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O'Connor DB, Wilding S, Ferguson E, Cleare S, Wetherall K, McClelland H, Melson AJ, Niedzwiedz C, O'Carroll RE, Platt S, Scowcroft E, Watson B, Zortea T, Robb KA, O'Connor RC. Effects of COVID-19-related worry and rumination on mental health and loneliness during the pandemic: longitudinal analyses of adults in the UK COVID-19 mental health & wellbeing study. J Ment Health 2023; 32:1122-1133. [PMID: 35579054 DOI: 10.1080/09638237.2022.2069716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/21/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The lasting effects of the coronavirus disease 2019 pandemic are likely to be significant. AIMS This study tracked worry and rumination levels during the pandemic and investigated whether periods with higher COVID-related worry and rumination were associated with more negative mental health and loneliness. METHODS A quota survey design and a sampling frame that permitted recruitment of a national sample were employed. Findings for waves 1 (March 2020) to 6 (November 2020) are reported (N = 1943). RESULTS Covid-related worry and rumination levels were highest at the beginning of the first lockdown, then declined but increased when the UK returned to lockdown. Worry levels were higher than rumination levels throughout. High levels of COVID-related worry and rumination were associated with a five- and ten-fold increase in clinically meaningful rates of depression and anxiety (respectively) together with lower well-being and higher loneliness. The effects of COVID-related worry on depression and anxiety levels were most marked and clinically meaningful in individuals living with a pre-existing mental health condition. CONCLUSIONS Psychological interventions should include components that specifically target COVID-related worry and rumination. Individuals with pre-existing mental health conditions should be prioritised as we emerge from the current pandemic and in any future public health crises.
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Affiliation(s)
| | - Sarah Wilding
- School of Psychology, University of Leeds, Leeds, England
| | | | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Heather McClelland
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Ambrose J Melson
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Claire Niedzwiedz
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | | | - Steve Platt
- Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | | | - Billy Watson
- Scottish Association for Mental Health, Glasgow, Scotland
| | - Tiago Zortea
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Kathryn A Robb
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
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2
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Wetherall K, Cleare S, McClelland H, Melson AJ, Niedzwiedz CL, O'Carroll RE, O'Connor DB, Platt S, Scowcroft E, Watson B, Zortea T, Ferguson E, Robb KA, O'Connor RC. Mental health and well-being during the second wave of COVID-19: longitudinal analyses of the UK COVID-19 Mental Health and Wellbeing study (UK COVID-MH). BJPsych Open 2022; 8:e103. [PMID: 35642377 PMCID: PMC9171032 DOI: 10.1192/bjo.2022.58] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/14/2022] [Accepted: 04/04/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Waves 1 to 3 (March 2020 to May 2020) of the UK COVID-19 Mental Health and Wellbeing study suggested an improvement in some indicators of mental health across the first 6 weeks of the UK lockdown; however, suicidal ideation increased. AIMS To report the prevalence of mental health and well-being of adults in the UK from March/April 2020 to February 2021. METHOD Quota sampling was employed at wave 1 (March/April 2020), and online surveys were conducted at seven time points. Primary analyses cover waves 4 (May/June 2020), 5 (July/August 2020), 6 (October 2020) and 7 (February 2021), including a period of increased restrictions in the UK. Mental health indicators were suicidal ideation, self-harm, suicide attempt, depression, anxiety, defeat, entrapment, loneliness and well-being. RESULTS A total of 2691 (87.5% of wave 1) individuals participated in at least one survey between waves 4 and 7. Depressive symptoms and loneliness increased from October 2020 to February 2021. Defeat and entrapment increased from July/August 2020 to October 2020, and remained elevated in February 2021. Well-being decreased from July/August 2020 to October 2020. Anxiety symptoms and suicidal ideation did not change. Young adults, women, those who were socially disadvantaged and those with a pre-existing mental health condition reported worse mental health. CONCLUSIONS The mental health and well-being of the UK population deteriorated from July/August 2020 to October 2020 and February 2021, which coincided with the second wave of COVID-19. Suicidal thoughts did not decrease significantly, suggesting a need for continued vigilance as we recover from the pandemic.
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Affiliation(s)
- Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - Heather McClelland
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - Ambrose J. Melson
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | | | | | | | - Steve Platt
- Usher Institute, University of Edinburgh, UK
| | | | | | - Tiago Zortea
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford, UK
| | | | | | - Rory C. O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
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3
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O'Connor RC, Wetherall K, Cleare S, McClelland H, Melson AJ, Niedzwiedz CL, O'Carroll RE, O'Connor DB, Platt S, Scowcroft E, Watson B, Zortea T, Ferguson E, Robb KA. Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. Br J Psychiatry 2021; 218:326-333. [PMID: 33081860 PMCID: PMC7684009 DOI: 10.1192/bjp.2020.212] [Citation(s) in RCA: 580] [Impact Index Per Article: 193.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The effects of coronavirus disease 2019 (COVID-19) on the population's mental health and well-being are likely to be profound and long lasting. AIMS To investigate the trajectory of mental health and well-being during the first 6 weeks of lockdown in adults in the UK. METHOD A quota survey design and a sampling frame that permitted recruitment of a national sample was employed. Findings for waves 1 (31 March to 9 April 2020), 2 (10 April to 27 April 2020) and 3 (28 April to 11 May 2020) are reported here. A range of mental health factors was assessed: pre-existing mental health problems, suicide attempts and self-harm, suicidal ideation, depression, anxiety, defeat, entrapment, mental well-being and loneliness. RESULTS A total of 3077 adults in the UK completed the survey at wave 1. Suicidal ideation increased over time. Symptoms of anxiety, and levels of defeat and entrapment decreased across waves whereas levels of depressive symptoms did not change significantly. Positive well-being also increased. Levels of loneliness did not change significantly over waves. Subgroup analyses showed that women, young people (18-29 years), those from more socially disadvantaged backgrounds and those with pre-existing mental health problems have worse mental health outcomes during the pandemic across most factors. CONCLUSIONS The mental health and well-being of the UK adult population appears to have been affected in the initial phase of the COVID-19 pandemic. The increasing rates of suicidal thoughts across waves, especially among young adults, are concerning.
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Affiliation(s)
- Rory C. O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - Heather McClelland
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | - Ambrose J. Melson
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | | | | | | | - Steve Platt
- Usher Institute, University of Edinburgh, UK
| | | | | | - Tiago Zortea
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
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4
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Zortea TC, Cleare S, Melson AJ, Wetherall K, O'Connor RC. Understanding and managing suicide risk. Br Med Bull 2020; 134:73-84. [PMID: 32435794 DOI: 10.1093/bmb/ldaa013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND Suicidal behaviours and non-suicidal self-harm (NSSH) are global public health concerns that affect millions of lives. SOURCES OF DATA This review is a narrative synthesis of systematic reviews, meta-analyses of randomized control trials (RCTs) and landmark studies published in scientific journals. AREAS OF AGREEMENT Restricting access to lethal means reduces the likelihood of future suicide deaths. AREAS OF CONTROVERSY Our ability to predict future suicidal behaviour is no better than chance. No individual risk prediction instrument offers sufficient sensitivity and specificity to inform clinically useful decision-making. GROWING POINTS Different types of psychosocial interventions may be effective in preventing future suicide attempts; such interventions include clinical assessment, tailored crisis response and safety plans and follow-up contact. AREAS TIMELY FOR DEVELOPING RESEARCH Whilst some psychosocial interventions can be effective in reducing suicide risk, little is known about the mechanisms of recovery from suicidal thoughts and behaviours.
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Affiliation(s)
- Tiago C Zortea
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - Ambrose J Melson
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow
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5
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Melson AJ, O’Connor RC. Differentiating adults who think about self-harm from those who engage in self-harm: the role of volitional alcohol factors. BMC Psychiatry 2019; 19:319. [PMID: 31660913 PMCID: PMC6816185 DOI: 10.1186/s12888-019-2292-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/16/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Self-harm, an act of self-poisoning or self-injury irrespective of motivation, is a major public health concern. Use of alcohol prior to or alongside acts of self-harm is common but little is known about the alcohol-related mechanisms of self-harm enaction. We utilised an ideation-to-action approach to clarify the extent to which volitional alcohol factors differentiated those who have thoughts of self-harm but do not act on them (self-harm ideation) and those who engage in self-harm (self-harm enaction). METHODS Cross-sectional analyses of the baseline phase of the Health Lifestyle and Wellbeing study: 1546 adults (1079 female; Mean age = 34 y; 92% White) resident in Scotland completed measures of demographics, lifetime self-harm, volitional alcohol factors and psychosocial factors. Multinomial logistic regression compared those with a history of self-harm thoughts ('ideation', n = 297), self-harm acts ('enaction', n = 346) and 'controls' (n = 897) to identify volitional alcohol factors associated with self-harm enaction. RESULTS Volitional alcohol factors differentiated those with a history of self-harm enaction from those with a history of self-harm ideation (as well as those with no history) in initial models adjusted for demographics and depressive symptoms: the self-harm enaction group reported stronger alcohol-related negative urgency (OR = 1.74, 95% CI 1.41-2.16, p < .001), more frequent heavy drinking (OR = 1.46, 95% CI 1.24-1.72, p < .001) and stronger expectancies that drinking alcohol leads to negative self-perceptions (OR = 1.33, 95% CI 1.03-1.72, p = 0.03) and markers of self-harm risk (OR = 1.64, 95% CI 1.18-2.30, p = 0.004). Alcohol-related negative urgency and heavy-drinking frequency continued to differentiate those in the self-harm enaction group from those in ideation group in multivariate models. Consistent with theoretical models positing phase-specific moderators of self-harm ideation and enaction, psychosocial factors (perceived stress, support, negative mood regulation expectancies) differentiated those with a history of self-harm ideation from those without but not those in the ideation and enaction groups. CONCLUSIONS Management of self-harm risk requires better understanding of alcohol-related mechanisms of self-harm enaction. Volitional alcohol factors may play a role in governing the translation of self-harm thoughts into self-harm acts.
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Affiliation(s)
- Ambrose J. Melson
- 0000 0001 2193 314Xgrid.8756.cSuicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Rory C. O’Connor
- 0000 0001 2193 314Xgrid.8756.cSuicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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6
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Crombie IK, Irvine L, Williams B, Sniehotta FF, Petrie DJ, Jones C, Norrie J, Evans JMM, Emslie C, Rice PM, Slane PW, Humphris G, Ricketts IW, Melson AJ, Donnan PT, McKenzie A, Huang L, Achison M. Text message intervention to reduce frequency of binge drinking among disadvantaged men: the TRAM RCT. Public Health Res 2018. [DOI: 10.3310/phr06060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Socially disadvantaged men are more likely to binge drink frequently and to experience high levels of alcohol-related harm.
Objectives
To test the effectiveness and cost-effectiveness of a text message intervention in reducing the frequency of binge drinking among disadvantaged men.
Study design
A four-centre, parallel-group, pragmatic, individually randomised controlled trial was conducted. Randomisation was carried out using a secure remote web-based system. It was stratified by participating centre and recruitment method and restricted using block sizes of randomly varying lengths.
Setting
The study was conducted in the community. Members of the public helped to develop the study methods.
Participants
Participants were men aged 25–44 years who had ≥ 2 episodes of binge drinking (> 8 units of alcohol in a single session) in the preceding 28 days. Men were recruited from areas of high deprivation.
Interventions
An empirically and theoretically based text message intervention was delivered by 112 interactive text messages over a 12-week period. The control group received an attentional control comprising 89 text messages on general health.
Primary outcome measure
The primary outcome measure was the proportion of men consuming > 8 units of alcohol on ≥ 3 occasions (in the previous 28 days) at 12 months post intervention.
Results
The recruitment target of 798 was exceeded and 825 men were randomised. Retention was high and similar in the intervention (84.9%) and control (86.5%) groups. Most men in the intervention group engaged enthusiastically with the text messages: almost all (92%) replied to text messages and over two-thirds (67%) replied more than 10 times. The intervention was estimated to have had a modest, statistically non-significant effect on the primary outcome at the 12-month follow-up [odds ratio 0.79, 95% confidence interval (CI) 0.57 to 1.08]. This corresponds to a net reduction of 5.7% in regular binge drinking. Five secondary outcomes showed small non-significant and inconsistent effects on alcohol consumption, with one suggesting a positive effect and four suggesting an adverse effect. Both the short- and the long-term cost per quality-adjusted life-year (QALY) analysis suggested that the brief intervention was dominated by a ‘do-nothing’ option. The intervention’s impacts on patterns of alcohol consumption, QALYs and downstream costs were inconsistent and uncertain.
Limitations
The study used an active control that, combined with the recruitment procedures and baseline assessments, could have biased the treatment effect towards the null. The measurement of alcohol consumption relied on self-reported drinking.
Conclusions
The trial has demonstrated that it is possible to recruit and retain large numbers of socially disadvantaged men in a research study. The text messages delivered a complex theoretically and empirically based intervention that fostered enthusiastic engagement with the key components of the behaviour change sequence. The intervention produced a modest, statistically non-significant effect on the primary outcome, with wide CIs. Further research is needed to reduce uncertainty about the treatment effect. The methods developed for this study provide a platform for the design and testing of interventions to reduce inequalities in health.
Future work
A future trial could reduce the uncertainty around the treatment effect of the intervention.
Trial registration
Current Controlled Trials ISRCTN07695192.
Funding
This study was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 6. See NIHR Journals Library website for further information.
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Affiliation(s)
- Iain K Crombie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Linda Irvine
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Brian Williams
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Dennis J Petrie
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - John Norrie
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Josie MM Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Carol Emslie
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Peter M Rice
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Peter W Slane
- Erskine Practice, Arthurstone Medical Centre, Dundee, UK
| | - Gerry Humphris
- School of Medicine, Medical and Biological Sciences, University of St Andrews, St Andrews, UK
| | | | - Ambrose J Melson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Peter T Donnan
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Andrew McKenzie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Li Huang
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Marcus Achison
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
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7
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Crombie IK, Irvine L, Williams B, Sniehotta FF, Petrie D, Jones C, Norrie J, Evans JMM, Emslie C, Rice PM, Slane PW, Humphris G, Ricketts IW, Melson AJ, Donnan PT, Hapca SM, McKenzie A, Achison M. Texting to Reduce Alcohol Misuse (TRAM): main findings from a randomized controlled trial of a text message intervention to reduce binge drinking among disadvantaged men. Addiction 2018; 113:1609-1618. [PMID: 29855105 DOI: 10.1111/add.14229] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/15/2017] [Accepted: 03/26/2018] [Indexed: 11/30/2022]
Abstract
AIMS To test the effectiveness of a theoretically based text-message intervention to reduce binge drinking among socially disadvantaged men. DESIGN A multi-centre parallel group, pragmatic, individually randomized controlled trial. SETTING Community-based study conducted in four regions of Scotland. PARTICIPANTS A total of 825 men aged 25-44 years recruited from socially disadvantaged areas who had two or more episodes of binge drinking (> 8 UK units on a single occasion) in the preceding 28 days: 411 men were randomized to the intervention and 414 to the control. INTERVENTION AND COMPARATOR A series of 112 interactive text messages was delivered by mobile phone during a 12-week period. The intervention was structured around the Health Action Process Approach, a comprehensive model which allows integration of a range of evidence-based behaviour change techniques. The control group received 89 texts on general health, with no mention of alcohol or use of behaviour change techniques. MEASUREMENTS The primary outcome measure was the proportion of men consuming > 8 units on three or more occasions (in the previous 28 days) at 12 months post-intervention. FINDINGS The proportion of men consuming > 8 units on three or more occasions (in the previous 28 days) was 41.5% in the intervention group and 47.8% in the control group. Formal analysis showed that there was no evidence that the intervention was effective [odds ratio (OR) = 0.79, 95% confidence interval (CI) = 0.57-1.08; absolute reduction 5.7%, 95% CI = -13.3 to 1.9]. The Bayes factor for this outcome was 1.3, confirming that the results were inconclusive. The retention was high and similar in intervention (84.9%) and control (86.5%) groups. Most men in the intervention group engaged with the text messages: almost all (92%) replied to text messages and 67% replied more than 10 times. CONCLUSIONS A theoretically based text-messaging intervention aimed at reducing binge drinking in disadvantaged men was not found to reduce prevalence of binge drinking at 12-month follow-up.
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Affiliation(s)
- Iain K Crombie
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - Linda Irvine
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - Brian Williams
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Clayton, VIC, Australia
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - John Norrie
- Edinburgh Clinical Trials Unit (ECTU), University of Edinburgh, Edinburgh, UK
| | - Josie M M Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Carol Emslie
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Peter M Rice
- Division of Neuroscience, University of Dundee,, Dundee, UK
| | - Peter W Slane
- Erskine Practice, Arthurstone Medical Centre, Dundee, UK
| | - Gerry Humphris
- Medical and Biological Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | | | - Ambrose J Melson
- Institute of Health and Wellbeing, University of Glasgow, Mental Health and Wellbeing Academic Centre, Gartnavel Royal Hospital, Glasgow, UK
| | - Peter T Donnan
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - Simona M Hapca
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - Andrew McKenzie
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - Marcus Achison
- Division of Population Health Sciences, University of Dundee, Dundee, UK
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8
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Irvine L, Melson AJ, Williams B, Sniehotta FF, McKenzie A, Jones C, Crombie IK. Real Time Monitoring of Engagement with a Text Message Intervention to Reduce Binge Drinking Among Men Living in Socially Disadvantaged Areas of Scotland. Int J Behav Med 2018; 24:713-721. [PMID: 28702758 PMCID: PMC5608862 DOI: 10.1007/s12529-017-9666-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose This study identified the extent and nature of engagement with a theoretically based behaviour change text message intervention intended to reduce binge drinking. The data were from a randomised controlled trial tackling binge drinking among socially disadvantaged men. Method An intervention, comprising 112 text messages, and based on the principles of the Health Action Process Approach, was delivered to 411 socially disadvantaged men. Participants sent almost 7500 responses to the text messages. Engagement was assessed by whether text message replies showed the intended response to key components of the behaviour change strategy. Results The median number of responses to the text messages was 17 per man (range 0–81). Men often gave detailed sensitive personal information about their drinking and the harms it caused them. They also described their attempts at drinking less, the setbacks encountered and the benefits they enjoy when they are successful at cutting down. Specific examples of engagement with the targeted messages include the following: of the 248 men who responded to the prompt on outcome expectancies, most (230) identified potential benefits of cutting down; for intention to reduce drinking, 260 men responded of whom 44% said they had thought about changing; of the 172 men who responded to the question on goal setting, 158 reported personal goals. Conclusions The responses showed that most men engaged as intended with the key components of the intervention. Text message interventions should include questions addressing key components of the behaviour change strategy to determine whether there is effective engagement with intervention components.
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Affiliation(s)
- Linda Irvine
- Division of Population Health Sciences, University of Dundee, Dundee, UK.
| | - Ambrose J Melson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Brian Williams
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Andrew McKenzie
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - Iain K Crombie
- Division of Population Health Sciences, University of Dundee, Dundee, UK
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9
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Irvine L, Crombie IK, Swanson V, Dimova ED, Melson AJ, Fraser TM, Barbour R, Rice PM, Allan S. Design and feasibility testing of a novel group intervention for young women who binge drink in groups. PLoS One 2018; 13:e0193434. [PMID: 29494683 PMCID: PMC5832245 DOI: 10.1371/journal.pone.0193434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/09/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Young women frequently drink alcohol in groups and binge drinking within these natural drinking groups is common. This study describes the design of a theoretically and empirically based group intervention to reduce binge drinking among young women. It also evaluates their engagement with the intervention and the acceptability of the study methods. METHODS Friendship groups of women aged 18-35 years, who had two or more episodes of binge drinking (>6 UK units on one occasion; 48g of alcohol) in the previous 30 days, were recruited from the community. A face-to-face group intervention, based on the Health Action Process Approach, was delivered over three sessions. Components of the intervention were woven around fun activities, such as making alcohol free cocktails. Women were followed up four months after the intervention was delivered. RESULTS The target of 24 groups (comprising 97 women) was recruited. The common pattern of drinking was infrequent, heavy drinking (mean consumption on the heaviest drinking day was UK 18.1 units). Process evaluation revealed that the intervention was delivered with high fidelity and acceptability of the study methods was high. The women engaged positively with intervention components and made group decisions about cutting down. Twenty two groups set goals to reduce their drinking, and these were translated into action plans. Retention of individuals at follow up was 87%. CONCLUSIONS This study successfully recruited groups of young women whose patterns of drinking place them at high risk of acute harm. This novel approach to delivering an alcohol intervention has potential to reduce binge drinking among young women. The high levels of engagement with key steps in the behavior change process suggests that the group intervention should be tested in a full randomised controlled trial.
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Affiliation(s)
- Linda Irvine
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Iain K. Crombie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Vivien Swanson
- Psychology Division, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland, United Kingdom
| | - Elena D. Dimova
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Ambrose J. Melson
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Tracey M. Fraser
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Rosaline Barbour
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, England, United Kingdom
| | - Peter M. Rice
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Sheila Allan
- Dundee City Council, Dundee, Scotland, United Kingdom
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Irvine L, Crombie IK, Cunningham KB, Williams B, Sniehotta FF, Norrie J, Melson AJ, Jones C, Rice P, Slane PW, Achison M, McKenzie A, Dimova ED, Allan S. Modifying Alcohol Consumption to Reduce Obesity: A Randomized Controlled Feasibility Study of a Complex Community-based Intervention for Men. Alcohol Alcohol 2017; 52:677-684. [PMID: 29016701 PMCID: PMC5860466 DOI: 10.1093/alcalc/agx067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/15/2017] [Accepted: 09/06/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Being obese and drinking more than 14 units of alcohol per week places men at very high risk of developing liver disease. This study assessed the feasibility of a trial to reduce alcohol consumption. It tested the recruitment strategy, engagement with the intervention, retention and study acceptability. METHODS Men aged 35-64 years who drank >21 units of alcohol per week and had a BMI > 30 were recruited by two methods: from GP patient registers and by community outreach. The intervention was delivered by a face to face session followed by a series of text messages. Trained lay people (Study Coordinators) delivered the face to face session. Participants were followed up for 5 months from baseline to measure weekly alcohol consumption and BMI. RESULTS The recruitment target of 60 was exceeded, with 69 men recruited and randomized. At baseline, almost all the participants (95%) exceeded the threshold for a 19-fold increase in the risk of dying from liver disease. The intervention was delivered with high fidelity. A very high follow-up rate was achieved (98%) and the outcomes for the full trial were measured. Process evaluation showed that participants responded as intended to key steps in the behaviour change strategy. The acceptability of the study methods was high: e.g. 80% of men would recommend the study to others. CONCLUSIONS This feasibility study identified a group at high risk of liver disease. It showed that a full trial could be conducted to test the effectiveness and cost-effectiveness of the intervention. TRIAL REGISTRATION Current controlled trials: ISRCTN55309164. TRIAL FUNDING National Institute for Health Research Health Technology Assessment (NIHR HTA). SHORT SUMMARY This feasibility study recruited 69 men at high risk of developing liver disease. The novel intervention, to reduce alcohol consumption through the motivation of weight loss, was well received. A very high follow-up rate was achieved. Process evaluation showed that participants engaged with key components of the behaviour change strategy.
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Affiliation(s)
- Linda Irvine
- Division of Population Health Sciences, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, UK
| | - Iain K Crombie
- Division of Population Health Sciences, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, UK
| | - Kathryn B Cunningham
- Division of Population Health Sciences, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, UK
| | - Brian Williams
- School of Health & Social Care, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Medical Faculty, University of Newcastle, UK
| | - John Norrie
- Edinburgh Clinical Trials Unit (ECTU), University of Edinburgh, No. 9, Bioquarter, Medical School, Teviot Place, Edinburgh, UK
| | - Ambrose J Melson
- Institute of Health and Wellbeing, University of Glasgow, Mental Health & Wellbeing Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, UK
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Peter Rice
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Peter W Slane
- Erskine Practice, Arthurstone Medical Centre, Dundee, UK
| | - Marcus Achison
- Division of Population Health Sciences, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, UK
| | - Andrew McKenzie
- Division of Population Health Sciences, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, UK
| | - Elena D Dimova
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Sheila Allan
- Dundee City Council, Community Health Inequalities Manager, Mitchell Street Centre, Dundee, UK
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Melson AJ, Monk RL, Heim D. Self-Other Differences in Student Drinking Norms Research: The Role of Impression Management, Self-Deception, and Measurement Methodology. Alcohol Clin Exp Res 2016; 40:2639-2647. [PMID: 27699801 DOI: 10.1111/acer.13241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/12/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Data-driven student drinking norms interventions are based on reported normative overestimation of the extent and approval of an average student's drinking. Self-reported differences between personal and perceived normative drinking behaviors and attitudes are taken at face value as evidence of actual levels of overestimation. This study investigates whether commonly used data collection methods and socially desirable responding (SDR) may inadvertently impede establishing "objective" drinking norms. METHODS U.K. students (N = 421; 69% female; mean age 20.22 years [SD = 2.5]) were randomly assigned to 1 of 3 versions of a drinking norms questionnaire: The standard multi-target questionnaire assessed respondents' drinking attitudes and behaviors (frequency of consumption, heavy drinking, units on a typical occasion) as well as drinking attitudes and behaviors for an "average student." Two deconstructed versions of this questionnaire assessed identical behaviors and attitudes for participants themselves or an "average student." The Balanced Inventory of Desirable Responding was also administered. RESULTS Students who answered questions about themselves and peers reported more extreme perceived drinking attitudes for the average student compared with those reporting solely on the "average student." Personal and perceived reports of drinking behaviors did not differ between multitarget and single-target versions of the questionnaire. Among those who completed the multitarget questionnaire, after controlling for demographics and weekly drinking, SDR was related positively with the magnitude of difference between students' own reported behaviors/attitudes and those perceived for the average student. CONCLUSIONS Standard methodological practices and socially desirable responding may be sources of bias in peer norm overestimation research.
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Affiliation(s)
- Ambrose J Melson
- Institute of Health & Wellbeing (AJM), College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Rebecca Louise Monk
- Department of Psychology , Edge Hill University, Ormskirk, Lancashire, United Kingdom
| | - Derek Heim
- Department of Psychology , Edge Hill University, Ormskirk, Lancashire, United Kingdom
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