A multi-centre individual-randomised controlled trial of screening and brief alcohol intervention to prevent risky drinking in young people aged 14-15 in a high school setting (SIPS JR-HIGH)

Early and heavy drinking by younger adolescents is a significant public health problem. The aim of the study is to evaluate the effectiveness and cost effectiveness of alcohol screening and brief intervention to reduce risky drinking in young people aged 14-15 (year 10) in the English high school setting compared to standard alcohol advice/education. The four centre, two-armed randomised controlled trial (RCT) incorporates a control arm of usual practice on alcohol issues and a 30-minute brief intervention arm. Interventions will be delivered by trained school based learning mentors. A qualitative component will explore staff and participants' experience of the interventions and of delivering, or participating in, the trial. Randomisation will be at participant level at 20 schools - five in each geographical area. All young people in year 10 will be asked to complete a lifestyle questionnaire with the Adolescent - Single Alcohol Questionnaire (A-SAQ) embedded. Young people who score positive and leave their name will be invited to meet with the learning mentor and asked to consent to the study. Training and the intervention will be manualised. Control: Usual practice on alcohol issues as delivered normally by the school as well as a healthy lifestyle leaflet with information on local sources of help for problems including alcohol problemsl, given by the learning mentor to those that consent to the trial. Intervention: In addition to input equivalent to the control arm; the young people who are eligible and consent to participate will take part in a 30-minute personalised interactive worksheet-based session which was developed during the pilot feasibility trial. This will be delivered by the learning mentor (at school) and will contain structured feedback about the individual student's drinking behaviour and advice about the health and social consequences of continued risky alcohol consumption. Primary (effectiveness) outcome measure: Total alcohol consumed in 28 days, using the 28 day time-line follow-back (TLFB) questionnaire at 12-month follow-up. Secondary (effectiveness) outcome measures: percent days abstinence, drinks per drinking day and days>2units from the 28 day TLFB. Risky drinking using the A-SAQ and Alcohol Use Disorder Identification Test (AUDIT) and TLFB; Smoking behaviour; Alcohol related problems using the Rutgers Alcohol Problems Inventory (RAPI); Emotional wellbeing using the Warwick Edinburgh Mental Well-being Scale (WEMWBS) and drinking motives using the Drinking Motives Questionnaire (DMQ). Secondary (health economic) outcome measures: Quality of life and health utility (EQ-5D 5L); National Health Service and social costs using a modified Short Service Use Questionnaire (S-SUQ) and a learning mentor diary sheet developed in the pilot study; incremental cost per quality-adjusted life-year (QALY) gained at 12 months will be calculated. Fidelity to intervention: 20% of randomly selected cases, with a minimum of one per learning mentor, will be audio taped and transcribed and assessed for treatment fidelity by two independent expert raters from the research team using the Behaviour Change Counselling Index (BECCI) rating scale. Qualitative work will explore barriers and facilitators of implementation with staff and young people. Organisational support: We have organisational support from education departments in each of the four geographical areas who will work with us to identify schools for the study. Schools will provide learning mentor time at no cost. NIHR PHR £866,000