JMIR Publications

ABSTRACT

Background:

Alcohol consumption, including binge drinking and excessive drinking, is one of the leading risk factors in Spanish adolescents with significant social, health and economic consequences. Reduction of binge drinking and excessive drinking in adolescents can be achieved using web-based computer-tailored interventions, providing highly personalized feedback that is adapted to a person’s individual characteristics and needs. Randomized controlled trials assessing the effects of tailored binge-drinking reduction programs among Spanish adolescents are scarce.

Objective:

The aim was to test the effectiveness of the Web-based Computer-Tailored intervention (Alerta Alcohol) aimed at the prevention of binge drinking in Spanish adolescents. The adherence and process evaluation were also assessed.

Methods:

A cluster randomized controlled trial conducted among 15 Spanish schools was developed. Each school was randomized into either an experimental (n=742) or a control (n=505) condition. Baseline assessment took place in January and February 2017. Demographic variables and alcohol use were assessed at baseline. Follow-up assessment of alcohol use took place 4 months later (May and June 2017). The independent variable was the participation versus non-participation in the intervention. After the baseline assessment, participants in the experimental condition started with the intervention consisting of short stories about binge drinking in which computer-tailored feedback was based on the I-change model to change behaviours. Participants in the control condition only received the baseline questionnaire. Effects of the intervention were assessed using a three-level mixed logistic regression analysis for binge drinking, excessive drinking, and lifetime consumption, and a three-level mixed linear regression analysis for weekly consumption.

Results:

In total, 1247 adolescents participated in the baseline assessment, and 612 adolescents in the follow-up (attrition rate = 50.9%). The intervention was effective in reducing excessive drinking among adolescents, being 9 times the odds of excessive drinking in the control condition than in the experimental condition (p=.040). No effects were found for binge drinking, lifetime consumption and weekly consumption. Process evaluations revealed that the adolescents were satisfied with the program (68.8%), would use the program again (52.9%), and would recommend the program to someone else (62.8%). In general, females and non-binge drinkers showed better responses in the process evaluation.

Conclusions:

Our intervention was effective for adolescents concerning excessive drinking but not for binge drinking, weekly consumption and lifetime consumption. It may be that limiting alcohol consumption to prevent excessive drinking was easier in the Spanish context than it was to carry out further steps such as reducing other patterns of alcohol consumption. Hence, additional actions are needed to accomplish these latter goals, including community approaches and policy actions aimed at denormalizing alcohol consumption among Spanish adolescents. Clinical Trial: Trial registration number (ClinicalTrials.gov): NCT03288896. This study was retrospectively registered on 19/09/2017.