Abstract
BackgroundThere is a large disparity between alcohol treatment access and prevalence of hazardous drinking among same-sex attracted women (SSAW). Yet, this population typically report low satisfaction with care and a reluctance to attend mainstream health services. Currently, there are few culturally tailored services for SSAW available despite evidence indicating that many feel uncomfortable in mainstream services. This paper describes the protocol of a randomised controlled trial aimed at examining the impact of a culturally sensitive four-week short message service (SMS) alcohol intervention on SSAW’s alcohol intake, wellbeing, and engagement with alcohol treatment.MethodsA randomised controlled trial comparing a culturally tailored SMS intervention (The Step One Program) with a generic ‘thank you’ message, and a nested qualitative study to further explore the intervention’s feasibility and acceptability. The Step One Program was co-designed using an Intervention Mapping framework and engaging potential consumers in the developmental process. Participants are block randomised (1:1 ratio) and followed up at the completion of the intervention and at 12 weeks post-intervention. The primary outcomes are alcohol reduction (as measured by the Alcohol Use Disorders Identification Test and self-reported alcohol intake), wellbeing (as measured by the Personal Wellbeing Index – Adult), and help-seeking (as measured by the number of alcohol services accessed and frequency of access). Upon completion of the 12-week post-intervention survey, participants in the intervention group were contacted via email regarding a phone interview on intervention acceptability.DiscussionThis study may have important implications for clinical practice, improve healthcare access and equity for SSAW, and provide direction for future research in this field. The outcomes of the current study may stimulate the development of other culturally tailored health programs for SSAW. The results will inform whether individually tailoring the messages according to content and delivery frequency may be warranted to increase its acceptability.Trial registrationThis trial was registered with the Australian New Zealand Clinical Trials Registry (trial ID: ACTRN12617000768392).
Highlights
There is a large disparity between alcohol treatment access and prevalence of hazardous drinking among same-sex attracted women (SSAW)
SSAW tend to drink more than heterosexual women but are generally less likely to seek treatment [4, 24, 60, 61]
There are a range of barriers to SSAW accessing treatment [1], including a reluctance to attend mainstream clinical services, reports of low satisfaction with their care in these services, and difficulty finding services that are culturally tailored, sensitive and meet their needs [5,6,7,8]
Summary
Study design A mixed methods approach was employed with a twogroup, parallel, single-blind RCT, and a nested qualitative. Participants from the Rainbow Women’s Help-Seeking study (which examined professional and social help-seeking by SSAW) [7], and the ALICE study (which investigated socio-cultural factors which influenced alcohol use, sexual orientation, mental health, and health service use among SSAW) [1], with permission from the University of Melbourne; 4. Public common areas, such as restrooms and community noticeboards. This includes transgender women, transgender men, and gender diverse individuals. Own a mobile phone with SMS capabilities and have access to the internet
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