Date Published: June 12, 2019
Publisher: Public Library of Science
Author(s): Ellen Lynch, Ruth McGovern, Catherine Elzerbi, Matthew Breckons, Paolo Deluca, Colin Drummond, Mohammed Fasihul Alam, Sadie Boniface, Simon Coulton, Eilish Gilvarry, Paul McArdle, Robert Patton, Ian Russell, John Strang, Eileen Kaner, Simone Rodda.
To explore adolescents’ experiences of consenting to, and participating in, alcohol intervention trials when attending for emergency care.
In-depth semi-structured interviews with 27 adolescents (16 males; aged 14–17 years (Mage = 15.7)) who had taken part in one of two linked brief alcohol intervention trials based in 10 accident and emergency departments in England. Interviews were transcribed verbatim and subject to thematic analysis.
Research and intervention methods were generally found to be acceptable though confidentiality was important and parental presence could hinder truthful disclosures regarding alcohol use. Participants discussed the importance of being involved in research that was relevant to them and recognised alcohol consumption as a normative part of adolescence, highlighting the importance of having access to appropriate health information. Beyond this, they recognised the benefits and risks of trial participation for themselves and others with the majority showing a degree of altruism in considering longer term implications for others as well as themselves.
Alcohol screening and intervention in emergency care is both acceptable and relevant to adolescents but acceptability is reliant on confidentiality being assured and may be inhibited by parental presence.
ISRCTN Number: 45300218
Although the proportion of young people who have never tried alcohol has increased in recent years, alcohol remains the most widely used psychoactive drug in this population . Adolescence is the key period for alcohol initiation with over 70% of young people having their first alcoholic drink by the age of 15  and normative increases in both frequency and quantity of alcohol consumption occur from early adolescence through to early adulthood . Adolescents may be especially vulnerable to the adverse effects of alcohol use . Adolescent alcohol use can influence brain development and resultant cognitive, emotional and social development . Research has identified associations between adolescent alcohol use and: heightened family conflict and lower educational outcomes [6, 7]; poorer physical  and mental health ; the development of alcohol use disorders [9, 10]; and disease in adulthood .
In this study, many of the interviewees recognised the importance of young people having the opportunity to take part in research on topics of significance to them. The findings generally support the acceptability of alcohol screening, interventions and alcohol intervention research with adolescent populations in emergency care. We found no indication that alcohol intervention per se or the emergency care setting was viewed as unacceptable to participants.
The research and intervention methods were generally found to be acceptable. The perceived relevance of the study seemed to be a key influence on willingness to become involved. The universal approach to screening, assurances of confidentiality and the non-judgemental approach of researchers contributed to acceptability which may in turn be inhibited by parental presence. Typical adolescents in this study appeared to understand the implications of participating in research; they described a process of considering potential benefits and harms both for themselves and for other people during the consent processes. Nevertheless, it is clear that many of the adolescents in this study did not have a full understanding of the specific research design. Future work would benefit from engaging young people in identifying how to explain the technical aspects of research designs as well as in the co-production of study materials and processes.