A new study evaluated the engagement of young adults with a text message intervention, Texting to Reduce Alcohol Consumption 2 (TRAC2), which aims at reducing weekend alcohol consumption. Participants (N = 38) included young adults between the ages of 18 to 25 years who had screened positive for hazardous drinking in an emergency department. At baseline, participants were asked about their demographics, alcohol-related characteristics and substance use. As for the TRAC2, it included pre-weekend goal commitments on drinking limit via ecological momentary assessments (EMA) that were personalized based on participant past 2-week alcohol consumption. It also included within-weekend goal reminders, self-efficacy EMA with support tailored to goal confidence, and maximum weekend alcohol consumption EMA with personalized drinking limit goal feedback. In addition to the goal support features, participants were offered the choice of opting out after each 4-week intervention block. The authors used a variety of methods for data analysis including chi-square tests to examine the associations between drinking behavior and drinking goals being met. Results showed that at baseline, there was a wide range of stages of change, with 38% of participants being pre-contemplative. All participants reported at least one negative consequence related to alcohol consumption in the last 3 months. Furthermore, substance use was common and 26% of participants smoked cigarettes at least daily, 50% reported cannabis use, and 10% used some form of opioid recreationally in the past month. In week 1 of the intervention, 78% of participants reported a plan to drink over the weekend, this decreased to 46% by week 4. These participants reported being willing to commit to the proposed drinking limit goal 96% of weekends. In week 1, the percentage of participants being prompted to commit to a drinking limit goal above the binge threshold was 52%, this decreased to 0% by week 4. Moreover, participants met their goal 89% of the times a goal was committed to. There were lower rates of goal success when participants reported lower confidence in meeting the goal (76%) compared with that when participants reported high confidence in meeting the goal (98%) (p = .001). There were reductions in alcohol consumption from baseline to 3 months, but reductions were not different by length of intervention exposure. Follow-up surveys revealed that there were reductions in maximum drinks consumed over typical weekends and prevalence of binge drinking in all groups exposed to TRAC2. In addition, there were significant reductions in the number of alcohol-related consequences among TRAC2-exposed participants.
Take away: This study found that there was a high level of engagement with a text message intervention, to reduce alcohol consumption, which incorporated adaptive goal support features. In addition, lower confidence in meeting drinking limit goals was associated with a lower probability of goal success.
Suffoletto, B., Chung, T., Muench, F., Monti, P., & Clark, D. B. (2018). A Text Message Intervention with Adaptive Goal Support to Reduce Alcohol Consumption Among Non-Treatment-Seeking Young Adults: Non-Randomized Clinical Trial with Voluntary Length of Enrollment. JMIR mHealth and uHealth, 6(2), e35.