JMIR Publications

ABSTRACT

Background:

Despite intervention efforts to date, the prevalence of risky drinking among adolescents and emerging adults remains high, increasing risk for health consequences as well as the development of alcohol use disorders. Peer influences are particularly salient among this age group, including via social media. Thus, the development of efficacious early interventions for youth, delivered with broad reach via trained peers on social media, could have an important role in addressing risky drinking.

Objective:

This paper describes the protocol for a randomized controlled trial (RCT) testing the efficacy of a social media intervention among adolescents and emerging adults who meet criteria for risky drinking (using the Alcohol Use Disorders Identification Test-Consumption; AUDIT-C), delivered with and without financial incentives for participation, as compared to an attention placebo control condition (i.e., entertaining social media content), on alcohol consumption and consequences.

Methods:

This RCT involved recruiting 955 youth (ages 16-24) via ads on Facebook and Instagram to self-administer a brief online screening survey. Those screening positive for past-3-month risky drinking (AUDIT-C positive: 16-17: >3 females, >4 males; ages 18-24: >4 females, >5 males) were eligible for the RCT. After providing consent (a waiver of parental consent was obtained for minors), participants completed an online baseline survey and several verification procedures, including a “selfie” photo matched to Facebook profile photos. Participants were then randomized to Facebook “secret” groups, which are not searchable or viewable by parents, friends, or anyone not recruited by the study and can be joined by an invitation from an e-coach only. The three conditions are: Social Media Intervention + Incentives (SMI+I), Social Media Intervention without incentives (SMI) and attention-placebo Control (C). Each condition lasts 8-weeks and consists of bachelor’s and master’s level therapist “e-coaches” posting relevant content and responding to participant posts in a manner consistent with Motivational Interviewing. Participants in the control condition and SMI condition did not receive payments, but were blind to condition assignment between these two conditions. Follow-ups occur at 3-, 6-, and 12-months post-start of groups.

Results:

We enrolled 955 participants over 10 waves of recruitment who screened positive for risky drinking into the RCT. Follow-ups are ongoing.

Conclusions:

Findings will provide the critical next step in delivering early alcohol interventions to youth, capitalizing on social media platforms, which could have enormous public health implications by altering alcohol use trajectories of adolescents and emerging adults engaged in risky drinking. Clinical Trial: ClinicalTrials.gov # AA024175. University of Michigan HUM#00102242,