Fresh Start: A pilot, randomized controlled trial of a virtual reality (VR) experience to develop discrepancy and elicit change talk in brief motivational interventions for hazardous drinking among young adults.

BACKGROUND: Alcohol use is the leading risk factor for premature death among young adults globally. Brief motivational interventions (BMIs) inspired by Motivational Interviewing (MI) are effective but produce modest and short-lived effects, prompting interest in ways of enhancing the effects of these interventions. Developing self-discrepancy, the perception that one's current behavior conflicts with important values or life goals, is a key mechanism in MI. Virtual Reality (VR) has the potential to help elicit self-discrepancy by immersing users in vivid, interactive experiences that encourage deep reflection. We designed Fresh Start, a VR experience that could be used in MI sessions to help develop discrepancy and elicit change talk. This paper describes the protocol for a pilot randomized controlled trial to evaluate the tolerability, acceptability, and preliminary efficacy of Fresh Start when integrated into BMIs on hazardous drinking among young adults. METHODS: Hazardous drinking young adults (N=120; ages 18-34) referred to the University of Alabama's Collegiate Recovery and Intervention Services will be randomized 1:1 to: (1) BMI with VR (Fresh Start) or (2) time-matched BMI only (control). Tolerability, acceptability, and feasibility of the VR experience will be assessed in a post-session survey. Alcohol use and problems will be assessed at 1, 2, 3, and 6 months post-intervention. DISCUSSION: This study will produce one of the first rigorous evaluations of a VR experience designed to help build motivation to change drinking by eliciting self-discrepancy. Results will provide important data on tolerability and acceptability outcomes of VR-enhanced BMI, as well as its preliminary efficacy, which are necessary for planning a larger effectiveness trial.