Reducing Consumption Levels of Alcohol In Midlife (ReCLAIM): The development and testing of a theory and evidence-based online intervention targeting automatic processes

Background: In the UK, prevalence of drinking at increased risk (>14 units a week) is higher than average among adults aged between 45 and 75 years, and 78% of alcohol-specific deaths occur in those aged between 40 and 69 years. There are indications of low engagement with alcohol-related information-based advice, and current support may not be suitable or easy to access for this population, leading to concerns about negative impacts on health and wellbeing in the short and long term. Aim: This PhD research programme systematically developed and tested a theory and evidence-based intervention targeting automatic processes, typified by fast, instinctive, or non-conscious decision making about health behaviours. Methods: The intervention development approach employed the Behaviour Change Wheel within the Medical Research Council guidance framework. Findings from literature reviews, a qualitative study (N=16), and public involvement activities informed the intervention development process. A two-arm pilot randomised controlled study (N=60) was conducted to assess the feasibility and acceptability of an online intervention (ReCLAIM), and to inform future research. Findings: The intervention development work identified main barriers to change as being connected with binary views of alcohol consumption, whereby most drinking behaviour was perceived as acceptable and normal, or unacceptable and exceptional. Barriers were addressed by utilising the social reaction pathway within the Prototype Willingness Model (PWM) as the underlying mechanism of change, in combination with five Behaviour Change Techniques (BCTs). Pilot study results indicated support for the acceptability of the ReCLAIM intervention and concluded that a full-scale trial with modifications could be feasible. Conclusion: Programme outputs indicated support for targeting automatic processes to reduce UK midlife adult alcohol consumption, and for the acceptability and feasibility of a PWM-based online intervention. Barriers connected with drinking identity were addressed by utilising social processes and five BCTs. Potential implications for theory, methodology, and future research were identified and discussed.

Grantor dc:publisher

Oxford Brookes University

Author dc:creator

• Matley, Fiona

Contributors dc:contributor

• Davies, Emma
• Foxcroft, David

Statement dc:rights

• All rights reserved

Language dc:language

en

DOI dc:identifier

https://doi.org/10.24384/wjtb-pj17

OAI identifier oai:identifier

tle:56ef9d0c-81c1-4036-a110-cc45b26a18ec:d6bd9758-527a-46cd-bfe2-c433766e8fca:1