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Cover of Brief alcohol intervention for risky drinking in young people aged 14–15 years in secondary schools: the SIPS JR-HIGH RCT

Brief alcohol intervention for risky drinking in young people aged 14–15 years in secondary schools: the SIPS JR-HIGH RCT

Public Health Research, No. 7.9

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Author Information
Southampton (UK): NIHR Journals Library; .

Headline

The intervention was ineffective in reducing risky drinking in young people aged 14–15 years, although it was well received by the young people and school staff who participated.

Abstract

Background:

Adverse effects from young people’s alcohol consumption manifest in a range of physical and psychosocial factors, including neurological issues, cognitive impairment and risk-taking behaviours. The SIPS JR-HIGH pilot trial showed alcohol screening and brief intervention (ASBI) to be acceptable to young people and schools in the north-east of England.

Objectives:

To conduct a two-arm, individually randomised controlled trial to evaluate the effectiveness and cost-effectiveness of ASBI for risky drinking in young people aged 14–15 years in the school setting, to monitor the fidelity of ASBI and to explore the barriers to, and facilitators of, implementation with staff, young people and parents.

Design:

A baseline survey with a 12-month follow-up. Interviews with 30 school staff, 21 learning mentors and nine teachers, and 33 young people and two parents.

Setting:

Thirty state schools in four areas of England: north-east, north-west, Kent and London.

Participants:

Year 10 school pupils who consented to the study (aged 14–15 years, recruited between November 2015 and June 2016), school-based staff and parents of the young people who took part in the study.

Interventions:

Young people who screened positively on a single alcohol screening question and consented were randomised to the intervention or control arm (blinded). The intervention was a 30-minute one-to-one structured brief intervention with a trained learning mentor and an alcohol leaflet. The control group received a healthy lifestyle leaflet (no alcohol information).

Main outcome measures:

The primary outcome measure was total alcohol consumed in the last 28 days. Secondary outcomes related to risky drinking, general psychological health, sexual risk-taking, energy drink consumption, age of first smoking, quality of life, quality-adjusted life-years, service utilisation and demographic information.

Results:

A total of 4523 young people completed the baseline survey, with 1064 screening positively (24%) and 443 being eligible to take part in the trial. Of those 443, 233 (53%) were randomised to the control arm and 210 were randomised to the intervention arm. Of the 443, 374 (84%) were successfully followed up at 12 months (intervention, n = 178; control, n = 196). The results were that the intervention showed no evidence of benefit for any alcohol-related measure when compared with the control arm. At 12 months we found a reduction from 61.9% to 43.3% using the Alcohol Use Disorders Identification Test cut-off point of 8 and cut-off point of 4 (69.0% to 60.7%). These results were not significant. A cost-effectiveness analysis showed that the average net cost saving of the brief intervention was £2865 (95% confidence interval –£11,272 to £2707) per year compared with usual practice, with the intervention showing a 76% probability of being cost saving compared with usual practice. The interview findings showed that school was an acceptable setting to carry out ASBI among staff and young people.

Limitations:

Recruitment of parents to take part in interviews was poor. Only 18 ASBI sessions were recorded, making it difficult to assess internal validity.

Conclusions:

Although the intervention was ineffective in reducing risky drinking in young people aged 14–15 years, it was well received by the young people and school staff who participated.

Future work:

Uniform reporting of the outcomes used for ASBI would generate more robust conclusions on the effectiveness of ASBI in the future. Pilot feasibility studies should include more than one geographical area. Future work on involving parents is needed.

Trial registration:

Current Controlled Trials ISRCTN45691494.

Funding:

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 9. See the NIHR Journals Library website for further project information.

Contents

About the Series

Public Health Research
ISSN (Print): 2050-4381
ISSN (Electronic): 2050-439X

Article history

The research reported in this issue of the journal was funded by the PHR programme as project number 13/117/02. The contractual start date was in September 2015. The final report began editorial review in April 2018 and was accepted for publication in August 2018. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PHR editors and production house have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.

Declared competing interests of authors

Eileen Kaner reports grants from the National Institute for Health Research (NIHR) Public Health Research Funding Board and grants from the NIHR Health Technology Assessment (HTA) programme. Denise Howel is a panel member for the NIHR Programme Grants for Applied Research (PGfAR) programme. Luke Vale is a member of the NIHR NTA Clinical Evaluation and Trials panel, was a panel member for NIHR PGfAR (2008–15), and is co-director of NIHR Research Design Service North East. Colin Drummond is part-funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and the NIHR Collaboration for Leadership in Applied Health Research and Care South London, and is in receipt of a NIHR Senior Investigator Award. Elaine McColl was a member of the NIHR Journals Library Editorial Group (PGfAR) from 2013 to 2016 and a panel member for NIHR PGfAR from 2008 to 2016. Harry Sumnall reports grants from Diageo (Diageo plc, London, UK) outside the submitted work, and he is an unpaid trustee of a drug and alcohol prevention charity, Mentor UK (London, UK), which seeks funding to deliver evidence-based prevention programmes.

Last reviewed: April 2018; Accepted: August 2018.

Copyright © Queen’s Printer and Controller of HMSO 2019. This work was produced by Giles et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.
Bookshelf ID: NBK540915PMID: 31067018DOI: 10.3310/phr07090

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