Screening and brief alcohol intervention to prevent hazardous drinking in adolescents aged 14–15 years in a high-school setting (SIPS JR-HIGH): a feasibility pilot trial

Abstract

BackgroundEarly and heavy drinking by young adolescents is linked to intellectual impairment, increased risk of injury, mental health issues, unprotected or regretted sexual experience, violence, and sometimes accidental death. Our aim was to assess the feasibility of delivering brief alcohol intervention in a school setting with adolescents aged 14–15 years; and to examine the acceptability of study measures to staff, young people, and parents, including take-up and follow-up rates. MethodsSeven schools across one geographical area in northeast England were recruited to this feasibility pilot trial. All schools within the study catchment area were judged eligible and approached to take part. Randomisation was done at the school level to reduce the chance of contamination. Allocation of schools to intervention was done by the study statistician, taking school size and socio-economic factors (proportion of free school meals) into account. Each school was randomly allocated to one of three groups: provision of an advice leaflet (control condition, two schools); a 30-min personalised session of structured advice delivered by the school learning mentor (level 1 condition, two schools); and a 60-min session with family members (level 2 condition, three schools). Trial participants were year 10 school pupils (aged 14–15 years) who screened positively for alcohol misuse with an alcohol screening questionnaire and who had consented to take part in the trial (n=181). Recruitment began on Jan 24, 2012, and finished on July 31, 2012. Statistical analyses were mainly descriptive, providing an estimate of eligibility, recruitment, intervention delivery, and retention rates in the study population. These key feasibility pilot trial parameters will inform the power calculation for a future definitive trial and confirm other aspects of trial design (particularly the acceptability of study processes and outcome measures to young people, their parents, teachers, and learning mentors). FindingsThis presentation focuses on the development of two manual-guided interventions for use with adolescents and parents, both of which encompass motivational interviewing principles and elements of the FRAMES approach to elicit behaviour change, which consists of the following elements: feedback, responsibility, advice, menu, empathy, and self-efficacy. Interventions were developed and piloted with young people and parents; training for learning mentors was divided into two half-day sessions. Each intervention used an A3-sized interactive document designed to promote a conversation about alcohol. The level 1 intervention was structured around a six-step method consisting of personalised feedback about drinking behaviour and advice about the health and social consequences of continued hazardous alcohol consumption. The level 2 intervention was structured around a four-step method designed to explore the young person's motivation to change their drinking behaviour and the family's motivation to facilitate and support change (appendix). InterpretationAlthough the use of brief interventions for adults is established in a health setting and there is evidence of their effectiveness in college and university students, very little work has been done in the UK to explore the early identification (screening) and brief intervention to reduce risky drinking in younger adolescents (aged 11–15 years), making a feasibility pilot study a necessary and important step of a definitive assessment. Results from this feasibility pilot trial will inform the development of a definitive randomised controlled trial to assess the effectiveness and cost-effectiveness of screening and brief alcohol intervention to reduce hazardous drinking in adolescents in a school setting. FundingThis project is funded by the National Institute for Health Research Public Health Research (NIHR PHR) programme (project number 10/3002/07).