Mobile phone text message intervention to reduce binge drinking among young adults: study protocol for a randomized controlled trial

Brian Suffoletto, Clifton W Callaway, Jeffrey Kristan, Peter Monti, Duncan B Clark, Brian Suffoletto, Clifton W Callaway, Jeffrey Kristan, Peter Monti, Duncan B Clark

Abstract

Background: Heavy episodic (binge) drinking is common among young adults and can lead to injury and illness. Young adults who seek care in the Emergency Department (ED) may be disproportionately affected with binge drinking behavior, therefore provide an opportunity to reduce future risk through screening, brief intervention and referral to treatment (SBIRT). Mobile phone text messaging (SMS) is a common form of communication among young adults and has been shown to be effective at providing behavioral support to young adult drinkers after ED discharge. Efficacy of SMS programs to reduce binge drinking remains unknown.

Methods/design: We will conduct a three parallel arm, randomized trial. A convenience sample of adults aged 18 to 25 years attending three EDs in Pittsburgh, PA and willing to participate in the study will be screened for hazardous alcohol consumption. Participants identified as hazardous drinkers will then be allocated to either 12 weeks of weekly SMS drinking assessments with feedback (SA+F), SMS drinking assessments without feedback (SA), or a control group. Randomization will be via an independent and remote computerized randomization and will be stratified by study site. The SA+F group will be asked to provide pre-weekend drinking intention as well as post-weekend consumption via SMS and will receive feedback messages focused on health consequences of alcohol consumption, personalized normative feedback, protective drinking strategies and goal setting. Follow-up data on alcohol use and injury related to alcohol will be collected through a password-protected website three, six and nine months later. The primary outcome for the study is binge drinking days (≥4 drinks for women; ≥5 drinks for men) during the previous month, and the main secondary outcome is the proportion of participants who report any injury related to alcohol in the prior three months.

Discussion: This study will test the hypothesis that a mobile phone text-messaging program will result in immediate and durable reductions in binge drinking among at-risk young adults. By testing an intervention group to an assessment-only and control group, we will be able to separate the effect of assessment reactivity. By collecting pre-weekend drinking intentions and post-weekend consumption data in the SA+F group, we will be able to better understand mechanism of change.

Trial registration: Clinicaltrials.gov NCT01688245.

Figures

Figure 1
Figure 1
Flowchart for the TRAC Trial.

References

    1. CDC. Alcohol-related disease impact (ARDI) [ ]
    1. Hingson RW, Edwards EM, Heeren T, Rosenbloom D. Age of drinking onset and injuries, motor vehicle crashes, and physical fights after drinking and when not drinking. Alcohol Clin Exp Res. 2009;33(5):783–790. doi: 10.1111/j.1530-0277.2009.00896.x.
    1. SA MHSA. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11–4658. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2011.
    1. Hingson RW, Zha W, Weitzman ER. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. J Stud Alcohol Drugs Suppl. 2009;16:12–20.
    1. Wechsler H, Kuo M, Lee H, Dowdall GW. Environmental correlates of underage alcohol use and related problems of college students. Am J Prev Med. 2000;19:24–29. doi: 10.1016/S0749-3797(00)00163-X.
    1. Edlund MJ, Booth BM, Feldman ZL. Perceived need for treatment for alcohol use disorders: results from two national surveys. Psychiatr Serv. 2009;60:1618–1628. doi: 10.1176/appi.ps.60.12.1618.
    1. Crundall IA. Perceptions of alcohol by student drinkers at university. Drug Alcohol Rev. 1995;14:363–368. doi: 10.1080/09595239500185491.
    1. Greenfield TK, Midanik LT, Rogers JD. A 10-year national trend study of alcohol consumption, 1984–1995: is the period of declining drinking over? Am J Public Health. 2000;90:47–52.
    1. National Institute on Alcohol Abuse and Alcoholism. Trends in underage drinking in the United States, 1991-2009: Surveillance Rweport #91. Rockville, MD: Department of Health and Human Services; 2011. .
    1. Schappert SM, Rechtsteiner EA. Ambulatory medical care utilization estimates for 2006. Natl Health Stat Report. 2008;8:1–29.
    1. Fortuna RJ, Robbins BW, Mani N, Halterman JS. Dependence on emergency care among young adults in the United States. J Gen Intern Med. 2010;25:663–669. doi: 10.1007/s11606-010-1313-1.
    1. Kelly TM, Donovan JE, Chung T, Bukstein OG, Cornelius JR. Brief screens for detecting alcohol use disorder among 18–20 year old young adults in emergency departments: comparing AUDIT-C, CRAFFT, RAPS4-QF, FAST, RUFT-Cut, and DSM-IV 2-Item Scale. Addict Behav. 2009;34(8):668–674. doi: 10.1016/j.addbeh.2009.03.038.
    1. Bernstein E, Bernstein JA, Stein JB, Saitz R. SBIRT in emergency care settings: are we ready to take it to scale? Acad Emerg Med. 2009;16(11):1072–1077. doi: 10.1111/j.1553-2712.2009.00549.x.
    1. Alcohol Screening in the Emergency Department. Approved April 2011. Revised and approved by the ACEP Board of Directors April 2011. [ ]. Accessed 11 January 2012.
    1. Gentilello LM. Alcohol and injury: American College of Surgeons Committee on trauma requirements for trauma center intervention. J Trauma. 2007;62:S44–S45. doi: 10.1097/TA.0b013e3180654678.
    1. Cunningham RM, Harrison SR, McKay MP, Mello MJ, Sochor M, Shandro JR, Walton MA, D’Onofrio G. National survey of emergency department alcohol screening and intervention practices. Ann Emerg Med. 2010;55:556–562. doi: 10.1016/j.annemergmed.2010.03.004.
    1. D’Onofrio G, Fiellin DA, Pantalon MV, Chawarski MC, Owens PH, Degutis LC, Busch SH, Bernstein SL, O’Connor PG. A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med. 2012;60:181–192. doi: 10.1016/j.annemergmed.2012.02.006.
    1. Monti PM, Barnett NP, Colby SM, Gwaltney CJ, Spirito A, Rohsenow DJ, Woolard R. Motivational interviewing versus feedback only in emergency care for young adult problem drinking. Addiction. 2007;102:1234–1243. doi: 10.1111/j.1360-0443.2007.01878.x.
    1. Havard A, Shakeshaft A, Sanson-Fisher R. Systematic review and meta-analyses of strategies targeting alcohol problems in emergency departments: interventions reduce alcohol-related injuries. Addiction. 2008;103:368–76. doi: 10.1111/j.1360-0443.2007.02072.x. discussion 377–8.
    1. Field CA, Baird J, Saitz R, Caetano R, Monti PM. The mixed evidence for brief intervention in emergency departments, trauma care centers, and inpatient hospital settings: what should we do? Alcohol Clin Exp Res. 2010;34:2004–2010. doi: 10.1111/j.1530-0277.2010.01297.x.
    1. McCormick R, Docherty B, Segura L, Colom J, Gual A, Cassidy P, Kaner E, Heather N. The research translation problem: alcohol screening and brief intervention in primary care: real world evidence supports theory. Drugs Educ Prev Policy. 2010;17:732–748. doi: 10.3109/09687630903286800.
    1. Lehrer JA, Pantell R, Tebb K, Shafer MA. Forgone health care among U.S. adolescents: associations between risk characteristics and confidentiality concerns. J Adolesc Health. 2007;40:218–226. doi: 10.1016/j.jadohealth.2006.09.015.
    1. Clark DB, Moss HB. Providing alcohol-related screening and brief interventions to adolescents through health care systems: obstacles and solutions. PLoS Med. 2010;7:e1000214. doi: 10.1371/journal.pmed.1000214.
    1. Millstein SG, Marcell AV. Screening and counseling for adolescent alcohol use among primary care physicians in the United States. Pediatrics. 2003;111:114–122. doi: 10.1542/peds.111.1.114.
    1. Pew Research Center. Americans and Text messaging [Pew Research web site] 2011. Available at: [ ]. Accessed 5 January 2012.
    1. Franklin VL, Waller A, Pagliari C, Greene SA. A randomized controlled trial of Sweet Talk, a text-messaging system to support young people with diabetes. Diabet Med. 2006;23:1332–1338. doi: 10.1111/j.1464-5491.2006.01989.x.
    1. Prabhakaran L, Chee WY, Chua KC, Abisheganaden J, Wong WM. The use of text messaging to improve asthma control: a pilot study using the mobile phone short messaging service (SMS) J Telemed Telecare. 2010;16:286–290. doi: 10.1258/jtt.2010.090809.
    1. Rodgers A, Corbett T, Bramley D, Riddell T, Wills M, Lin RB, Jones M. Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging. Tob Control. 2005;14:255–261. doi: 10.1136/tc.2005.011577.
    1. Lim MS, Hocking JS, Aitken CK, Fairley CK, Jordan L, Lewis JA, Hellard ME. Impact of text and email messaging on the sexual health of young people: a randomised controlled trial. J Epidemiol Community Health. 2012;66:69–74. doi: 10.1136/jech.2009.100396.
    1. Suffoletto B, Callaway CW, Kraemer K, Clark DB. Text-message-based drinking assessments and brief interventions for young adults discharged from the emergency department. Alcohol Clin Exp Res. 2012;36:552–560. doi: 10.1111/j.1530-0277.2011.01646.x.
    1. Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11:32. doi: 10.1186/1745-6215-11-32.
    1. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–1795. doi: 10.1001/archinte.158.16.1789. Sep 14.
    1. Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the health belief model. Health Educ Q. 1988;15:175–183. doi: 10.1177/109019818801500203.
    1. Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychol Bull. 1992;111:455–474.
    1. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211. doi: 10.1016/0749-5978(91)90020-T.
    1. US Department of Health and Human Services. Rethinking drinking: alcohol and your health (NIH Publication No. 10-3770) New York, NY: National Institute on Alcohol Abuse and Alcoholism; 2010.
    1. Miller WR. Motivational interviewing: research, practice, and puzzles. Addict Behav. 1996;21:835–842. doi: 10.1016/0306-4603(96)00044-5.
    1. McCambridge J, Kypri K. Can simply answering research questions change behaviour? Systematic review and meta-analyses of brief alcohol intervention trials. PLoS One. 2011;6:e23748. doi: 10.1371/journal.pone.0023748.
    1. Reinert DF, Allen JP. The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res. 2007;31:185–199. doi: 10.1111/j.1530-0277.2006.00295.x.
    1. Sobell LC, Sobell MB. In: Measuring alcohol consumption: Psychosocial and biological methods. Litten RZ, Allen J, editor. New Jersey: Humana Press; 1992. Timeline followback: a technique for assessing self-reported alcohol consumption; pp. 41–72.
    1. Longabaugh R, Woolard RE, Nirenberg TD, Minugh AP, Becker B, Clifford PR, Carty K, Licsw, Sparadeo F, Gogineni A. Evaluating the effects of a brief motivational intervention for injured drinkers in the emergency department. J Stud Alcohol. 2001;62:806–816.
    1. Humeniuk R, Ali R, Babor TF, Farrell M, Formigoni ML, Jittiwutikarn J, de Lacerda RB, Ling W, Marsden J, Monteiro M, Nhiwatiwa S, Pal H, Poznyak V, Simon S. Validation of the alcohol, smoking and substance involvement screening test (ASSIST) Addiction. 2008;103:1039–1047. doi: 10.1111/j.1360-0443.2007.02114.x.
    1. Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50:613–621.
    1. Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008;27:379–387.
    1. Cafazzo JA, Leonard K, Easty AC, Rossos PG, Chan CT. The user-centered approach in the development of a complex hospital-at-home intervention. Stud Health Technol Inform. 2009;143:328–333.

Source: PubMed

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