Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)

Abstract

Background and aims: Alcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and costeffectiveness of ASBI compared with screening alone (SA) in high-risk adolescents.Design, Setting and Participants: Multi-centre, three-group, single-blind, individually randomized trial with follow-ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT-C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white.Interventions: Interventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA.Measures: The primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post-randomization, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society.Findings: At 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38-3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 For affiliations refer to page 2212.

A sex- and gender-based analysis of alcohol treatment intervention research involving youth: A methodological systematic review

“…In 54 of the studies (63.0%), sex and/or gender was used as a covariate in the analysis, and this was often done to control for the effects of sex and/or gender on their intervention [33][34][35][39][40][41][42][43][44][45][46][47][48][49][50][51][53][54][55][56][58][59][60][61]63,70,71,[75][76][77][78][80][81][82][83][84]86,89,90,93,96,[99][100][101][102][103]105,106,[109][110]…”

“…In 64 of the studies (74.4%), the authors did not discuss whether sex or gender were relevant to their hypothesis or analysis [33,[35][36][37][38][39][40][41][43][44][45][46][47][48][49][50][51][52][53][54][55][56][58][59][60]62,93,[95][96][97][106][107][108][109]111,[113][114][115][116]118]. Half of the 86 studies in the sample (n = 43, 50%) did not mention sex or gender in their discussion sections, neither as variables which were significant or relevant to their findings, nor as factors that they explicitly featured in their recommendations for practice or policy based on their findings [33,35,39,41,[47][48][49]…”

“…Fifty-four (62.8%) of the 86 included studies inaccurately used sex-specific terminology to describe participants’ gender identities by stating that the participants’ genders were male and female (rather than men and women) [ 34 – 36 , 40 , 42 , 44 – 47 , 49 , 50 , 52 – 56 , 58 , 59 , 61 – 63 , 67 , 69 – 72 , 74 , 75 , 77 – 79 , 81 – 83 , 86 , 87 , 89 – 91 , 94 – 97 , 101 , 105 , 108 – 111 , 114 – 118 ]. For example, one study described how randomization was stratified by gender but inaccurately operationalized this by indicating each condition is comprised of equal proportions of “male” and “female” students [ 110 ].…”

“…Thirteen (15.1%) of the studies reported that they collected the sexes of participants [ 39 , 41 , 43 , 44 , 48 , 60 , 68 , 76 , 79 , 80 , 93 , 104 , 118 ]. A further 14 (16.3%) studies reported collecting the genders of participants [ 45 , 47 , 52 , 54 – 56 , 62 , 63 , 70 , 71 , 75 , 77 , 84 , 86 ]. However, none of these 27 studies (31.4%) described how they undertook the task of assessing, collecting, and measuring the sexes and/or genders of the participants.…”

“…Fifty-four (62.8%) of the 86 included studies inaccurately used sex-specific terminology to describe participants' gender identities by stating that the participants' genders were male and female (rather than men and women) [34][35][36]40,42,[44][45][46][47]49,50,[52][53][54][55][56]58,59,[61][62][63]67,[69][70][71][72]74,75,[77][78][79][81][82][83]86,87,[89][90][91][94][95][96][97]101,105,[108][109][110][111][114]…”