A web-based intervention to reduce alcohol consumption in problem drinkers

ISRCTN ISRCTN55671858
DOI https://doi.org/10.1186/ISRCTN55671858
Secondary identifying numbers IPHS-1314-LB-238
Submission date
04/06/2014
Registration date
13/06/2014
Last edited
11/12/2018
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Many heavy drinkers want to reduce their drinking but most do not seek treatment, which puts them at risk of health problems and alcohol dependence. Barriers to standard treatments include availability and cost. The inability to stop inappropriate behaviour (disinhibition) plays a causal role in heavy drinking. Recent research suggests that computerised training tasks that improve inhibition lead to reductions in alcohol consumption, at least in the short-term. Internet interventions (E-health) can overcome traditional barriers to treatment. The aim of this study is to assess the effectiveness of different forms of inhibition training delivered via the Internet, for the reduction of alcohol consumption in problem drinkers.

Who can participate?
Heavy drinkers aged between 25-65 who are motivated to cut down their alcohol consumption

What does the study involve?
Participants attend the test site for initial screening before completing a brief online alcohol intervention (www.downyourdrink.org.uk). They are asked to monitor their alcohol consumption for 1 week, and when they return to the laboratory 1 week later they complete initial measures of inhibition and an alcohol association task before being randomly allocated to one of four groups. Three of the groups undergo different types of inhibition training and one group undergoes sham training. They are sent a link every other day (on average) for 28 days which takes them to a secure website hosting the training assessments and self-report measures of alcohol consumption. At the end of the 28-day training period, they return to the test site and complete the measures of inhibition and the alcohol association task again. Finally, their alcohol consumption is monitored via email at 2, 4 and 6 weeks after the end of the training period.

What are the possible benefits and risks of participating?
Participants may find the training too time-consuming, in which case they will be advised to withdraw from the study. Regular monitoring of their own alcohol consumption may prompt some participants to be concerned that they have a serious alcohol problem, in which case they are advised to withdraw from the study and contact their doctor.

Where is the study run from?
Study visits take place in laboratories at the University of Liverpool (UK). The Internet intervention can be completed anywhere at the participant's convenience (e.g., home, work).

When is the study starting and how long is it expected to run for?
April 2014 to December 2015

Who is funding the study?
Medical Research Council (UK)

Who is the main contact?
Prof. Matt Field
mfield@liv.ac.uk

Contact information

Prof Matt Field
Scientific

Department of Psychological Sciences
University of Liverpool
Eleanor Rathbone Building
Bedford Street South
Liverpool
L69 7ZA
United Kingdom

Phone +44 (0)151 794 1124
Email mfield@liv.ac.uk
Dr Andrew Jones
Scientific

University of Liverpool
Psychological Sciences
Bedford Street South
Liverpool
L69 7ZA
United Kingdom

Email ajj@liv.ac.uk

Study information

Study designPhase II single-site randomised double-blind controlled intervention
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeTreatment
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleA comparison of three types of web-based inhibition training for the reduction of alcohol consumption in problem drinkers
Study hypothesisParticipants randomised to the active inhibition training groups will show reductions in alcohol consumption over four weeks of training and six weeks of follow-ups, compared to those who receive a control intervention. The trialists do not make any a-priori hypotheses about differential effectiveness of the different forms of inhibition training, although they will compare them against each other. They are recruiting more participants than they require on the assumption that some participants will reduce their drinking before randomisation, and these participants may need to be excluded from primary analyses. They also predict psychological changes as a result of inhibition training: Cue-specific inhibition training will lead to improvements in cue-specific inhibition; General inhibition training will lead to improvements in general inhibition; and Alcohol No-Go training will lead to changes in automatic affective alcohol associations.
Ethics approval(s)University of Liverpool Research Ethics Committee, 07/02/2014, ref. IPHS-1314-LB-238
ConditionAlcohol use disorders
InterventionAll participants will complete a brief online alcohol intervention (www.downyourdrink.org.uk) before one-week of self-monitoring of alcohol consumption, before randomisation to one of the following groups. All participants will complete their training sessions on the Internet every other day, on average, for 28 days (maximum of 14 training sessions in total):
1. Cue-specific inhibition training. Participants will rapidly categorize alcohol and neutral pictures by pressing keys on their keyboard. On 50% of alcohol trials (25% of all trials) they will be required to inhibit this response whenever they see the stop signal (two red lines superimposed over the alcohol image). The stop signal initially occurs at 250 ms after stimulus presentation. Performance is tracked and with every successful training session (participant successfully inhibits on > 50% of inhibition trials) the subsequent training session becomes more difficult: the stop signal appears 10 ms later, which makes inhibition more difficult. There will be 200 trials (100 alcohol images and 100 neutral images), with 50 inhibition trials, in each training session.
2. General inhibition training. Participants will rapidly categorize arbitrary stimuli (the letters 'X' and 'O') by pressing keys on their keyboard. On 50% of trials they will be required to inhibit this response whenever they see the stop signal (two red lines superimposed over the letter). The stop signal initially occurs at 250 ms after stimulus presentation. Performance is tracked and with every successful training session (participant successfully inhibits on >50% of inhibition trials) the subsequent training session becomes more difficult: the stop signal appears 10 ms later, which makes inhibition more difficult. There will be 200 trials (100 letter X and 100 letter O), with 50 inhibition trials, in each training session.
3. Alcohol No-Go training. On each trial, an alcohol or neutral picture will be presented with the letter 'P' or 'R' superimposed in the corner of the picture. The letter P is the 'Go' cue that signifies that participants should rapidly respond by pressing the space bar. The letter R is the No-Go cue that signifies that participants should inhibit their response on that trial. The Go cue will always occur on neutral picture trials and the No-Go cue will always appear on alcohol picture trials, thus participants will always inhibit in response to alcohol pictures. There will be 200 trials (100 alcohol No-Go trials and 100 neutral Go trials) in each training session.
4. Control (sham training). Participants will rapidly categorize alcohol and neutral stimuli by pressing keys on their keyboard. There will be no inhibition trials. There will be 200 trials (100 alcohol images and 100 neutral images) in training session.

Added 07/02/2017:
A random number generator was used for randomization; follow-up period was 6 weeks after intervention ceased.
Intervention typeOther
Primary outcome measureAlcohol consumption, specifically the total number of units consumed and the number of heavy drinking days (defined as >60 g of alcohol for men and >40 g alcohol for women), measured using a two-week retrospective alcohol diary (the Timeline Follow-Back) at baseline, after the first two weeks of intervention and after the second two weeks of intervention
Secondary outcome measuresThe number of abstinent days, measured using a two-week retrospective alcohol diary (the Timeline Follow-Back) at baseline, after the first two weeks of intervention and after the second two weeks of intervention
Overall study start date01/04/2014
Overall study end date12/12/2015

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants268
Participant inclusion criteria1. Aged 25-65
2. Heavy drinker (14+ UK units per week if female, 21+ units per week if male)
3. Have computer and internet access

Note: 1 UK unit = 8 g of alcohol
Participant exclusion criteria1. History of alcohol or substance use disorder
2. Attention deficit hyperactivity disorder (ADHD)
3. Previous or current treatment for alcohol or substance use disorder or an impulse control disorder
Recruitment start date07/04/2014
Recruitment end date12/12/2015

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of Liverpool
Liverpool
L69 7ZA
United Kingdom

Sponsor information

University of Liverpool (UK)
University/education

c/o Liz Brignal
IPHS Research Ethics Committee
School of Psychology
Eleanor Rathbone Building
Bedford Street South
Liverpool
L69 7ZA
England
United Kingdom

ROR logo "ROR" https://ror.org/04xs57h96

Funders

Funder type

Research council

Medical Research Council (ref: MR/K001558)
Government organisation / National government
Alternative name(s)
Medical Research Council (United Kingdom), UK Medical Research Council, MRC
Location
United Kingdom

Results and Publications

Intention to publish date01/05/2017
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planResults will be submitted to a peer-reviewed journal in spring 2017.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Prof. Matt Field (m.field@liv.ac.uk).

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 05/08/2014 Yes No
Results article results 01/12/2018 Yes No

Editorial Notes

11/12/2018: Publication reference added.