DYD-RCT: On-line randomised controlled trial of an interactive web-based intervention for reducing alcohol consumption

Lead Research Organisation: University College London
Department Name: Unlisted

Abstract

We are investigating whether a website (Down Your Drink) can help heavy drinkers drink less alcohol. It is estimated that around 7.1 million people in England aged 16 - 64 (26% of the population) are drinking over the recommended safe levels. Although treatments do exist, there are many people in need of treatment that do not have access to it.

Some studies have found the use of websites for people with long-term conditions (such as heart disease) to be associated with improved knowledge, confidence, social support, health behaviours and clinical outcomes. Internet interventions are popular with users, as they are convenient (can be used at any time of day or night), accessible (can be used by anyone with Internet access), anonymous and confidential. They can be revisited as often as wanted, which may help to change behaviour and prevent relapse.

We have updated the existing Down Your Drink website inline with user feedback and research findings on user requirements of Internet interventions. To find out what features of Down Your Drink are responsible for changing behaviour, if any, our participants have access to different areas of the website. We hope to make Down Your Drink freely available in December 2009.

Technical Summary

Excess alcohol consumption is a major public health problem with around one quarter of the UK population at risk of harm from excess alcohol. Brief interventions are known to be effective in reducing alcohol consumption, but often fail to reach those at risk. A pilot study found that an on-line intervention could reduce alcohol consumption in heavy drinkers. The aim of the study is to determine whether the fully interactive on-line intervention DYD: www.downyourdrink.org.uk leads to important reductions in alcohol consumption amongst members of the public at risk of harm from alcohol. The comparator for the study will be the minimially interactive website HYD: www.howsyourdrink.org.uk which will provide information only. The trial will be conducted entirely on-line, including registration, screening, recruitment, randomisation and baseline and follow-up assessments. This will be a 3.5-year complex intervention study, incorporating a Phase 2 development stage taking 15 months (optimization of intervention, on-line trial materials, and overall trial design, together with a pilot phase to determine the likely rates of recruitment and compliance), and a Phase 3 two-arm randomized controlled trial conducted on-line, with recruitment over 12 months and follow-up for 12 months. Stop-go criteria will be used for decisions regarding progression from Phase 2 to Phase 3. Trial closure, analysis and publication will take a further 3 months.

Publications

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Essex HN (2014) Quality of life among hazardous and harmful drinkers: EQ-5D over a 1-year follow-up period. in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation

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Linke S (2008) Development of a psychologically enhanced interactive online intervention for hazardous drinking. in Alcohol and alcoholism (Oxford, Oxfordshire)

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Murray E (2013) Attrition revisited: adherence and retention in a web-based alcohol trial. in Journal of medical Internet research

 
Description AERC, Developing people project grant
Amount £15,950 (GBP)
Organisation Alcohol Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2008 
End 04/2008
 
Description CLAHRC
Amount £9,000,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR CLAHRC North Thames
Sector Private
Country United Kingdom
Start  
 
Description Collaboration with Kingston Primary Care Trust
Amount £79,764 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 02/2009 
End 01/2011
 
Description Feasibility study of electronic screening and brief intervention for alcohol misuse in public sector workplace settings
Amount £52,000 (GBP)
Organisation Alcohol Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Title TOT-AL 
Description As part of this study, we have developed a tool called the "TOT-AL" (total past week alcohol consumption). This tool allows users to input everything they have drunk in the last week using drop down menus, and the amount of units is then calculated. The user does not see the total amount of units - it is recorded in a database. 
Type Of Material Database/Collection of Data/Biological Samples 
Provided To Others? No  
Impact We have been approached by other alcohol researchers asking if they can use the tool, and we are currently investigating ways in which we can make the tool widely available as we believe it will prove extremely useful. 
 
Title TOT-AL 
Description The "TOT-AL" (total past week alcohol consumption) tool allows users to input everything they have drunk in the last week using drop down menus, and the amount of units is then calculated. The user does not see the total amount of units - it is recorded in a database. 
IP Reference  
Protection Copyrighted (e.g. software)
Year Protection Granted 2010
Licensed No
Impact We hope this will be a valuable tool for other alcohol researchers, and work is underway to make it downloadable from the e-Health Unit webpages. It will be license protected.
 
Description Annual Young Statisticians Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Primary Audience Public/other audiences
Results and Impact PILOT DownYourDrink: An online randomized controlled trial of a fully interactive web-based intervention for reducing excessive alcohol consumption

It informed young statisticians about statistical techniques available to handle common problems of RCTs like missing outcome data and incomplete uptake of intervention
Year(s) Of Engagement Activity 2008
 
Description British Psychological Society; Faculty of Addictions 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact Down your Drink - web-based alcohol treatment

Stuart Linke was invited to participate in the NICE guideline development consultation.
Year(s) Of Engagement Activity 2008
 
Description INEBRIA Conference, Brussels 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact 'Down Your Drink: 'pilot study'

As a result of this meeting, the PI is involved as a Work Package lead in an application for an EU Framework Vll grant to determine the potential to implement Internet based screening and intervention programmes in primary care seettings in Europe
Year(s) Of Engagement Activity 2007
 
Description INEBRIA Conference, Brussels 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact An analysis of feedback from people who have completed a 6 week internet intervention for problem drinking

Dissemination of research.
Year(s) Of Engagement Activity 2007
 
Description Royal Society of Medicine Telemed & e-Health 07 Conference 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact An analysis of feedback from people who have completed a 6 week internet intervention for problem drinking

This keynote presentation to the Annual RSM Telemed & e-Health conference had a significant international audience. As a result of the presentation, attendees realised the potential of the internet for delivering behaviour change and self-help interventions.
Year(s) Of Engagement Activity 2007
 
Description SAPC, Galway 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact DIGITAL POSTER PRESENTATION WITH DISCUSSION - The DYD-RCT Pilot: an on-line trial of an on-line intervention to help heavy drinkers drink less

This presentation to an international conference of primary care academics focused on the research challenges that arise when undertaking a randomised controlled trial entirely on-line. This is a new methodological field, which was of considerable interest to delegates.
Year(s) Of Engagement Activity 2008
 
Description Society for the Study of Addiction Annual Symposium Plenary Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience Public/other audiences
Results and Impact This talk was entitled: "Down your Drink: An online intervention for heavy drinkers"

The Society for the Study of Addiction is the main UK body pursuing a scholarly interest in research and practice in addiction. The presentation about DYD in this forum resulted in the major opinion formers and policy makers in this field understanding the potential impact and reach of an internet based self-help programme for alcohol.
Year(s) Of Engagement Activity 2007
 
Description Synergy Workshop, Bath 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Primary Audience Public/other audiences
Results and Impact Using the internet for behavior change; the Down Your Drink Case Study

A keynote presentation to a specialised symposium on use of the internet for behaviour change. The UK is slightly behind countries such as the US and Canada in this field, and one benefit of this presentation was to show that there is cutting edge research occurring in the UK in this area.
Year(s) Of Engagement Activity 2008
 
Description UCL sub-department of Clinical Health Psychology Conference 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact Hazardous drinking : use of new techniques in screening and brief intervention

Links were strengthed with the UCL Psychology department, and future collaborations are being discussed. Stuart Linke was also approached by two trainee clinical psychologists who decided to take up research in the e-Health field after this presentation.
Year(s) Of Engagement Activity 2008