Study plan: Can tailoring a digital alcohol intervention to why people drink improve how it works?

What is it about?

This is the protocol for a three-arm randomised controlled trial testing whether a digital alcohol intervention that is tailored to an individual's specific reasons for drinking and their readiness to change is more effective than a standard personalised digital intervention or referral to general online health information. The trial recruits risky drinkers in Sweden who are actively seeking help online, using social media and search engine advertising. Participants are randomly allocated to one of three groups for 16 weeks: an enhanced tailored intervention that adapts content to drinking motives such as coping, social, or enhancement reasons, and to readiness to change stage; a previously validated personalised digital intervention; or redirection to national alcohol health websites. Primary outcomes are weekly alcohol consumption and frequency of heavy episodic drinking, measured over eight months using a Bayesian sequential design that enables the trial to stop recruiting as soon as sufficient evidence accumulates for benefit, harm or futility.

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Why is it important?

Despite taxation, sales restrictions and updated drinking guidelines, rates of risky alcohol use in Sweden have not declined over 15 years, and only a tiny fraction of people who drink at risky levels receive any professional support, partly due to stigma and workforce shortages. Digital brief interventions have shown promise, and a previous trial of the personalised version of this intervention reduced alcohol consumption by 23%. This trial advances that work by testing whether matching intervention content to the psychological mechanisms that drive an individual's drinking, specifically their motives and stage of change readiness, produces greater reductions. The use of a Bayesian sequential design is a methodological contribution in itself, enabling efficient, ethical recruitment without the risk of stopping too early or too late. Results are expected in 2027 and could reshape how digital alcohol behaviour change tools are designed and personalised at scale.