Alcohol brief interventions for male remand prisoners: a mixed-methods feasibility and acceptability study

Abstract

BackgroundThe global prison population exceeds 10 million. Drinking at levels that put a person at risk of health or social harms is a recognised public health concern in remand prisoners. We aimed to explore the feasibility and acceptability of an alcohol brief intervention for adult men on remand in prison and to develop an appropriate alcohol brief intervention and protocol for a multicentre pilot randomised controlled trial. MethodsWe used mixed-methods design in two prisons in the UK (one in Scotland and one in England). Individuals were given information leaflets before the study and consent was obtained from all participants. We used a survey that included questions relating to alcohol use (using the 10-item Alcohol Use Disorders Identification Test) and semi-structured interviews to explore feasibility, and acceptability of an intervention trial, to collect data between June 16, 2016, and Nov 25, 2016. Findings502 incarcerated males (237 [47%] sentenced; 265 [53%] remand) pariticpated in the survey (257 participants in Scotland, 245 particiapnts in England). Most participants were white British (480 men [96%]) and mean age was 33 years (SD 10). 402 (81%) of 496 men scored positive for an alcohol use disorder (188 [80%] of 235 sentenced men; 214 [82%] of 261 remand prisoners). 208 (42%) of 496 men scored as probably dependent on alcohol (81 [34%] of 235 sentenced men; 127 [49%] of 261 remand prisoners). 417 (92%) of 453 men reported that they would not feel coerced to take part in research. 166 (64%; 95% CI 57–69) of 261 men on remand and 113 (48%; 42–55) of 234 sentenced prisoners thought that an alcohol brief intervention of at least 20 min would be useful in the prison setting. We did semi-structured interviews with 24 participants (12 participants in Scotland, 12 participants in England; mean age 30·71 years, range 18–64) to ascertain views of participants. The results show that participants thought that prison is a feasibile and acceptable setting for an alcohol brief intervention; however, participants would like follow-up interventions after release and considered it important that the intervention was not delivered by prison staff. InterpretationThis study resulted in a successful bid to progress this work through a pilot randomised controlled trial. FundingMedical Research Council Public Health Intervention Development scheme (MRC-PHIND).