title: Health on the web: randomised trial of work-based online screening and brief intervention for hazardous and harmful drinking.
abstract: BACKGROUND
  Alcohol misuse is a significant international public health problem. Screening and brief intervention (SBI) in primary care reduces alcohol consumption by about 15 - 30%, sustained over 12 months in hazardous or harmful drinkers but implementation has proved difficult leading to growing interest in exploring the effectiveness of SBI in other settings, including the workplace. Computerised interventions for alcohol misuse can be as effective as traditional face-to-face interventions and may have advantages, including anonymity, convenience and availability.
  
  
  METHODS
  Individually randomised controlled trial to determine the effectiveness and cost-effectiveness of offering online screening and brief intervention for alcohol misuse in a workplace.
  
  
  METHODS
  adults (aged 18 or over) employed by participating employers scoring 5 or more on a three item screen for alcohol misuse (the AUDIT-C) indicating possible hazardous or harmful alcohol consumption, recruited through the offer of an online health check providing screening for a range of health behaviours with personalised feedback. PARTICIPANTS who accept the health check and score 5 or more on the alcohol screen will be randomised to receiving immediate feedback on their alcohol consumption and access to an online intervention offering support in reducing alcohol consumption (Down Your Drink) or delayed feedback and access to Down Your Drink after completion of follow-up data at three months. All employees who take the online health check will receive personalised feedback on other screened health behaviours including diet, physical activity, smoking, and body mass index. The primary outcome is alcohol consumption in the past week at three months; secondary outcomes are the AUDIT, EQ-5D, days off work, number and duration of hospital admissions, costs and use of the intervention. A sample size of 1,472 participants (736 in each arm) provides 90% power with 5% significance to determine a 20% reduction in alcohol consumption. Outcomes between groups at three months will be compared following the intention to treat principle and economic analyses will follow NICE guidance.
  
  
  CONCLUSIONS
  This innovative design avoids recruitment bias by not mentioning alcohol in the invitation and avoids reactivity of assessment by not collecting baseline data on alcohol consumption.
authors.affiliation: Research Department of Primary Care and Population Health, University College London, Upper Floor 3, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, England. Elizabeth.murray@ucl.ac.uk.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Murray
authors.forename: Zarnie
authors.initials: Z
authors.lastname: Khadjesari
authors.forename: Stuart
authors.initials: S
authors.lastname: Linke
authors.forename: Rachael
authors.initials: R
authors.lastname: Hunter
authors.forename: Nick
authors.initials: N
authors.lastname: Freemantle
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion; D006801:Humans; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D018579:Patient Selection; D011314:Preventive Health Services / Q000379:methods; D016896:Treatment Outcome