title: Development of a text message intervention aimed at reducing alcohol-related harm in patients admitted to hospital as a result of injury.
abstract: BACKGROUND
  Screening for alcohol misuse and brief interventions (BIs) for harm in trauma care settings are known to reduce alcohol intake and injury recidivism, but are rarely implemented. We created the content for a mobile phone text message BI service to reduce harmful drinking among patients admitted to hospital following an injury who screen positive for hazardous alcohol use. The aim of this study was to pre-test and refine the text message content using a robust contextualisation process ahead of its formal evaluation in a randomised controlled trial.
  
  
  METHODS
  Pre-testing was conducted in two phases. First, in-depth interviews were conducted with 14 trauma inpatients (16-60 years) at Auckland City Hospital and five key informants. Participants were interviewed face-to-face using a semi-structured interview guide. Topics explored included: opinions on text message ideas and wording, which messages did or did not work well and why, interactivity of the intervention, cultural relevance of messages, and tone of the content. In a second phase, consultation was undertaken with Māori (New Zealand's indigenous population) and Pacific groups to explore the relevance and appropriateness of the text message content for Māori and Pacific audiences.
  
  
  RESULTS
  Factors identified as important for ensuring the text message content was engaging, relevant, and useful for recipients were: reducing the complexity of message content and structure; increasing the interactive functionality of the text message programme; ensuring an empowering tone to text messages; and optimising the appropriateness and relevance of text messages for Māori and Pacific people. The final version of the intervention (named 'YourCall(™)') had three pathways for people to choose between: 1) text messages in English with Te Reo (Māori language) words of welcome and encouragement, 2) text messages in Te Reo Māori, and 3) text messages in English (with an option to receive a greeting in Samoan, Tongan, Cook Island Māori, Niuean, Tokelauan, Tuvaluan, or Fijian).
  
  
  CONCLUSIONS
  We have developed a text message intervention underpinned by established BI evidence and behaviour change theory and refined based on feedback and consultation. The next step is evaluation of the intervention in a randomised-controlled trial.
authors: Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. s.sharpe@auckland.ac.nz.
authors: Sarah
authors: S
authors: Sharpe
authors: School of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand. m.shepherd@auckland.ac.nz.
authors: Matthew
authors: M
authors: Shepherd
authors: Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. b.kool@auckland.ac.nz.
authors: Bridget
authors: B
authors: Kool
authors: National Institute for Health Innovation, University of Auckland, and Waitemata District Health Board, Auckland, New Zealand. r.whittaker@auckland.ac.nz.|The National Institute for Health Innovation, University of Auckland, Auckland, New Zealand. r.whittaker@auckland.ac.nz.|Waitemata District Health Board, Auckland, New Zealand. r.whittaker@auckland.ac.nz.
authors: Robyn
authors: R
authors: Whittaker
authors: Pacific Health Section, School of Population Health, University of Auckland, Auckland, New Zealand. v.nosa@auckland.ac.nz.
authors: Vili
authors: V
authors: Nosa
authors: National Institute for Health Innovation, University of Auckland, and Waitemata District Health Board, Auckland, New Zealand. e.dorey@auckland.ac.nz.|The National Institute for Health Innovation, University of Auckland, Auckland, New Zealand. e.dorey@auckland.ac.nz.
authors: Enid
authors: E
authors: Dorey
authors: Community Alcohol & Drug Services, Auckland, New Zealand. susanna.galea@waitematadhb.govt.nz.|Centre for Addictions Research & Honorary Senior Lecturer, University of Auckland, Auckland, New Zealand. susanna.galea@waitematadhb.govt.nz.
authors: Susanna
authors: S
authors: Galea
authors: Te Kupenga Hauora Māori, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand. p.reid@auckland.ac.nz.
authors: Papaarangi
authors: P
authors: Reid
authors: Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. s.ameratunga@auckland.ac.nz.
authors: Shanthi
authors: S
authors: Ameratunga
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D055815:Young Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control; D054521:Cultural Competency; D040261:Harm Reduction; D006760:Hospitalization; D009520:New Zealand / Q000453:epidemiology; D060145:Text Messaging; D014947:Wounds and Injuries / Q000453:epidemiology