Abstract
BackgroundBinge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications. This paper describes the design, implementation and evaluation of the first web-based computer tailored intervention aimed at the prevention of binge drinking in Spanish adolescents.MethodsThe Alerta Alcohol program is based on the I-Change Model. First, feedback from focus and Delphi groups are used for cultural adaptation and to obtain further information on the items to be included on the program. A pilot study is then conducted to assess feasibility and to identify strengths and weaknesses. Second, a Cluster Randomized Controlled Trial is conducted to test the effectiveness of Alerta Alcohol in students aged 16 to 18 years. The study is performed in 16 high schools from Andalusia (southern Spain), which are randomized either to the experimental or the control condition (EC and CC). The EC receives the Alerta Alcohol intervention, which consists of four sessions at school (baseline questionnaire, two sessions in three scenarios: at home, celebrations, and public places, and a final evaluation). The adolescents are provided with answers related to their views of each scenario; this information is used to provide highly specific feedback regarding their knowledge, risk perception, self-esteem, attitude, social influence, and self-efficacy. In addition, two booster sessions are given at home to reinforce the previous messages. The CC just completes the baseline and the final evaluation questionnaires and then they are allowed to receive the intervention as well (as a waiting list). Evaluation takes place after four months. The primary endpoint is binge drinking within 30 days prior to the evaluation and alcohol use in the previous week. It is expected that Alerta Alcohol reduce the prevalence of binge drinking by 10%. Follow up analyses are carried out to determine the differences in effectiveness according to the compliance of the program (quality of the implementation).DiscussionThe results are expected to be applicable and may incorporate improvements in the practice of the Healthcare and Education Systems. If the program proves to be effective, regional and eventual national implementation should be considered.Trial registrationTrial registration number (ClinicalTrials.gov): NCT03288896. This study was retrospectively registered on 19/09/2017.
Highlights
Binge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications
Alcohol drinking in adolescents is a socio-health problem of crucial importance, because of its high prevalence and the physical and mental health risks affecting the adolescent consumers, in addition to the psychosocial and community implications derived from alcohol abuse [3,4,5,6, 47]
This paper describes the design, implementation, and evaluation of the first computer tailoring (CT) tailored intervention aimed to prevent alcohol drinking and binge drinking in Spanish adolescents aged 16 to 18
Summary
Binge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications. Alcohol drinking has become endemic, and part of the social and cultural life, resulting in a great social permissiveness and a low perception of its risks. It is widely available, easy accessible and lacks restrictive legislation [4]. In the recent years, important changes have occurred concerning the amount of ingested alcohol and the drinking patterns, in the adolescent and the young adult population [5]. Binge drinking, defined as consuming five or more drinks by men, or four or more by women, within a short period of time [6, 7], is increasingly prevalent among youngsters aged 15 to 24, in whom it is becoming the usual pattern of consumption
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