309 research outputs found
Data for: Latency to enrol, attrition and intervention effect estimation: Meta-epidemiological study of four randomised behaviour change trials
No full textData and do fil
Data for: Latency to enrol, attrition and intervention effect estimation: Meta-epidemiological study of four randomised behaviour change trials
No full textData from four (published) web-based intervention trials used here to test methodological hypothese
Can simply answering research questions change behaviour? Systematic review and meta analyses of brief alcohol intervention trials.
No full textBACKGROUND: Participant reports of their own behaviour are critical for the provision and evaluation of behavioural interventions. Recent developments in brief alcohol intervention trials provide an opportunity to evaluate longstanding concerns that answering questions on behaviour as part of research assessments may inadvertently influence it and produce bias. The study objective was to evaluate the size and nature of effects observed in randomized manipulations of the effects of answering questions on drinking behaviour in brief intervention trials. METHODOLOGY/PRINCIPAL FINDINGS: Multiple methods were used to identify primary studies. Between-group differences in total weekly alcohol consumption, quantity per drinking day and AUDIT scores were evaluated in random effects meta-analyses. Ten trials were included in this review, of which two did not provide findings for quantitative study, in which three outcomes were evaluated. Between-group differences were of the magnitude of 13.7 (-0.17 to 27.6) grams of alcohol per week (approximately 1.5 U.K. units or 1 standard U.S. drink) and 1 point (0.1 to 1.9) in AUDIT score. There was no difference in quantity per drinking day. CONCLUSIONS/SIGNIFICANCE: Answering questions on drinking in brief intervention trials appears to alter subsequent self-reported behaviour. This potentially generates bias by exposing non-intervention control groups to an integral component of the intervention. The effects of brief alcohol interventions may thus have been consistently under-estimated. These findings are relevant to evaluations of any interventions to alter behaviours which involve participant self-report
Approaches to Brief Intervention for Hazardous Drinking in Young People
No full textThis article represents the proceedings of a symposium at the 2002 joint conference of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism in San Francisco. The chair was John B. Saunders. The focus of the symposium was on brief intervention approaches for hazardous drinking among young people. The presentations were (1) Evidence for the effectiveness of brief intervention as an approach to reducing hazardous alcohol use, by John B. Saunders; (2) College student hazardous drinking in New Zealand, the USA, UK, and Australia: implications for research, policy, and intervention, by Kypros Kypri; (3) Applications of motivational feedback on the college campus, by Scott T. Walters; (4) A population based individualized alcohol harm reduction feedback intervention: preliminary results from the college-based alcohol risk reduction (CBARR) trial, by Robert G. Laforge; and (5) Brief interventions: conclusions and future directions, by Mary E. Larimer
Exploratory randomized controlled trial evaluating the impact of a waiting list control design
No full textBACKGROUND Employing waiting list control designs in psychological and behavioral intervention research may artificially inflate intervention effect estimates. This exploratory randomized controlled trial tested this proposition in a study employing a brief intervention for problem drinkers, one domain of research in which waiting list control designs are used. METHODS All participants (N = 185) were provided with brief personalized feedback intervention materials after being randomly allocated either to be told that they were in the intervention condition and that this was the intervention or to be told that they were in the waiting list control condition and that they would receive access to the intervention in four weeks with this information provided in the meantime. RESULTS A total of 157 participants (85%) were followed-up after 4 weeks. Between-group differences were found in one of four outcomes (proportion within safe drinking guidelines). An interaction was identified between experimental manipulation and stage of change at study entry such that participant change was arrested among those more ready to change and told they were on the waiting list. CONCLUSIONS Trials with waiting list control conditions may overestimate treatment effects, though the extent of any such bias appears likely to vary between study populations. Arguably they should only be used where this threat to valid inference has been carefully assessed.During the conduct of this research, John Cunningham was supported as the Canada Research Chair on Brief Interventions for Addictive Behaviours. Kypros Kypri is supported by a National Health & Medical Research Council Senior Research Fellowship (APP1041867) and a Senior Brawn Fellowship from the University of Newcastle Jim McCambridge is supported by a Wellcome Trust Research Career Development fellowship in Basic Biomedical Science (WT086516MA)
Regression to the mean and alcohol consumption: a cohort study exploring implications for the interpretation of change in control groups in brief intervention trials.
No full textBACKGROUND: Reductions in drinking among individuals randomised to control groups in brief alcohol intervention trials are common and suggest that asking study participants about their drinking may itself cause them to reduce their consumption. We sought to test the hypothesis that the statistical artefact regression to the mean (RTM) explains part of the reduction in such studies. METHODS: 967 participants in a cohort study of alcohol consumption in New Zealand provided data at baseline and again six months later. We use graphical methods and apply thresholds of 8, 12, 16 and 20 in AUDIT scores to explore RTM. RESULTS: There was a negative association between baseline AUDIT scores and change in AUDIT scores from baseline to six months, which in the absence of bias and confounding, is RTM. Students with lower baseline scores tended to have higher follow-up scores and conversely, those with higher baseline scores tended to have lower follow-up scores. When a threshold score of 8 was used to select a subgroup, the observed mean change was approximately half of that observed without a threshold. The application of higher thresholds produced greater apparent reductions in alcohol consumption. CONCLUSIONS: Part of the reduction seen in the control groups of brief alcohol intervention trials is likely to be due to RTM and the amount of change is likely to be greater as the threshold for entry to the trial increases. Quantification of RTM warrants further study and should assist understanding assessment and other research participation effects
The use of deception in public health behavioral intervention trials: a case study of three online alcohol trials.
No full textSome public health behavioral intervention research studies involve deception. A methodological imperative to minimize bias can be in conflict with the ethical principle of informed consent. As a case study, we examine the specific forms of deception used in three online randomized controlled trials evaluating brief alcohol interventions. We elaborate our own decision making about the use of deception in these trials, and present our ongoing findings and uncertainties. We discuss the value of the approach of pragmatism for examining these kinds of ethical issues that can arise in research on public health interventions
Evaluation of Campus Watch: a community-based initiative to reduce alcohol-related harm and social disorder in a university setting
No full textBackground: The total social cost of alcohol-related harm in New Zealand is as high as $5 billion annually. In New Zealand and other high income countries, young people are at a greater risk of alcohol-related harm from their alcohol consumption, as they are more likely to drink hazardously, and are vulnerable to longer term risks from exposure at this age.
In North Dunedin, university students represent a large portion of the population and drink more frequently and more hazardously than their non-student peers. This environment increases the likelihood of experiencing harms caused by their own or others’ alcohol consumption, and these harms extend to non-drinking students and the wider community.
In 2007, amid concerns that anti-social behaviour was having serious impacts on students and the North Dunedin community, the University of Otago launched Campus Watch, using round-the-clock patrols of the university and surrounding neighbourhoods to provide pastoral care to students, improve the quality of the surrounding neighbourhood, and enforce the University’s Code of Student Conduct on and off campus. This programme did not aim to specifically target alcohol consumption.
Aims: The aim of this study was to evaluate the effect of Campus Watch on alcohol-related harm and social disorder among university students and residents of North Dunedin.
Methods: This quasi-experimental evaluation of Campus Watch used a recognised three-step evaluation framework to understand how the programme was developed and introduced (process), what behavioural change occurred after implementation (impact), and the effectiveness of the programme in reducing alcohol-related harm and disorder (outcome).
Data were collected using key informant interviews, Community Surveys (2008 and 2009), and national web-based surveys of university students (2005, 2007, 2009). Secondary analysis of Campus Watch incident data, New Zealand Police data, and New Zealand Fire Service data was also undertaken. Where possible, comparison sites were included and relative changes measured.
Results: The process evaluation showed that the broad objectives of the programme allowed it to be responsive to the needs of the North Dunedin community. Campus Watch staff were highly visible in the area and were well received, with high levels of satisfaction among students and other residents.
The impact and outcome evaluations showed significant decreases in student alcohol consumption, some types of alcohol-related harms, nuisance fires, and other forms of social disorder in the wider university area. Crime rates decreased in the Campus Watch area after 18 months of the programme’s introduction and continued to decrease to the end of 2010. There were no significant changes in North Dunedin residents’ perceptions of their neighbourhood or its problems between 2008 and 2009.
Conclusions: Campus Watch had a positive impact on students and the North Dunedin community, by reducing hazardous drinking, some alcohol-related harms, crime rates, and nuisance fires. The programme’s flexibility and its balance between enforcement and pastoral care were important to the programme’s success. A clarification of its role within the university and the wider community and the development of effective indicators to measure further changes will help the programme adapt in light of imminent legislative changes surrounding the sale and supply of alcohol
Drinking patterns, drinking in partnerships and informal social controls on drinking in New Zealand
No full textBackground: National surveys have been used to measure alcohol consumption patterns and some aspects of alcohol related harm, but do not tell us much about the role of alcohol in social networks. Understanding the drinking patterns of intimate partners and social influences on drinking may help us understand alcohol’s contribution to satisfaction, disorder, and violence in families.
Aim: To describe 1.Patterns of drinking in the adult population, by key demographic characteristics; 2.Similarities and differences in drinking between intimate partners; 3.The experience of informal social controls on drinking.
As this research relies on survey data, an important aspect of the work was to assess the impact of incomplete response on the findings.
Methods: Data were collected in a cross-sectional nationally representative survey of 18 – 70 year olds, conducted in 2007 as part of Gender, Alcohol and Culture: an International Study (GENACIS). This postal survey of a sample from the combined electoral roll, used a questionnaire designed by the International Research Group on Gender and Alcohol (IRGGA) adapted for New Zealand conditions. Standard descriptive statistics have been used, along with logistic regression models to estimate associations between variables while controlling for confounders. Potential non-response bias was investigated by comparing known characteristics of respondents and non-respondents, comparing early, intermediate and late respondents, and comparing key findings with other national surveys of alcohol use.
Results: The survey had a response rate of 49.5%. Men, people of Maori ethnicity, people living in high deprivation areas, and young adults were less likely to respond to the survey. Late respondents were more like non-respondents in terms of demographics and more likely to be binge drinkers, suggesting binge drinking was underestimated in the survey.
Most of the sample were current drinkers (12 month prevalence 89.6%), and prevalence of drinking decreased with age. Men were more likely to be identified as binge drinkers, along with the youngest age group, those of Maori descent, people classified as never married and people living in the most deprived areas.
Most intimate partnerships (86%) differed in drinking frequency by less than 2 points, and 58% of partnerships differed in typical quantity per occasion by only 1-5 drinks. The more time couples spent drinking together the more concordant they were for both drinking frequency and quantity of alcohol per occasion. Higher concordance for alcohol per occasion was associated with higher reporting of happiness with the relationship.
Pressure to drink less, came most commonly from family and spouses, rather than friends, workmates or health professionals. Binge drinkers of both sexes, and young men in general, were the most likely groups to have experienced this type of pressure.
Pressure to drink more was most common in the youngest age group (60.1%), and decreased with age. Binge drinkers were most likely to experience pressure to drink more of all drinker status groups (OR=2.7 relative to lifetime abstainers).
Conclusions: This study provides new insights into drinking patterns by gender and relationship status. It provides information about drinking within relationships and what informal controls are operating. This helps identify groups and situations at higher risk of alcohol-related harm. However, longitudinal research would be required to reveal whether the associations identified in this study might be causal, and where appropriate interventions might be focused
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