A randomised trial of the effect of appearance versus health-framed messages on engagement with an online brief screening and alcohol reduction intervention

Abstract

<b>Objectives:</b> To compare the impact of appearance versus health-framed messages on engagement in a brief web-based risk screening and alcohol reduction intervention. <b>Design:</b> Randomised trial delivered via Drinkaware's website. Visitors were exposed to appearance (<i>n</i> = 51,588) or health-framed messages (<i>n</i> = 52,639) directing them towards an AUDIT-C risk screening questionnaire. Users completing this questionnaire were given feedback on their risk level and extended frame-congruent information. <b>Outcomes:</b> The primary outcome is completion of the AUDIT-C questionnaire. The secondary outcome is whether the participant accessed any of four further resources. <b>Results:</b> The appearance-framed message led to a small but significant increase in the number of users completing the AUDIT-C compared to the health-framed message (<i>n</i> = 3,537, 6.86% versus <i>n</i> = 3,355, 6.37%, <i>p</i> < 0.01). Conversely, following subsequent risk feedback, users exposed to extended health-framed information were more likely to access further resources (<i>n</i> = 1,146, 2.17% versus <i>n</i> = 942, 1.83%, <i>p</i> < 0.01). <b>Conclusions:</b> Physical appearance-framed messages increased the likelihood of engagement with an online alcohol screening and brief intervention tool, whereas health-framed messages increased the likelihood of accessing further resources. This highlights the potential for the use of multi-level approaches in alcohol reduction interventions.