title: Health on the web: randomised controlled trial of online screening and brief alcohol intervention delivered in a workplace setting.
abstract: BACKGROUND
  Alcohol misuse in England costs around £7.3 billion (US$12.2 billion) annually from lost productivity and absenteeism. Delivering brief alcohol interventions to employees as part of a health check may be acceptable, particularly with online delivery which can provide privacy for this stigmatised behaviour. Research to support this approach is limited and methodologically weak. The aim was to determine the effectiveness of online screening and personalised feedback on alcohol consumption, delivered in a workplace as part of a health check.
  
  
  RESULTS
  This two-group online individually randomised controlled trial recruited employees from a UK-based private sector organisation (approx. 100,000 employees). 3,375 employees completed the online health check in the three week recruitment period. Of these, 1,330 (39%) scored five or more on the AUDIT-C (indicating alcohol misuse) and were randomised to receive personalised feedback on their alcohol intake, alongside feedback on other health behaviours (n = 659), or to receive feedback on all health behaviours except alcohol intake (n = 671). Participants were mostly male (75%), with a median age of 48 years and half were in managerial positions (55%). Median Body Mass Index was 26, 12% were smokers, median time undertaking moderate/vigorous physical activity a week was 173 minutes and median fruit and vegetable consumption was three portions a day. Eighty percent (n = 1,066) of participants completed follow-up questionnaires at three months. An intention to treat analysis found no difference between experimental groups for past week drinking (primary outcome) (5.6% increase associated with the intervention (95% CI -4.7% to 16.9%; p = .30)), AUDIT (measure of alcohol-related harm) and health utility (EQ-5D).
  
  
  CONCLUSIONS
  There was no evidence to support the use of personalised feedback within an online health check for reducing alcohol consumption among employees in this organisation. Further research is needed on how to engage a larger proportion of employees in screening.
  
  
  BACKGROUND
  International Standard Randomised Controlled Trial Number Register ISRCTN50658915.
authors.affiliation: Research Department of Primary Care and Population Health, University College London, Royal Free Hospital, London, United Kingdom.
authors.forename: Zarnie
authors.initials: Z
authors.lastname: Khadjesari
authors.affiliation: Research Department of Primary Care and Population Health, University College London, Royal Free Hospital, London, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Freemantle
authors.affiliation: Camden and Islington NHS Foundation Trust, London, United Kingdom.
authors.forename: Stuart
authors.initials: S
authors.lastname: Linke
authors.affiliation: Research Department of Primary Care and Population Health, University College London, Royal Free Hospital, London, United Kingdom.
authors.forename: Rachael
authors.initials: R
authors.lastname: Hunter
authors.affiliation: Research Department of Primary Care and Population Health, University College London, Royal Free Hospital, London, United Kingdom.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Murray
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006262:Health; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017132:Workplace