Alcohol Brief Intervention Plus Personalized Mobile Chat-based Intervention to Reduce Alcohol Misuse in an Emergency Department

Study Overview
=================
Brief Summary
-----------------
This project focuses on patients in AED. Objectives of this project are: To examine the factors associated with alcohol drinking and alcohol use disorder To examine the effect of face-to-face alcohol brief intervention on drinking reduction To examine the effect of a continuous interactive chat-based intervention via WhatsApp on drinking reduction To explore the perception of face-to-face alcohol brief intervention To explore the perception of continuous interactive chat-based intervention via instant messaging mobile application WhatsApp

Detailed Description
-----------------
According to the Department of Health, a local epidemiological study was conducted in 2001 and showed that about one in ten of all motor vehicle deaths were associated with alcohol consumption. Also, the statistics from the Transportation department showed that 874 vehicle accidents resulting in personal injury were related to alcohol misuse, which included 24 fatal cases between the period of 2000 and 2010. With the aforementioned statistics supported, the hospital Accident and Emergency Department (AED) serves as the most important entrance and safeguard to the healthcare system for the public, since victims of traffic accidents or violence related to heavy drinking are frequently encountered in AED, this serves as an ideal place for provision of initial alcohol intervention and further stabilization related to alcohol problem of patients. Although AED is a hectic environment with very high patients turnover, substantial evidence had shown feasibility and efficacy of Alcohol Brief Intervention (ABI) in reducing patients' subsequent alcohol drinking. In oversea, multiple research had been done to show ABI were effective and feasible for reducing alcohol misuse, but the effect was not long lasting and lead to subsequent relapse. In addition to this, no further trial has been done to investigate the feasibility of implementing an RCT on evaluating the effect of ABI and continuous chat-based intervention on reducing alcohol consumption among patients in AED in Hong Kong. According to the WHO, the standard ABI approach includes: giving feedback and information about the screening result and hazard of drinking; emphasizing the benefits of quit drinking and informing about alcohol problems; setting goal on reducing alcohol consumption; reviewing advice and ; giving encouragement. In this pilot study, a brief alcohol counselling using face-to-face ABI will be delivered together with continuous interactive chat-based intervention via instant messaging mobile application WhatsApp to those patients with AUDIT score ≥ 8, who are considered to have hazardous and harmful drinking problems according to the guideline.

Official Title
-----------------
A Pilot Study on the Feasibility of Alcohol Brief Intervention Plus Personalized Mobile Chat-based Intervention to Reduce Alcohol Misuse in an Emergency Department in Hong Kong

Conditions
-----------------
Alcohol Use Disorder

Intervention / Treatment
-----------------
* Behavioral: Mobile chat-based instant messages
* Behavioral: Alcohol brief intervention


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Hong Kong resident aged 18 to 65 scored ≥ 8 in the Alcohol Use Disorder Identification Test (AUDIT) in the past 12 months able to communicate in Cantonese (including reading Chinese) using a phone with instant messaging mobile application WhatsApp installed for communication. Exclusion Criteria: patients with communication barrier (either physically or cognitively) currently participating in other alcohol treatment services or clinics will be hospitalized immediate after A&E consultation

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Alcohol brief intervention+mobile chat-based instant messages | Behavioral: Mobile chat-based instant messages<br>* Subjects in the active arm study will receive 5-minute face-to-face ABI, alcohol leaflet from Department of Health (DH) plus continuous interactive chat-based intervention for 1 month as an extension of alcohol brief intervention at baseline<br>Behavioral: Alcohol brief intervention<br>* The Control group will receive face-to-face ABI plus an alcohol leaflet from DH.<br>|
| Active Comparator: control group<br>Alcohol brief intervention | Behavioral: Alcohol brief intervention<br>* The Control group will receive face-to-face ABI plus an alcohol leaflet from DH.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in unit of alcohol consumption in gram | Assessed by unit in gram and compare the alcohol consumption between intervention and control group at 3-month after baseline. | at 3-month after baseline. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in unit of alcohol consumption in gram | Assessed by unit in gram and compare the alcohol consumption between intervention and control group at 1-month after phase I | at 1-month after phase I | 
| change in episode of binge drinking measured by asking Never, less than a month, two to four times a month,  two to three times a week and almost everyday | Defined by 5 [male] or 4 [female] in a row for binge drinking and compare the episode of binge drinking between intervention group and control at baseline, 1 and 3-month follow-up questionnaires | at 1 and 3 months after phase I | 
| change in frequency of drinking by asking Never, less than a month, two to four times a month,  two to three times a week and almost everyday | Compare the frequency of drinking between intervention group and control at baseline, 1 and 3-month follow-up questionnaires | at 1 and 3 months after phase I | 
| attempt to reduce drinking measured by asking whether they have tried to reduce drinking at past month (yes or no) | Compare the attempt to reduce drinking between intervention group and control group at baseline, 1 and 3-month follow-up questionnaires | at 1 and 3 months after phase I | 
| change in confidence to reduce drinking measured by Likert scale (1-10) | Score ranges from 0 to 10 with higher score indicates a high level. The score will be compared between intervention group and control group at baseline, 1 and 3-month follow-up questionnaires | at 1 and 3 months after phase I | 
| Alcohol Problems Scale at 1 and 3-month follow-up | The 14-item measure of alcohol-related personal, social, sexual, and legal problems (eg, being physically aggressive toward someone while under the influence of alcohol).The score will be compared between intervention group and control group at baseline, 1 and 3-month follow-up questionnaires | at 1 and 3 months after phase I | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
AUDIT, instant messaging, chat-based intervention, alcohol brief intervention, Alcohol misuse, Accident & Emergency Department