Alcohol Brief Intervention Integrated With Mobile Chat-based Support for Risky Drinkers in Emergency Departments: a Pragmatic Randomised Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- The University of Hong Kong
- Enrollment
- 632
- Locations
- 2
- Primary Endpoint
- Amount of alcohol consumption per week (gram/week) at 12-month follow-up
Study Overview
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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts 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
Arms & Interventions
Intervention group
Alcohol brief intervention, leaflets, regular personalized messages on ABI through IM Apps, real-time chat-based support through IM Apps
Intervention: Alcohol brief intervention (Behavioral)
Intervention group
Alcohol brief intervention, leaflets, regular personalized messages on ABI through IM Apps, real-time chat-based support through IM Apps
Intervention: 12-page health warning leaflet (Behavioral)
Intervention group
Alcohol brief intervention, leaflets, regular personalized messages on ABI through IM Apps, real-time chat-based support through IM Apps
Intervention: Regular messages through Instant Messaging (IM) (Behavioral)
Intervention group
Alcohol brief intervention, leaflets, regular personalized messages on ABI through IM Apps, real-time chat-based support through IM Apps
Intervention: Real-time chat-based support through IM Apps (Behavioral)
Intervention group
Alcohol brief intervention, leaflets, regular personalized messages on ABI through IM Apps, real-time chat-based support through IM Apps
Intervention: AUDIT score interpretation sheet adapted from the Department of Health of Hong Kong (Behavioral)
control group
Alcohol brief intervention, leaflets, regular messages on general health through SMS
Intervention: Alcohol brief intervention (Behavioral)
control group
Alcohol brief intervention, leaflets, regular messages on general health through SMS
Intervention: 12-page health warning leaflet (Behavioral)
control group
Alcohol brief intervention, leaflets, regular messages on general health through SMS
Intervention: AUDIT score interpretation sheet adapted from the Department of Health of Hong Kong (Behavioral)
Outcomes
Primary Outcomes
Amount of alcohol consumption per week (gram/week) at 12-month follow-up
Time Frame: 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
Time Frame: 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 Outcomes
- Health status of participants at 12-month(12 months after baseline)
- Current health of participants at 12-month(12 months after baseline)
- Amount of alcohol consumption per week (gram/week) at 3- and 6-month follow-ups(3 and 6 months after baseline)
- AUDIT scores at 3-, 6- and 12-month follow-ups(3, 6 and 12 months after baseline)
- Number of standard drinks (10g of alcohol) per week at 3-, 6-, and 12-month follow-ups(3, 6 and 12 months after baseline)
- Episode of binge drinking in the past 30-day at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- Episode of heavy drinking in the past 30-day at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- Planned drinking measured in the coming 30-day at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- Re-attendance of AED at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- Amount of alcohol consumption per week (gram/week) at 3- and 6-month follow-ups(3 and 6 months after baseline)
- Episode of binge drinking in the past 30-day at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- Planned drinking measured in the coming 30-day at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- AUDIT scores at 3-, 6- and 12-month follow-ups(3, 6 and 12 months after baseline)
- Number of standard drinks (10g of alcohol) per week at 3-, 6-, and 12-month follow-ups(3, 6 and 12 months after baseline)
- Episode of heavy drinking in the past 30-day at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- Re-attendance of AED at 3-, 6- and 12-month follow-ups(3, 6, and 12 months after baseline)
- Health status of participants at 12-month(12 months after baseline)
- Current health of participants at 12-month(12 months after baseline)
Investigators
Dr. Wang Man-Ping
Professor
The University of Hong Kong