Web-based alcohol intervention for Māori university students: double-blind, multi-site randomised controlled trial

Aims: Like many indigenous peoples, New Zealand Māori bear a heavy burden of alcohol-related harm relative to their non-indigenous compatriots, and disparaties are greatest among young adults. We tested the effectiveness of web-based alcohol screening and brief intervention (e-SBI) for reducing hazardous drinking among Māori university students. Design: Parallel, double-blind, multi-site, randomised controlled trial. Setting: Seven of New Zealand's eight universities. Participants: In April 2010, we sent e-mail invitations to all 6,697 17-24 year-old Māori students to complete a brief web questionnaire including the AUDIT-C, a screening tool for hazardous and harmful drinking. Intervention: Those screening positive were computer randomised to: <10 minutes of web-based alcohol assessment and personalized feedback (intervention) or screening alone (control). Measurements: We conducted a fully automated five month follow-up assessment with observers and participants blinded to study hypotheses, design, and intervention delivery. Predetermined primary outcomes were: (1) frequency of drinking (2) amount consumed per typical drinking occasion, (3) overall volume of alcohol consumed, and (4) academic problems. Findings: 1,789 participants were hazardous or harmful drinkers (AUDIT-C ≥ 4) and were randomized: 850 to control, 939 to intervention. Follow-up assessments were completed by 682 controls (80%) and 733 intervention group members (78%). Relative to controls, participants receiving intervention drank less often (RR=0.89; 95% confidence interval: 0.82 to 0.97), less per drinking occasion (RR=0.92; 0.84 to 1.00), less overall (RR=0.78; 0.69 to 0.89), and had fewer academic problems (RR=0.81; 0.69 to 0.95). Conclusions: Web-based screening and brief intervention reduced hazardous and harmful drinking among non-help-seeking Māori students in a large scale pragmatic trial. The study has wider implications for behavioural intervention in the important but neglected area of indigenous health.