Qualitative evaluation of web-based digital intervention to prevent and reduce excessive alcohol use and harm among young people age 14-15 years: A ‘Think-Aloud’ study

Laura E Tinner, Eileen Kaner, Garnett Claire, Siobhan Mitchell, Matt Hickman, Rona M Campbell, Georgina J Macarthur*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

Abstract

Background
In the UK despite some downward trends in alcohol use among young people, over one fifth young people report excessive alcohol use in the past month, which is associated with short and long-term harms to health. Digital interventions to reduce alcohol use, such as websites, among young people present an appealing and cost-effective mode of intervention that can be integrated into the education system. However, relatively few school-based digital alcohol-focused interventions have been developed and evaluated for young people in the UK.

Objective
This study sought to: (1) develop a novel web-based intervention, ‘Rethink Alcohol’, to prevent and reduce excessive alcohol use and related harm among young people aged 14-15, and (2) explore the views of young people, teachers and youth workers in relation to the content, design and usability of the intervention.

Methods
Intervention development followed the person-based approach, using theories of social norms and social influence. Qualitative ‘Think-Aloud’ interviews, either one-to-one or paired, were conducted while participants perused and worked through the web-based intervention, talking aloud. Participants included 20 young people (12F: 8M), four youth workers (4F: 1M), three teachers (2M: 1F) and one clinical professional (1M), recruited via youth groups and professional networks. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.

Results
The prototype web-based intervention included normative feedback, information, a quiz, interactive activities and scenarios. On a rating scale of impressions from poor (1) to excellent (5), participants gave an average score of 3.6/5. Five themes were identified: (1) content, (2) credibility of the website, (3) make the website easy to understand, (4) design and navigation and (5) suitability for the audience. These themes reflected views that (i) content was interesting, credible and informative and embodied a neutral and non-judgemental tone, but that stronger messaging was needed regarding social pressures and short-term risks regarding safety and risk behaviour alongside clarity around pathways of risk; (ii) credibility and trustworthiness of information were critical features, determined in part, by the professionalism of design and referencing of sources of information provided; (iii) messages should be succinct and come to life through design and interactive features.

Conclusions
Together, data illustrated the importance and challenge of communicating nuanced alcohol-focused public health messages to young people in concise, clear, non-judgemental and appealing ways. Young people report interest in clear, credible, neutral and interactive messages regarding social pressures and short-term risks of alcohol use via a web-based intervention. There is scope for optimisation and feasibility testing of the Rethink Alcohol intervention.
Original languageEnglish
JournalJMIR Pediatrics and Parenting
Publication statusAccepted/In press - 29 Oct 2020

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