title: An Interactive Text Message Intervention to Reduce Binge Drinking in Young Adults: A Randomized Controlled Trial with 9-Month Outcomes.
abstract: BACKGROUND
  Binge drinking is associated with numerous negative consequences. The prevalence and intensity of binge drinking is highest among young adults. This randomized trial tested the efficacy of a 12-week interactive text message intervention to reduce binge drinking up to 6 months after intervention completion among young adults.
  
  
  RESULTS
  Young adult participants (18-25 y; n = 765) drinking above the low-risk limits (AUDIT-C score >3/4 women/men), but not seeking alcohol treatment, were enrolled from 4 Emergency Departments (EDs) in Pittsburgh, PA. Participants were randomized to one of three conditions in a 2:1:1 allocation ratio: SMS Assessments + Feedback (SA+F), SMS Assessments (SA), or control. For 12 weeks, SA+F participants received texts each Thursday querying weekend drinking plans and prompting drinking limit goal commitment and each Sunday querying weekend drinking quantity. SA+F participants received tailored feedback based on their text responses. To contrast the effects of SA+F with self-monitoring, SA participants received texts on Sundays querying drinking quantity, but did not receive alcohol-specific feedback. The control arm received standard care. Follow-up outcome data collected through web-based surveys were provided by 78% of participants at 3- months, 63% at 6-months and 55% at 9-months. Multiple imputation-derived, intent-to-treat models were used for primary analysis. At 9-months, participants in the SA+F group reported greater reductions in the number of binge drinking days than participants in the control group (incident rate ratio [IRR] 0.69; 95% CI .59 to.79), lower binge drinking prevalence (odds ratio [OR] 0.52; 95% CI 0.26 to 0.98]), less drinks per drinking day (beta -.62; 95% CI -1.10 to -0.15) and lower alcohol-related injury prevalence (OR 0.42; 95% CI 0.21 to 0.88). Participants in the SA group did not reduce drinking or alcohol-related injury relative to controls. Findings were similar using complete case analyses.
  
  
  CONCLUSIONS
  An interactive text-message intervention was more effective than self-monitoring or controls in reducing alcohol consumption and alcohol-related injury prevalence up to 6 months after intervention completion. These findings, if replicated, suggest a scalable approach to help achieve sustained reductions in binge drinking and accompanying injuries among young adults.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01688245.
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Suffoletto
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kristan
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Tammy
authors.initials: T
authors.lastname: Chung
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Kwonho
authors.initials: K
authors.lastname: Jeong
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Anthony
authors.initials: A
authors.lastname: Fabio
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, United States of America.
authors.forename: Peter
authors.initials: P
authors.lastname: Monti
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Duncan B
authors.initials: DB
authors.lastname: Clark
mesh_terms: D000293:Adolescent; D000328:Adult; D063425:Binge Drinking / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004636:Emergency Service, Hospital; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis / Q000706:statistics & numerical data*; D008297:Male; D012648:Self Care; D013686:Telemetry; D060145:Text Messaging; D014947:Wounds and Injuries / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*
chemical_list: D000431:Ethanol