Development and Acceptability of a Co-Produced Online Intervention to Prevent Alcohol Misuse in Adolescents: A Think Aloud Study.

Background: The prototype willingness model (PWM) may offer an appropriate basis for explaining and preventing adolescent alcohol misuse. An intervention was developed using a co-production approach, and consisted of an online quiz featuring 10 questions linked to the PWM.
Objective: This study sought to determine the acceptability and relevance of the intervention content to young people, to incorporate their feedback into a final version.
Methods: A qualitative think aloud study with follow-up semistructured interviews was undertaken with 16 young people aged 11-15 (50%). Transcripts were analyzed using thematic analysis.
Results: The following 3 main themes relating the acceptability of the intervention were identified: "challenging expectations of alcohol education"; "motivations for drinking or not drinking," and "the inevitability of drinking." Participants found the intervention appealing because it was counter to their expectations. The content appeared to reflect their experiences of social pressure and drinking encounters. There was evidence that a focus on drinker/nondrinker prototypes was too narrow and that because adolescents perceived drinking as inevitable, it would be challenging to enact any plans to resist pressure to drink.
Conclusions: An online intervention based on the PWM has the potential to engage and interest adolescents. A wide range of alcohol prototypes should be targeted and a focus on short-term harms should ensure that the intervention is credible to young people.