Behaviour change in 160 characters:

A novel brief intervention for disadvantaged men

Professor Iain K Crombie

Alcohol brief interventions

substantial evidence of effectiveness 10-20 minutes of encouragement and goal setting usually delivered by a doctor

tested on middle-aged men usually in healthcare settings reduce weekly consumption

Drinking and disadvantaged men: 25-44 years

hard to reach group seldom attend health care low participation in research

limitations of the intervention methodamount of informationopportunities for interactionmonitoring intervention delivery

2 recruitment strategiesGP registersRespondent-driven sampling – community outreach, chain

referralEvidence-based techniques to increase recruitment

financial incentivesmultiple attempts at contactpersonalised approaches, assurances of confidentiality

Recruitment target: 60 - Achieved 67

Recruitment strategies

Comparing the recruitment strategiesGP Community

OutreachMarried 75% 36%

Employed 78% 54%

Mean consumption(units previous month)

66 140

Frequent sessions of ≥8 units (>5 per month)

17% 57%

Frequent sessions of ≥16 units(>5 per month)

5% 37%

Forgot what happened(> 1 per month)

6% 54%

Intervention development

Focus groups

Design team

experience of alcohol harms widespread mature drinker role

recognition of social expectations• employer, partner, family

discrepancy binge drinking and mature drinker role

don’t preach

Focus group findings

mid-week sobrietypersonalise harms, benefits of moderated drinking

early Friday eveningencourage moderated drinking

Sunday afternoon/evening reflect on adverse consequences

mid-week sobriety seek commitment to change

Focus group: windows of opportunity

Causal model forbehaviour change

What’s the main reason U drink? a.It’s a Habitb.To feel better c.To have fund.To copee.To wash down your chips.

Text me your answer!

Engagement•humour•reflection•interactivity

Dave from Dundee says –“Many a weekend I’ve thought if I’d just went home at 8-9pm, I wouldn’t be sitting here now feeling like a bag of shite”. Discrepancy

Andy from Dundee says –“I cut back on drinking because my father-in-law died of it”. What would be a good reason for U to cut back? Text me back!

Motivate change

Can U think of someone who’d be happy if U made a change! What would U hear them say? Please text me your answer! Views of others

Reinforce intention to change

Responses to texts

Reasons for drinking less “I really wanna stay out of trouble and not become the

person I can be after a few too many”

Money saved “£200 a month or more easy. That would be on carry outs

and the pub.”

Buy with money saved “Trek 2.5 road bike - cost £1650.00 RR”

Benefits to others “My dad. Its good ur no phoning me for a lift at 2am!”

Content of the responses

Summary exceeded recruitment target

recruited hazardous drinkers 96% retention

outcomes measured theoretically and empirically based text messages

in 160 characters high level of engagement

key components behaviour change strategy full trial underway

The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the NIHR PHR programme or the Department of Health.

Funded by the National Institute for Health Research Public Health Research programme (project numbers 09/3001/09).

Collaborators

Professor Iain Crombie Epidemiologist

Dr Carol Emslie Sociologist

Dr Josie Evans Epidemiologist

Professor Gerry Humphris Health Psychologist

Dr L Irvine Research methodologist

Ms Claire Jones Software Engineer

Professor John Norrie Statistician and Trialist

Dr Dennis Petrie Health economist

Dr Peter Rice Consultant Psychiatrist

Professor Ian Ricketts Computer Scientist

Dr Peter Slane GP

Dr Falko Sniehotta Health Psychologist

Ms Selena Law Graphic Designer

Professor Brian Williams Medical Sociologist