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Coulton S, Giles EL, McGeechan GJ, Deluca P, Drummond C, Howel D, Kaner E, McColl E, McGovern R, Scott S, Sumnall H, Vale L, Albani V, Boniface S, Ferguson J, Gilvarry E, Hendrie N, Howe N, Ramsay A, Newbury-Birch D. The Effectiveness and Cost-Effectiveness of Screening and Brief Alcohol Intervention to Reduce Alcohol Consumption in Young People in the High School Setting: A Pragmatic Randomized Controlled Trial (SIPS JR-HIGH). Alcohol Alcohol 2022; 57:261-269. [PMID: 35134128 PMCID: PMC8919403 DOI: 10.1093/alcalc/agab087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Simon Coulton
- Centre for Health Service Studies, University of Kent, Canterbury, UK
| | - Emma L Giles
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Grant J McGeechan
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Paolo Deluca
- Institute of Psychiatry, Psychology & Neuroscience, King’s College, London, UK
| | - Colin Drummond
- Institute of Psychiatry, Psychology & Neuroscience, King’s College, London, UK
| | - Denise Howel
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Elaine McColl
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Stephanie Scott
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Harry Sumnall
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Luke Vale
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Viviana Albani
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | | | - Jennifer Ferguson
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Eilish Gilvarry
- Northumberland, Tyne & Wear NHS Foundation Trust, St Nicholas Hospital, Newcastle-upon-Tyne, UK
| | - Nadine Hendrie
- Centre for Health Service Studies, University of Kent, Canterbury, UK
| | - Nicola Howe
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle-upon-Tyne, UK
| | - Amy Ramsay
- Institute of Psychiatry, Psychology & Neuroscience, King’s College, London, UK
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Waedel L, Daubmann A, Zapf A, Reis O. Effectiveness of a mindfulness-oriented substance use prevention program for boys with mild to borderline intellectual disabilities: study protocol for a randomised controlled trial. BMC Public Health 2020; 20:1780. [PMID: 33238932 PMCID: PMC7686945 DOI: 10.1186/s12889-020-09878-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Boys with mild to borderline intellectual disabilities (MBID) are at particular risk to drink in harmful ways once they start to consume alcohol. Interventions based on mindfulness have been proven to be effective in preventing substance use, but mostly for adults with MBID. A mindfulness oriented intervention targeting 11-17 years old boys will be tested in a randomised controlled trial. Study aim is to investigate the benefits of this new intervention compared to an active control condition within a 12 months follow-up. METHODS In this randomised controlled proof of concept study, 82 boys with MBID who consumed any alcohol during the last year will be randomised either to the 6 week mindfulness oriented intervention or the control group receiving a control intervention equal in dose and length. The intervention group undergoes mindfulness training combined with interactive drug education, while the control group completes a health training combined with the same education. In the intention-to-treat analysis the primary outcome is the self-reported delay of first post-intervention drunkeness within a 12 months follow-up time span, measured weekly with a short app-based questionnaire. Secondary outcome is the use of alcohol, tobacco and other drugs within 30 days post-intervention. Changes in neurobiological behavioural parameters, such as impulse control, reward anticipation, and decision making, are also investigated. Other secondary outcomes regard trait mindfulness, emotion regulation, psychopathological symptoms, peer networks, perceived stress, and quality of life. In addition, a prospective registry will be established to record specific data on the population of 11-17 year old boys with MBID without any alcohol experience. DISCUSSION This study offers the opportunity to gain first evidence of the effectiveness of a mindfulness-oriented program for the prevention of substance use for boys with MBID. TRIAL REGISTRATION German Clinical Trials Register, DRKS00014042 . Registered on March 19th 2018.
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Affiliation(s)
- Lucie Waedel
- Department of Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Antonia Zapf
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Olaf Reis
- Department of Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
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Giles EL, McGeechan GJ, Scott SJ, McGovern R, Boniface S, Ramsay A, Hendrie N, McColl E, Sumnall H, Newbury-Birch D, Kaner E. A qualitative account of young people's experiences of alcohol screening and brief interventions in schools: SIPS Jr-HIGH trial findings. J Public Health (Oxf) 2020; 42:e259-e267. [PMID: 32812046 PMCID: PMC7435216 DOI: 10.1093/pubmed/fdz074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 05/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The United Kingdom (UK) has seen a decrease in the number of young people drinking alcohol. However, the UK prevalence of underage drinking still ranks amongst the highest in Western Europe. Whilst there is a wealth of evidence reporting on the effectiveness of both primary, and secondary interventions, there are few reports of the experiences of young people who receive them. METHODS The present study reports findings from interviews with 33 young people who were involved in an alcohol screening and brief intervention randomized controlled trial in schools in England. All interviews were analysed using inductive applied thematic analysis. RESULTS Three major themes were identified following the analysis process: 1) drinking identities and awareness of risk; 2) access to support and advice in relation to alcohol use; and 3) appraisal of the intervention and potential impact on alcohol use. CONCLUSIONS There appeared to be a reluctance from participants to describe themselves as someone who drinks alcohol. Furthermore, those who did drink alcohol often did so with parental permission. There was variation amongst participants as to how comfortable they felt talking about alcohol issues with school staff. Overall participants felt the intervention was useful, but would be better suited to 'heavier' drinkers.
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Affiliation(s)
- E L Giles
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - G J McGeechan
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BX, UK
| | - S J Scott
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BX, UK
| | - R McGovern
- Institute of Health and Society, Newcastle University, Newcastle, NE2 4AX, UK
| | - S Boniface
- Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London SE5 8AF, UK
| | - A Ramsay
- Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London SE5 8AF, UK
| | - N Hendrie
- Centre for Health Services Research, University of Kent, Canterbury, Kent, CT2 7NF, UK
| | - E McColl
- Institute of Health and Society, Newcastle University, Newcastle, NE2 4AX, UK
| | - H Sumnall
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, L3 2 ET, UK
| | - D Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BX, UK
| | - E Kaner
- Institute of Health and Society, Newcastle University, Newcastle, NE2 4AX, UK
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Giles EL, McGeechan GJ, Coulton S, Deluca P, Drummond C, Howel D, Kaner E, McColl E, McGovern R, Scott S, Stamp E, Sumnall H, Todd L, Vale L, Albani V, Boniface S, Ferguson J, Gilvarry E, Hendrie N, Howe N, Mossop H, Ramsay A, Stanley G, Newbury-Birch D. Brief alcohol intervention for risky drinking in young people aged 14–15 years in secondary schools: the SIPS JR-HIGH RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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.
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Affiliation(s)
- Emma L Giles
- School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - Grant J McGeechan
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Simon Coulton
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Paolo Deluca
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Colin Drummond
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Denise Howel
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Stephanie Scott
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Elaine Stamp
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Harry Sumnall
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, UK
| | - Liz Todd
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Viviana Albani
- Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Sadie Boniface
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Jennifer Ferguson
- School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - Eilish Gilvarry
- Northumberland, Tyne and Wear NHS Foundation Trust, St Nicholas Hospital, Newcastle upon Tyne, UK
| | - Nadine Hendrie
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Nicola Howe
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Helen Mossop
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Amy Ramsay
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Grant Stanley
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, UK
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