Modifying Alcohol Consumption to Reduce Obesity: A Randomized Controlled Feasibility Study of a Complex Community-based Intervention for Men

Abstract

ObjectivesBeing obese and drinking more than 14 units of alcohol per week places men at very high risk of developing liver disease. This study assessed the feasibility of a trial to reduce alcohol consumption. It tested the recruitment strategy, engagement with the intervention, retention and study acceptability.MethodsMen aged 35–64 years who drank >21 units of alcohol per week and had a BMI > 30 were recruited by two methods: from GP patient registers and by community outreach. The intervention was delivered by a face to face session followed by a series of text messages. Trained lay people (Study Coordinators) delivered the face to face session. Participants were followed up for 5 months from baseline to measure weekly alcohol consumption and BMI.ResultsThe recruitment target of 60 was exceeded, with 69 men recruited and randomized. At baseline, almost all the participants (95%) exceeded the threshold for a 19-fold increase in the risk of dying from liver disease. The intervention was delivered with high fidelity. A very high follow-up rate was achieved (98%) and the outcomes for the full trial were measured. Process evaluation showed that participants responded as intended to key steps in the behaviour change strategy. The acceptability of the study methods was high: e.g. 80% of men would recommend the study to others.ConclusionsThis feasibility study identified a group at high risk of liver disease. It showed that a full trial could be conducted to test the effectiveness and cost-effectiveness of the intervention.Trial registrationCurrent controlled trials: ISRCTN55309164.Trial fundingNational Institute for Health Research Health Technology Assessment (NIHR HTA).Short summaryThis feasibility study recruited 69 men at high risk of developing liver disease. The novel intervention, to reduce alcohol consumption through the motivation of weight loss, was well received. A very high follow-up rate was achieved. Process evaluation showed that participants engaged with key components of the behaviour change strategy.

Game of Stones: feasibility randomised controlled trial of how to engage men with obesity in text message and incentive interventions for weight loss

“…The Game of Stones study adds to the evidence base demonstrating the feasibility of recruiting men for research on sensitive subjects, such as obesity, through community outreach and GP practice lists 11–13…”

“…Community recruitment strategies that report success for recruiting men in disadvantaged areas were used 11–13. This included researchers working on stands with study information leaflets and table banners in supermarkets, fitness centres, hospital foyers, health centres, council workplaces and community centres across both sites.…”

“…Narrative SMS can be broadly defined as interactive life stories, which are based around a group of characters with whom recipients can identify 10. Text message-based interventions using narratives have been used to engage hard to reach men in moderating their alcohol consumption and were found to be acceptable 11–13. Narrative approaches to weight management in men may be a promising tool to support behaviour and weight change.…”

Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT

“…107 HAPA is a comprehensive sociocognitive model that has been successfully used to predict and change lifestyle behaviours, including weight-related behaviours. 108 Moreover, HAPA has successfully informed the content of previous NIHR-funded SMS-delivered interventions. [108][109][110] The weight loss aspect of the intervention was shaped by the specific behaviour change phases encompassed by HAPA, including the motivational and volitional phases.…”

“…108 Moreover, HAPA has successfully informed the content of previous NIHR-funded SMS-delivered interventions. [108][109][110] The weight loss aspect of the intervention was shaped by the specific behaviour change phases encompassed by HAPA, including the motivational and volitional phases. The specific psychological processes to increase motivation include outcome and risk perceptions, as well as task self-efficacy (i.e.…”