JMIR Publications

ABSTRACT

Background:

Sexual minority women (SMW) disproportionately engage in heavy drinking and shoulder the burden of alcohol dependence. Although several intensive interventions are being developed to meet the needs of treatment-seeking SMW, there remains a lack of preventative interventions able to reduce drinking and consequences among women not yet motivated to reduce their consumption.

Objective:

This hybrid trial examined the feasibility and efficacy of reducing alcohol-related risks among via personalized normative feedback (PNF) on alcohol use and coping delivered within LezParlay, a social media–inspired, digital competition designed to challenge negative stereotypes about lesbian, bisexual, and queer (LBQ) identified SMW.

Methods:

Feasibility was assessed by examining LezParlay engagement outside of the context of an incentivized research study, assessing the characteristics of LBQ women taking part, examining the competition’s ability to derive risk-reducing actual norms as well as levels of acceptability and perceived benefits reported by participating LBQ drinkers. Intervention efficacy was examined by randomizing a subsample of LBQ drinkers already taking part in the competition to receive sexual identity specific PNF on alcohol use and coping, alcohol use only, or control topics only over 2 rounds of play. Changes in alcohol use and negative consequences were examined 2 and 4 months following PNF delivery.

Results:

A total of 2,667 diverse LBQ women played 1 or more rounds of LezParlay. The competition attracted large numbers of moderate and heavy drinkers; however, risk-reducing actual norms were still able to be derived in round from round data to be featured in PNF. Efficacy results revealed that LBQ drinkers (N=499) who received PNF on alcohol use and both alcohol use and coping similarly reduced their weekly drinks (Ps < .001-.003), peak drinks (Ps < .001), and negative consequences (Ps < .001) relative to those who received PNF on control topics at the 2-month follow-up. However, at the 4-month follow-up, reductions in alcohol consumption outcomes faded among those in who received alcohol PNF only (Ps =.06-.11) while they remained relatively robust among those who received PNF on both alcohol use and coping (Ps =.02-.03). Finally, the subsample of LBQ drinkers surveyed found the competition as a whole to be highly acceptable and psychologically beneficial.

Conclusions:

The LezParlay competition was found to be a feasible and efficacious means of reducing alcohol-related risks among LBQ women. Findings demonstrate the utility of correcting sexual identity specific drinking and coping norms to reduce alcohol-related risks among LBQ women and suggest that this approach may also prove fruitful in other stigmatized health disparity populations. Findings also point to packaging PNF within a broader culturally tailored competition designed to challenge negative stereotypes in order to both engage these populations in the real world and expand the psychological benefits associated with PNF. Clinical Trial: ClinicalTrials.gov NCT03884478; https://clinicaltrials.gov/ct2/show/NCT03884478