Excessive alcohol use is common among young adults and is associated with many consequences. Although in-person interventions have been effective at reducing alcohol consumption, researchers were looking to create an intervention that could have wide-scale population effects through the use of technology. One unique way of delivering a computerized intervention is through the use of text messaging (short message service [SMS]), which has been an effective strategy in addressing other health issues. Texting to Reduce Alcohol Consumption (TRAC) is an SMS intervention that has been effective at reducing alcohol consumption among at-risk young adults. This study was conducted to examine response patterns to TRAC texts with a focus on weekend drinking cognitions such as drinking plans and willingness to commit to a low consumption goal. Text responses from 12 weeks of intervention were reviewed and changes over time were examined. Participants of this study were 384 individuals that had been randomized to receive the TRAC intervention in a previously conducted randomized clinical trial. Participants were 18-25 years old hazardous drinkers that were not seeking treatment for substance use. Individuals received SMS queries on Thursday and Sunday for 12 weeks. On Thursdays, participants were asked if they planned on drinking that weekend and whether they were likely to have more than 3 or 4 (women/men) drinks. They were then asked if they were willing to commit to a goal of consuming less than 4/5 drinks (women/men) per occasion that weekend. Feedback messages were sent to participants that expressed support for low consumption or encouraged reflection on not setting a consumption goal. Participants reported the number of drinks they had each Sunday at noon, and received additional feedback messages. Drinking cognitions were divided into three groups of individuals: those that planned not to drink, those that were willing to limit drinks, and those not willing to limit drinks. Not surprising, those that planned not to drink reported fewer heavy drinking episodes in the first week and had the greatest reduction in prevalence over the 12 weeks (24% reported heavy drinking during the first week, then 6% after the intervention). The group of individuals not willing to limit drinks had a high, relatively unchanged rate of heavy drinking episodes throughout the twelve weeks. The group willing to limit drinks had intermediate values ranging from 55% to 31% reporting a heavy drinking episode.
Take away: Together, the “planned not to drink” and “willing to limit drinking” groups (88% of participants) reduced their weekend drinking and increased their willingness to commit to limiting alcohol consumption, even after the intervention. Sending these text messages to individuals with no intention to drink may be reinforcement for later weeks. This intervention was most successful for individuals that planned not to drink, had a moderate effect on those willing to limit drinking, and was least effective for those not willing to limit alcohol consumption. Similar interventions should be designed with content targeting these different groups.