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Are brief alcohol interventions useful harm minimisation strategy


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A research proposal : Are brief interventions useful harm minimisation strategy for Australian University students

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Are brief alcohol interventions useful harm minimisation strategy

  1. 1. Are brief alcohol interventions useful harm minimisation strategy for Australian university students? A randomised control trial An example of a research proposal Dr Gargi Sinha
  2. 2. Before we start….. This document is written for completion of an assignment in the unit of Research Proposal and Preparation and Research Methods at School of Medical and Health Sciences, Edith Cowan University, Western Australia
  3. 3. Content Context of study Literature Review Research Question Theoretical Framework Methodology Ethical consideration Appendix and references
  4. 4. Strength and limitation Analysis Strengths first to integrate university setting, harm minimisation and brief intervention for Australian university students Limitations Recruiting sample from a single Australian university may raise the question of generalizability.
  5. 5. Context Magnitude of the problem Excessive consumption of alcohol among university students is a challenging public health problem in Australia Alcohol-related problem contributes significantly to acute hospital admission and costs the health system (NSW Ministry of Health, 2015). In 2014-15, approximately,70,000 patients presented to emergency department of Australia for alcohol-induced problems (Australian Institute of Health and Welfare, 2016a).
  6. 6. How university students are more vulnerable towards the harm of alcohol Issues of young people • Alcohol consumption is estimated to cause road traffic accidents, violence and derailment of the career in the young population (Scott-Parker, Watson, King, & Hyde, 2014; Snowden & Pridemore, 2014). Researchers indicated that young generation in the university uses alcohol for both to socialise and to spend their idle time (Leontini et al., 2015). These studies identified a variety of factors which amalgamated with harmful consumption of alcohol by the university students. Issues of university students • the legal age of purchasing alcohol for 18 years coincides with the start of academic studies at university in Australia (Leontini et al., 2015). Additionally, peer pressure, adjustment towards a new course and residing alone and away from the family also instrumental for the young generation to indulge in heavy alcohol use (Rinker & Neighbours, 2013).
  7. 7. Areas for further research Literature suggests : despite risk factors, there are a limited number of strategies adopted by the universities to reduce the harmful effect of alcohol (Shop, Brooks, & Schooley, 2015). University students are at risk of consuming harmful level at one time because of peer pressure or lack of knowledge about binge drinking (Rickwood et al., 2011). However, there is a notable gap is present in the research area for university population.
  8. 8. How it will contribute to the new knowledge of existing evidence Unlike aged and chronic drinker, those who require pharmacological treatment under the supervision of a specialist, the young alcohol user often need early intervention and support. . It is well established that brief early intervention has a role in preventing the harm caused by alcohol (McClatchey, Boyce, & Dombrowski, 2015). A brief intervention is a short conversation in an evidence- based way, with a person about a health issue in a non-confrontational manner.
  9. 9. Literature review Young et al. (2006) argued that drinking behaviour of university students governed by other interrelated outcomes such as socialisation and relaxation. Similarly, Rickwood et al. (2011) revealed that Australian University students experienced a range of problem due to alcohol including unwanted sexual involvement, physical violence and accidents. Additionally, university students are not confident to refuse drink which aggravates the problem of binge drinking. Hence, university students inevitably faced with a situation where they experience social pressure to drink. Young et al. (2006) proposed that focused intervention of alcohol for university setting would benefit the university student’s alcohol problem. Therefore, brief intervention can assist university student to minimise the harm of alcohol and keep the level of drink at a safe limit.
  10. 10. Why do we need to do a brief intervention in a university setting The current trend for brief intervention utilises a combination of screening and intervention. While the general practitioner usually provides brief intervention, however, there is reasonable evidence which suggests that this intervention can be sufficiently delivered by trained people such as the pharmacist, nurse (Fitzgerald, Molloy, MacDonald, & McCambridge, 2015). Moreover, research also suggests that there are heaps of barrier while concentrating on providing brief intervention for young people in primary health care setting (Johnson et al., 2011). -for more info…List location or contact for specification (or other related documents)
  11. 11. A pragmatic approach to harm minimisation strategies Concerning the alcohol consumption by the university students, many evidence empirically support harm minimisation strategies (Cousins, Connor, & Kypri, 2014; Wachtel & Staniford, 2010). Firstly, total absenteeism of alcohol seems to an unrealistic goal because of cultural and social acceptance of alcohol in Australia (Hernandez et al., 2013). Secondly, university students are usually not chronic alcoholics and don't view consuming alcohol as a problem (Morton & Tighe, 2011).
  12. 12. Principles of harm minimisation strategies Demand reduction • Prevent uptake • Delay the use alcohol Supply reduction • reduce • Remove supply alcohol Harm reduction • Reduce harm to self • community
  13. 13. Analysis of brief intervention and harm minimisation in a university setting there are several limitations for alcohol discussion with the General Practitioner. Firstly, in case patient's symptoms not directly linked to the alcohol, they are often not at ease with alcohol enquiry (Tam et al., 2015). Secondly, there is an element of fear and shame involved in answering the question regarding alcohol by General Practitioner (Tam et al., 2015). Berends and Lubman (2013) suggested a tailored approach required for timely intervention of alcohol problem. Researchers proposed various solutions to the university student’s accessibility problem of alcohol services in Australia including community clinics, emergency setting and university health clinics (Berends & Lubman, 2013; Ehrlich, Haque, Swisher-McClure, & Helmkamp, 2006; Helmkamp, Hungerford, Williams, & Manley, 2003).
  14. 14. Research question P- population I- Intervention C- comparision O- outcome
  15. 15. PICO question Population (P) - Australian University Students Intervention (I)-Brief alcohol intervention Comparison (C)- With no brief intervention Outcome(O)- Knowledge about reducing the harm caused by alcohol
  16. 16. THEORETICAL FRAMEWORK Pre-Contemplative stage - Individuals at this stage do not usually consider changing. Individual often express as 'I enjoy drinking and doesn't want to change '. Contemplative stage- Individual at this juncture is aware of the harm of drinking, however ambivalent to change. Preparation stage -Individual at this stage are prepared to act. The individual will often express I am ready to cut down on alcohol. Goal setting strategies are useful at this stage. Action stage- Individual at this stage, are currently engaged in attempts to reduce or stop drinking Maintenance -stage Individual at this stage successfully change drinking behaviour, however, need strategies for relapse prevention. Miller and Rollnick (2002) elaborate a model developed by Prochaska and DiClemente which provide a framework to understand an individual’s willingness to change.
  17. 17. Appendices Information Letter to Participants Informed Consent Document The Alcohol Use Disorders Identification Test (AUDIT)
  18. 18. Informed consent sample
  19. 19. Information letter for participants :sample
  20. 20. AUDIT questioner: sample
  21. 21. For full proposal  Please visit intervention-and-harm-minimisation/
  22. 22. References
  23. 23. References
  24. 24. References
  25. 25. REFERENCES Morton, F., & Tighe, B. (2011). Prevalence of, and factors influencing, binge drinking in young adult university under-graduate students. Journal of Human Nutrition & Dietetics, 24(3), 296-297. doi:10.1111/j.1365-277X.2011.01175_25.x National Health and Medical Research Council. (2009). Alcohol guidelines:reducing the health risk. NSW Ministry of Health. (2015). The Hospital Drug and Alcohol Consultation Liaison Model of Care. Retrieved from Reilly, D., & Mitchell, E. (1998). Alcohol education in licensed premises using brief intervention strategies. Addiction, 93(3), 385-398. Rickwood, D., George, A., Parker, R., & Mikhailovich, K. (2011). Harmful Alcohol Use on Campus: Impact on Young People at University. Youth Studies Australia, 30(1), 34-40. Rinker, D. V., & Neighbors, C. (2013). Social influence on temptation: perceived descriptive norms, temptation and restraint, and problem drinking among college students. Addictive Behaviors, 38(12), 2918-2923. doi:10.1016/j.addbeh.2013.08.027 Saitz, R. (2010). Alcohol screening and brief intervention in primary care: Absence of evidence for efficacy in people with dependence or very heavy drinking. Drug and Alcohol Review, 29(6), 631-640. Scott-Parker, B., Watson, B., King, M. J., & Hyde, M. K. (2014). “I drove after drinking alcohol” and other risky driving behaviours reported by young novice drivers. Accident Analysis and Prevention, 70, 65-73.
  26. 26. References Seale, J. P., Velasquez, M. M., Johnson, J. A., Shellenberger, S., von Sternberg, K., Dodrill, C., . . . Grace, D. (2012). Skills-based residency training in alcohol screening and brief intervention: results from the Georgia-Texas "Improving Brief Intervention" Project. Substance abuse, 33(3), 261-271. Shupp, M. R., Brooks, F., & Schooley, D. (2015). Assessing Effective Alcohol and Other Drug Interventions with the College-Age Population: A Longitudinal Review. Alcoholism Treatment Quarterly, 33(4), 422- 443. doi:10.1080/07347324.2015.1077630 Snowden, A. J., & Pridemore, W. A. (2014). Off-premise alcohol outlet characteristics and violence. The American journal of drug and alcohol abuse, 40(4), 327-335. Suresh, K., Suresh, G., & Thomas, S. (2012). Design and data analysis 1 study design. Annals of Indian Academy of Neurology, 15(2), 76-80. Tam, C. W., Knight, A., & Liaw, S. T. (2016). Alcohol screening and brief interventions in primary care - Evidence and a pragmatic practice-based approach. Australian family physician, 45(10), 767-770. Tam, C. W., Leong, L., Zwar, N., & Hespe, C. (2015). Alcohol enquiry by GPs - Understanding patients' perspectives: A qualitative study. Australian family physician, 44(11), 833-838. Wachtel, T., & Staniford, M. (2010). The effectiveness of brief interventions in the clinical setting in reducing alcohol misuse and binge drinking in adolescents: a critical review of the literature. Journal of Clinical Nursing, 19(5-6), 605-620. Wardle, J. (2015). Price-based promotions of alcohol: Legislative consistencies and inconsistencies across the Australian retail, entertainment and media sectors. International Journal of Drug Policy, 26(5), 522-530. World Health Organisation. (2014). Global status report on alcohol and health. Retrieved from Young, R. M., Connor, J. P., Ricciardelli, L. A., & Saunders, J. B. (2006). The role of alcohol expectancy and drinking refusal self-efficacy beliefs in university student drinking. Alcohol and alcoholism (Oxford, Oxfordshire), 41(1), 70-75. Zoorob, R., Snell, H., Kihlberg, C., & Senturias, Y. (2014). Screening and brief intervention for risky alcohol use. Current problems in pediatric and adolescent health care, 44(4), 82-87.
  27. 27. Thank you For your attention