Program Reviews

Alcohol Alert

Program Overview

Alcohol Alert is an internet-based game to deliver delivered tailored feedback on adolescents’ attitudes and ideas about alcohol to enhance motivation to reduce binge drinking.

Alcohol Alert is an internet-delivered game for adolescents (16-18 years old) that includes three scenarios where the player has just woken up from blacking out after drinking the night before and something has happened to the character (e.g. lost their keys). The goal of each scenario is to figure out what happened. While playing the game, the player is asked questions about their attitudes about binge drinking and received personalized feedback based on responses to increase motivation for reduced drinking. A fourth session gives player the opportunity to receive normative feedback about their drinking, set reduction goals and develop a plan of action to reach goals. If an adolescent does not have a drinking event coming up or they do not want to take the challenge, they are given advice on using action plans to reduce binge drinking. A fifth session lets players report back on goals and provides opportunity for repeating the challenge A parental component gives parents personalized feedback about how to talk to their child about alcohol consumption and set rules about alcohol consumption.

Delivery:
Web-based

Theoretical Approaches:
Integrated behavior change

Target Substance(s):
Alcohol

Target Outcome(s):
Frequency
Quantity
Motivation to change

Ages:
Adolescents (11-17)
Young Adults (18-30)
Adults (30+)

Genders:
Male
Female

Races/Ethnicities:
Dutch
Belgian
German
Surinamese
Moroccan
Turkish
Other

Setting:
School
Home

Geographic Location:
The Netherlands

Language:
Dutch

Evaluations

  • Jander A, Crutzen R, Mercken L, Candel M, de Vries H. Journal of Medical Internet Research. 2016. 18(2). PMCID: PMC4757780.

    Summary: The Alcohol Alert Intervention was tested in a cluster randomized controlled trial in 34 Dutch schools. The objective was to assess the effectiveness of the intervention in reducing binge drinking in adolescents 15 to 18 years old. A total of 2649 adolescents participated in the study. Adolescents were randomized, by school, into a group that received the intervention or an assessment-only control group. At baseline, students completed a survey that assessed past 30-day frequency of binge drinking, frequency and quantity of drinking in the last week, and motivational factors (i.e. attitudes, modeling, social norms, perceived pressures, and self-efficacy). Participants had the option to provide a parent’s email address that could be used to invite the parent to take part in the intervention. Rates of parental involvement were low, 199 parents were invited and 91 participated. For the intervention group, adolescents played the three sessions of the game in school; the fourth and fifth sessions were completed at home. Participants completed a 4-month follow up assessment. Attrition was high; only 824 students participated in the 4-month follow up survey. Additionally, adherence to the intervention was low; only 27 participants completed the fourth session and no participants completed the fifth session. There were group differences at baseline between conditions and between participants who completed the follow-up assessment and those who dropped out. This, along with low adherence levels made the results difficult to interpret. The intervention was effective at reducing drinking in 15 year olds and parent participation was related to less binge drinking in their child. Results suggest that the Alcohol Alert intervention may be most effective for younger adolescents and that further research is needed to increase adherence.

    Take Away: Alcohol Alert shows the potential to reduce drinking in 15 and 16 year olds, especially when parents are involved, but more research needs to be done to improve adherence and randomization of participants.

  • Drost R, Paulus A, Jander AF, Mercken L, de Vries H, Ruwaard D, & Evers SMAA. (2016). Journal of Medical Internet Research, 18(4), e93–e93.

    Summary: This study assessed the cost-effectiveness of an Internet computer-tailored intervention for alcohol use among adolescents. The researchers evaluated costs from a health care perspective and from a societal perspective (that includes intersectoral costs and benefits). A cluster randomized controlled trial was conducted where participants either played a game on alcohol awareness called Alcohol Alert or received care as usual. In the Netherlands, 21 schools were randomly assigned to the intervention condition and 23 schools were assigned to the control. Data were collected at baseline and after 4 months and calculated incremental cost-effectiveness ratios. From both a healthcare and societal perspective, the intervention was significantly more costly and more effective for alcohol use and binge drinking than care as usual. The intervention was cost-effective from a societal perspective for subgroups who are 17-19 years old and have lower educational level. From a healthcare perspective, it is cost-effective for male, lower education, 17-19 years old and nonreligious subgroups. Overall, computer-tailored feedback can be a cost-effective way to target alcohol use among adolescents. Further research needs to explore the effect of the intervention for specific subgroups.

    Take Away: Alcohol Alert is a cost-effective intervention for excessive alcohol use among adolescents.

  • A Web-based computer tailored game to reduce binge drinking among 16 to 18 year old Dutch adolescents: Development and study protocol. Jander A, Crutzen R, Mercken L, de Vries H. BMC Public Health. 2014. 14(1). PMCID: PMC4210522.

    A Web-based computer-tailored alcohol prevention program for adolescents: Cost-effectiveness and intersectoral costs and benefits. Drost R, Paulus ATG, Jander AF, Mercken L, de Vries H, Ruwaard D, Evers SMAA. Journal of Medical Internet Research. 2016. 18(4). PMCID: PMC4858595.

    Design, implementation and evaluation of a web-based computer-tailored intervention to prevent binge drinking in adolescents: study protocol. Lima-Serrano M, Martinez-Montilla J, Lima-Roiguez JS, Mercken L, & de Vries H (2018). BMC Public Health, 18(1), 449–449. https://doi.org/10.1186/s12889-018-5346-4