P112 Texting or talking? Which works better to reduce hazardous drinking by sexual health clinic attendees?

Abstract

Data are collected in real time, and all partner notification outcomes are recorded. The platform is extendable to facilitate centralised partner notification within sexual health clinical networks across many different heath care providers. P111A Background Control of STIs in vulnerable populations is difficult because of inadequate access to prompt diagnosis and treatment and may be enhanced by better community based STI surveillance. The high rates of mobile and smart phone use in these populations and the development of novel personalised diagnostic technologies which theoretically enable highly accurate self-testing diagnostics for STIs that can be electronically linked to clinical care pathways and STI data capture, may help address these challenges. A major challenge for these systems is the development of clinically relevant and acceptable Human Technology Interfaces (HTIs) for Mobile-Web Applications. Objectives To describe a methodological approach to develop a mobile phone/web-based management system that can link rapid self-test diagnostics to clinical care pathways and community based surveillance. Methods We adopt a user centred approach to the development of a HTI for self-managing STI diagnosis with initial exploratory pilot studies to gather functional, user and clinical requirements of the HTI. Iterative development of functional prototypes exploring design possibilities and technology features is followed by the formative evaluation of interface design alternatives through qualitative and controlled usability studies with target users and existing surveillance capture mechanisms. Results A user centred, multi-disciplinary approach allows for successful capture and integration of social science methods to inform functional requirements for an effective and user acceptable mobile and web-based self-managing STI diagnostics and surveillance system. Discussion Future testing in simple and complex, community based studies are needed to primarily assess safety and then effectiveness for improving access to care, enhanced partner notification and development of community based capture of surveillance data. Background Hazardous drinking is associated with an increased risk of catching an STI, getting pregnant unintentionally, being sexually assaulted and sexually assaulting someone else. An Alcohol Brief Intervention (ABI), a type of motivational interview, has been shown to reduce hazardous drinking in men over the age of 25. There is an paucity of evidence of the benefit in younger people or in women. Texting has been shown to be useful in supporting smoking cessation, weight reduction and diabetes control. There have been no studies of its potential value in reducing hazardous drinking or its consequences.

Screening for alcohol misuse in sexual health clinics

“…However, on subgroup analysis the study demonstrated that ABI was more effective than SMS in under 25 year olds, but that SMS was superior to ABI in over 25 year olds. Simple screening and feedback was effective in reducing AUDIT scores in women, but was only effective in men aged over 25 years ( S Baguley, personal communication, 2014) 12. This study raises the question as to whether interventions may need to be tailored according to age and gender in order to be effective.…”

“…Of note, a systematic review showed that just being in the control group in intervention studies produced a benefit, a finding that is also apparent in randomised clinical trials (RCTs) conducted within the sexual health setting 7 11 12…”

“…Although no systematic reviews or meta-analyses have been published assessing ABI in the sexual health setting, three RCTs conducted in sexual health clinics in Sydney, London and Aberdeen showed that screening for excessive alcohol consumption is acceptable in sexual health clinics and identifies high rates of hazardous drinking (S Baguley, personal communication, 2014) 1 7 12. An important finding from two of these RCTs is that screening and simple feedback alone can lead to a significant reduction in AUDIT scores 7 12.…”

“…An important finding from two of these RCTs is that screening and simple feedback alone can lead to a significant reduction in AUDIT scores 7 12. None of these RCTs demonstrated that ABI is more effective in reducing alcohol consumption than simple feedback (S Baguley, personal communication, 2014) 1 7 12. The methods, duration and timing of ABI delivery differed between the three RCTs.…”

“…The authors concluded that universal screening and brief advice for excessive alcohol use did not result in significant reductions in alcohol consumption or provide a cost-effective use of resources, but it is important to note that only 20% of excessive drinkers recruited to the intervention arm actually attended for the AHW appointment, which may explain the lack of benefit in the intervention arm. The RCT in the Aberdeen sexual health clinic consisted of three study arms and compared ABI (2–5 min duration), weekly motivational text messaging (SMS) and simple feedback 12. Overall, there was no difference in efficacy between the intervention and control arms.…”