title: An Internet-Based Intervention to Promote Alcohol-Related Attitudinal and Behavioral Change Among Adolescents: Protocol of a Cluster Randomized Controlled Trial.
abstract: BACKGROUND
  Underage drinking is a prevalent risk behavior and common public health problem. Research shows that alcohol abuse not only affects the quality of life of drinkers themselves. The problems resulting from underage drinking pose substantial costs to society as well. The proposed study will address underage drinking with the use of an Internet campaign, which is a cost-effective way of tackling the problem.
  
  
  OBJECTIVE
  The aims of this study are to test the effectiveness of an online quiz competition in changing adolescents' alcohol-related attitudes and behavior and to explore the feasibility of using Internet viral marketing to reach a significant number of adolescents.
  
  
  METHODS
  The study will constitute a cluster randomized controlled trial for 20 secondary schools (6720 Grade 7-9 students). Schools will be randomized to intervention or control arm with equal likelihood. Students in intervention schools will be invited to take part in the Internet campaign, whereas those in control schools will receive relevant promotional leaflets.
  
  
  RESULTS
  Alcohol-related attitude and behavior will be the primary outcome measures. The results of the proposed study will provide evidence on the efficacy of an Internet intervention in modifying adolescents' attitudes and behavior and guide further investigation into the prevention of and intervention in such risk behaviors as underage drinking. The project was funded July 2015, enrollment started September 2015, and results are expected July 2017.
  
  
  CONCLUSIONS
  With the Internet increasingly being recognized as a practical and cost-effective platform for health information delivery, the proposed Internet-based intervention is expected to be more effective in altering adolescents' alcohol-related attitudes and behaviors than traditional health promotion.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02450344; https://clinicaltrials.gov/ct2/show/NCT02450344 (Archived by WebCite at http://www.webcitation.org/6heB2zMBD).
authors.affiliation: The University of Hong Kong, Department of Paediatrics and Adolescent Medicine, Hong Kong, China (Hong Kong). patricip@hku.hk.
authors.forename: Patrick
authors.identifier: http://orcid.org/0000-0002-6797-6898
authors.initials: P
authors.lastname: Ip
authors.forename: Ko-Ling
authors.identifier: http://orcid.org/0000-0001-8508-9224
authors.initials: KL
authors.lastname: Chan
authors.forename: Chun-Bong
authors.identifier: http://orcid.org/0000-0002-5675-7972
authors.initials: CB
authors.lastname: Chow
authors.forename: Tai-Hing
authors.identifier: http://orcid.org/0000-0002-2033-9971
authors.initials: TH
authors.lastname: Lam
authors.forename: Sai-Yin
authors.identifier: http://orcid.org/0000-0001-9485-0273
authors.initials: SY
authors.lastname: Ho
authors.forename: Wilfred Hing-Sang
authors.identifier: http://orcid.org/0000-0001-8396-2368
authors.initials: WH
authors.lastname: Wong
authors.forename: Margaret Fung-Yee
authors.identifier: http://orcid.org/0000-0002-0813-3655
authors.initials: MF
authors.lastname: Wong
keywords: Internet intervention; Internet viral marketing; attitude change; behavioural change; risk behaviour; underage drinking