Developing a coping motives targeted brief intervention for high-risk young drinkers

The first aim of the fellowship is to build on my PhD research to develop a novel brief intervention for hazardous drinking young people. Although alcohol use is declining in teenagers and young adults overall, a particular subset of individuals who drink to regulate or manage their emotions remain at particularly high risk of developing later dependence (Beseler et al. 2008; Crum et al. 2013; Merrill et al. 2014). These high-risk individuals require targeted interventions. My proposed intervention combines a number of elements with prior evidence of efficacy in hazardous alcohol use. High-risk individuals will be provided with personalised feedback regarding the specific negative emotions which trigger their drinking (for example, anger, sadness, boredom) (Blevins and Stephens 2016) and encouraged to generate individualised alternative coping strategies (Conrod et al. 2013). Crucially, individuals will also be instructed in functional imagery training, a promising technique used to encourage adoption of adaptive behaviours in high-risk scenarios. We consider this third component critical to the long-term success of this intervention, since there is evidence that such training can promote enduring changes in key health behaviours, including food choice in obesity (Solbrig et al. 2018). While personalised feedback on drinking motives and generation of alternative coping strategies have proved effective in hazardous drinking populations (Blevins and Stephens 2016; Conrod et al. 2013), my proposed research would be the first to combine these, with functional imagery training, into a preventative intervention for young people. It would also condense these effective components into a briefer, and therefore cheaper, intervention than has been previously developed (e.g. by Conrod et al. (2013)), with the potential for online delivery.

Pilot 1: Y-Smart Drug and Alcohol Service for under 18s

The first planned pilot study will test this novel intervention in a high-risk population of alcohol treatment-engaged adolescents (in partnership with the charity Y-Smart which delivers services to this cohort). This pilot will provide critical information regarding the feasibility and acceptability of the intervention in service users. Sixteen young people who endorse regularly drinking to cope (and who are therefore at risk of later alcohol dependence) will be selected, and randomly assigned to intervention or active control group (standard alcohol education). At two-week follow up, a drinking monitoring log will measure alcohol consumption, urge to drink, and alcohol-related problems. It is expected that the brief intervention should reduce each of these indices, providing preliminary evidence of efficacy. The intervention will be designed to be brief, resource efficient, and easily deliverable electronically, allowing broad dissemination should it be successful.

Pilot 2: South African adolescents

This intervention will also be piloted concurrently in a sample of high-risk South African adolescents, in collaboration with Prof Soraya Seedat at Stellenbosch University (Hogarth et al. 2019). This will establish the cross-cultural utility of the intervention and its potential for roll out in low and middle income countries (LMICs).

Additional outputs

The development and ultimate validation of the intervention proposed is a long-term project, for which this fellowship would provide a significant initial stepping stone. Secondary aims of the fellowship have therefore been designed to facilitate longer term project goals, and professional development of the PI. Additional planned outputs from this fellowship include publication of four original research projects from my PhD, a systematic review, and development of three grant applications. These are detailed in the work plan, and described in further detail below and in the case for support.