Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 10, 2020
Date Accepted: May 6, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Comparison of Peer versus Provider Messaging to Reduce Alcohol Use for College Students with Type 1 Diabetes: Results from a Pilot Trial
ABSTRACT
Background:
College environments promote high volume/binge alcohol consumption among youth, which may be especially harmful for those with Type 1 Diabetes (T1D). Little is known about the acceptability and effectiveness of preventive interventions targeting reduced alcohol use by college youth with T1D, and it is unclear whether intervention spokesperson matters. Interventions promoted by peer educators may be highly relatable and socially persuasive, while those delivered by clinical providers may be highly credible and motivating.
Objective:
We sought to determine the acceptability and impacts of an alcohol use psychoeducational preventive intervention delivered asynchronously via online channels to college youth with T1D. We further sought to compare impacts of two competing versions of the intervention that differed by spokesperson.
Methods:
We recruited 138 college students (ages 17-25) with T1D via online channels and delivered a brief intervention to participants randomly assigned to one of two otherwise-identical versions that differed only with respect to the audiovisually recorded spokesperson narrator. We assessed impacts of the exposure to the intervention overall and by group, comparing levels of alcohol and diabetes related knowledge, perceptions, and use between baseline, immediately and two weeks following intervention delivery.
Results:
Of 138 enrolled participants, 122 (88.4%) completed all follow-up assessments; participants were predominantly female (80.3%), white non-Hispanic (83.6%), and past year drinkers (82.8%). Both groups saw significant post-intervention gains in knowledge of alcohol’s impacts on diabetes-related factors, health-protecting attitudes toward drinking, and concerns about drinking. All participants reported significant decreases in binge drinking two weeks post-intervention (21.3%, OR 0.48, 95%CI 0.31-0.75) compared to the two weeks prior (35.2%). Changes in binge drinking post-intervention were impacted by changes in concerns about alcohol use and T1D. Those who received the provider intervention were significantly more likely to rate their spokesperson as knowledgeable and trustworthy; there were no other significant difference in intervention effects by spokesperson.
Conclusions:
The intervention model was highly acceptable and effective at reducing self-reported binge drinking at follow-up, offering potential for broad dissemination and reach given the online format and use of asynchronously delivered content. Both intervention spokespersons increased knowledge, improved health-protecting attitudes, and increased concerns regarding alcohol use. Participant perception of expertise and credibility differed by spokesperson. Clinical Trial: NCT02883829
Citation
