Health on the Web: Randomised Controlled Trial of Online Screening and Brief Alcohol Intervention Delivered in a Workplace Setting

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. Methods and Findings 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. Trial Registration International Standard Randomised Controlled Trial Number Register ISRCTN50658915背景 英格兰地区的酒精滥用问题每年因生产力流失与缺勤造成约73亿英镑（折合122亿美元）的经济负担。将简短酒精干预作为健康检查的一部分提供给员工具备可行性，且线上交付模式可为这类带有污名化色彩的行为提供隐私保护。目前支持该干预方案的相关研究较为匮乏且方法学质量欠佳。本研究旨在评估作为职场健康检查组成部分的线上筛查与个性化反馈对员工酒精消费行为的干预效果。 方法与结果 本研究为两组设计的线上个体随机对照试验，招募对象来自英国一家私营企业（员工总数约10万名）。在为期三周的招募周期内，共计3375名员工完成了线上健康检查。其中1330名（占比39%）在酒精使用障碍识别测试消费分量表（AUDIT-C）上得分≥5分，提示存在酒精滥用风险，随后被随机分为两组：实验组（n=659）接收针对自身酒精摄入量的个性化反馈，并附加其他健康行为的反馈内容；对照组（n=671）仅接收除酒精摄入外的其他健康行为反馈。受试者以男性为主（75%），中位年龄为48岁，55%的受试者处于管理岗位。受试者的中位体质指数（BMI）为26，12%为吸烟者，每周中等强度/高强度体力活动的中位时长为173分钟，每日水果与蔬菜摄入量的中位值为3份。80%的受试者（n=1066）完成了3个月后的随访问卷。意向性治疗分析结果显示，两组在过去一周饮酒量（主要结局指标）上无显著组间差异（干预组相关饮酒量较对照组增加5.6%，95%置信区间为-4.7%~16.9%；p=0.30），在酒精使用障碍识别测试（AUDIT，酒精相关伤害评估工具）得分与健康效用值（EQ-5D）方面亦未观察到显著组间差异。 结论 本研究未发现证据支持在职场线上健康检查中加入个性化反馈，以降低该企业员工的酒精消费行为。未来仍需开展进一步研究，探索如何提升员工的筛查参与率。 试验注册 国际标准随机对照试验注册号ISRCTN50658915