The effect of an online diabetes risk communication intervention for people impacted by alcohol and other drugs: A randomized controlled trial

INTERVENTION: Brief Online Type 2 Diabetes Risk Communication Intervention The randomized controlled trial will replicate the procedures that have been used in a previous online study (linked study record). (1) Participants will be directed to the online survey (i.e. Qualtrics) to complete the study. Upon starting the survey, participants will have to give informed consent in order to proceed. (2) Participants will first undergo the screening phase by completing a series of questions pertaining to their demographics, drug and/or alcohol history and the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Questions/questionnaires in the screening phase were compiled specifically for this study and will take approximately 5 minutes to complete. Participants who do not meet the eligibility requirements will be screened out of the survey. (3) Eligible participants will proceed on to the intervention phase and will be randomized to be in either the intervention or active control group. Participants in the intervention group will receive the personalized Type 2 diabetes risk message, while participants in the active control group will receive a COVID‐19 health message. (4) Participants will complete a series of questions on risk perception and related‐behavioural intentions pre‐ and post‐intervention. (5) At the end of the survey, participants will be given the option to download their personalised Type 2 diabetes risk message and the COVID‐19 health message. Participants will also be directed to a second survey to enter their email address to enter the lucky draw (10 x $50 visa gift cards). Type 2 Diabetes Risk Message (Intervention): For this study, we will focus on the personalized/tailored manipulation, which had the most promising results (from the previous study CONDITION: Mental Health ‐ Addiction Metabolic and Endocrine ‐ Diabetes Public Health ‐ Health promotion/education Type 2 Diabetes;Drug and alcohol dependence; ; Type 2 Diabetes ; Drug and alcohol dependence SECONDARY OUTCOME: COVID‐19 Preventive Behaviour Intentions. ; ; Participant’s engagement of key COVID‐19 protective behaviours, as identified in previous studies, will be measured. Participants will be asked how often they engage in (a) handwashing/sanitising, (b) physical distancing (i.e. staying 1.5‐2m away from people) when outside, (c) going to work or outside despite having symptoms of COVID‐19, and (d) wearing of mask. The items are rated on a 7‐point scale ranging from (1) not at all to (7) as often as possible.[Pre‐ and post‐intervention] Perceived Risk of COVID‐19. ; ; Consistent with previous studies (Dryhurst et al., 2020), COVID‐19 risk perception will be assessed using six‐items that measure participants’ seriousness of the COVID‐19 pandemic, perceived likelihood of contracting the virus themselves over the next 6 months, perceived likelihood of their family and friends catching the virus, and their present level of worry about the virus. Three items are measured on a 5 point likert scale with 1 being strongly disagree and 5 being strongly agree, while the other three items are measured on a 7 point likert scale with 1 being not at all likely and 7 being very likely.[Pre‐ and post‐intervention] ‐ People aged 18 and above living in Australia or the United States of America (USA), ‐ have had problems with illicit drugs or alcohol and/or have attended alcohol or other drugs (AOD) treatment in the past 12 months For participants to proceed on to the intervention phase, the inclusion criteria for participants are: ‐ do not have a diabetes diagnosis, ‐ score an intermediate or high risk on the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). PRIMARY OUTCOME: Accuracy of Type 2 Diabetes Risk. ; ; Dichotomous measures of accuracy will be created for Type 2 Diabetes (T2D) risk by comparing participants' actual and perceived T2D risk pre‐ and post‐intervention. Participants will be considered to have either improve (i.e. inaccurate to accurate risk perception), stayed the same, or worsened (i.e. accurate to inaccurate risk perception). Actual risk will be calculated using the AUSDRISK while perceived risk will be calculated using the two items from the RPS‐DD as stated above in Primary Outcome 1.; ; AUSDRISK: Participants' Type 2 Diabetes (T2D) risk will be examined using the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). It identifies individuals at high risk of developing T2D and consists of 11 items which assess demographic and diabetes risk factors. While the AUSDRISK was originally developed for an Australian sample population, the responses of ‘country of birth’ and ‘ethnicity’ have been modified (based on how specific race/ethnic groups have been defined in the USA) to fit a sample population in the USA. [Pre‐ and post‐intervention; ] Behavioural intentions.; ; In line with published recommendations, behavioural intentions for physical activity and diet will be measured individually using three items: e.g. In the next month: (i) ‘I intend to exercise more’, (ii) ‘I expect to exercise more, (iii) ‘I will try to exercise more’. The items are rated on a 7‐point scale ranging from (1) very unlikely to (7) very likely, and the average score will be used from the total of the 3 items.[Pre‐ and post‐intervention] Type 2 diabetes risk perception.; ; Consistent with previous studies, risk perception of Type 2 diabetes will be assessed using two items from the Risk Perception Survey for Developing Diabetes questionnaire (RPS‐DD): (1) What do you think your risk or chance is for getting diabetes over the next 10 years?; and (2) If you don’t change your lifestyle behaviours, such as diet or exercise, what is your risk or chance of getting diabetes over the next 10 years?. Responses are scored on a Likert‐type scale of 1 (almost no chance) to 4 (high chance). The scale is scored as the average of both items and a higher score is interpreted as a higher diabetes perceived risk.[Pre‐ and post‐intervention] INCLUSION CRITERIA: This study involves a screening phase and intervention phase to maximise data collection. Specifically, this will allow us to understand the rates of diabetes among people with drug and alcohol problems. The inclusion criteria for the screening phase are: