A Gamified, Social Media Inspired, Personalized Normative Feedback Alcohol Intervention for Sexual Minority Women: Protocol for a Hybrid Trial (Preprint)

BACKGROUND Sexual minority women (SMW) are more likely to drink alcohol, engage in heavy drinking, and experience alcohol-related problems than are heterosexual women. Yet, to date, culturally tailored interventions for this population have been slow to emerge. OBJECTIVE This Type I Effectiveness/Implementation Trial examines the feasibility and efficacy of a gamified, culturally tailored, personalized normative feedback (PNF) alcohol intervention for SMW. METHODS The core components of a PNF intervention were delivered within LezParlay, a fun, social media inspired, digital competition designed to challenge negative stereotypes about lesbian, bisexual, and queer women and increase visibility. Following two rounds of play by a large cohort of SMW, a sub-sample of 500 drinkers already taking part in the competition were invited to participate in an evaluation study. Study participants were randomized to receive 1 of 3 unique sequences of PNF (i.e., Alcohol & Stigma-Coping, Alcohol & Control, or Control topics only) over 2 intervention rounds. RESULTS Analyses will evaluate whether PNF on alcohol use reduced participants’ drinking and negative consequences 2 and 4 months post-intervention, examine whether providing PNF on stigma-coping behaviors in addition to alcohol use further reduces alcohol use and consequences beyond alcohol PNF alone, identify mediators and moderators of intervention efficacy, and examine broader LezParlay app engagement, acceptability, and perceived benefits. CONCLUSIONS This “incognito” intervention approach is uniquely oriented toward engaging and preventing alcohol-related risks among community populations of SMW who may view their heavy drinking as normative and not in need of change due to the visibility of alcohol use in sexual minority community spaces. Thus, the present intervention strategy diverges from, and is intended to compliment more intensive programs being developed to meet the needs of SMW already motivated to reduce their consumption. CLINICALTRIAL ClinicalTrials.gov NCT03884478; https://clinicaltrials.gov/ct2/show/NCT03884478