most appropriate response level. Responses are coded as single-digit numbers expressing the severity level selected in each dimension. Extreme problem is coded as 5, severe problem is coded as 4, moderate is coded as 3, slight problem is coded as 2 and no problem is coded as 1. |
| Current health of participants at 12-month | 12 months after baseline | Measured by EQ VAS. Participant is asked to rate his/her health on a vertical visual analogue scale. The scale is numbered from 0-100.100 means the best health, 0 is the worst. Participant will put a cross on the scale to indicate his/her current health. |
| Planned drinking measured in the coming 30-day at 3-, 6- and 12-month follow-ups | 3, 6, and 12 months after baseline | Compare the number of planned drinking (yes or no) between intervention group and control group at 3-, 6- and 12-month follow-ups |
| AUDIT scores at 3-, 6- and 12-month follow-ups | 3, 6 and 12 months after baseline | Assessed by Alcohol Use Disorders Identification Test (ranged 0-40 with higher score indicating problematic alcohol use) and compare the AUDIT between intervention and control group at 3-, 6- adn 12-month after baseline. |
Countries
Hong Kong
Outcome results
None listed