Text message program continued to cut binge drinking after ending
A University of Pittsburgh School of Medicine-led trial to test a text message-based program aimed at reducing binge drinking is the first to show such an intervention can successfully produce sustained reductions in alcohol consumption in young adults.
The findings revealed that the first-of-its-kind program, designed by lead author Brian Suffoletto, M.D ., assistant professor of emergency medicine at Pitt, reduced binge drinking and alcohol-related injuries when compared to a control group and a self-monitoring group. The positive effect continued six months after the program ended. The results have been published in the journal PLOS ONE and are now available online.
“Given the low cost to send text messages and the capacity to deliver them to almost every at-risk young adult, a text message-based intervention targeting binge drinking could have a public health impact on reducing both immediate and long-term health problems,” said Dr. Suffoletto.
The 12-week trial randomized into three groups 765 18- to 25-year-olds who were discharged from four urban emergency departments in western Pennsylvania. The control group received standard care and no text messages.
The self-monitoring group received text messages on Sundays asking about drinking quantity but received no feedback. The final group received the full program, which consisted of text messages on Thursdays inquiring about weekend drinking plans and promoting a goal commitment to limit drinking, followed by another text on Sunday to inquire about actual drinking and give tailored feedback aimed at reducing alcohol consumption.
If someone receiving the full intervention program reported anticipating a heavy drinking day (more than five drinks during any 24-hour period for men and more than four for women), he or she received a text message expressing concern about those levels and asking if they would be willing to set a goal to limit their drinking below binge thresholds for the weekend. Those who responded to the affirmative then received messages expressing positive reinforcement and strategies for cutting down.
Those who refused to set goals received a text message encouraging them to reflect on the decision For example, “It’s OK to have mixed feelings about reducing your alcohol use. Consider making a list of all the reasons you might want to change.”
Six months after the end of the trial, participants who were exposed to the full text-message intervention reported an average of one less binge drinking day per month. There also was a 12 percent reduced incidence of binge drinking. The control group and the self-monitoring group both had no reduction in alcohol consumption.
“Compared to in-person interventions with a clinician discussing drinking habits with a young adult in the emergency department, which requires time and resources not routinely available, suffers high variability in how it is performed, and has shown limited ability to produce lasting reductions in hazardous drinking among young adults, our text message-based intervention is scalable, provides uniform behavioral materials, and seems to produce meaningful, potentially life-saving results,” said Dr. Suffoletto.
“By interacting with these young adults in a way in which they are receptive to communicating, and reducing the stigma associated with traditional face-to-face counseling, text messages can provide the boost they need to control their drinking when they are at their most vulnerable to forget what is healthiest for them.”
Co-authors of the study are Jeffrey Kristan, B.S ., Tammy A. Chung, Ph.D ., Kwonho Jeong, B.A ., Anthony Fabio, Ph.D ., and Duncan B. Clark, M.D ., Ph.D ., all of Pitt; and Peter M. Monti, Ph.D ., of Brown University.
The study was supported by an Emergency Medicine Foundation grant.