A new study explores text messaging as a method to interact with young adults to reduce alcohol consumption and decrease binge episodes.
The novel intervention uses the mobile platform to intervene among young adults who present at a hospital Emergency Department for alcohol-related problems.
Researchers examined the use of text messaging, both to collect drinking data from young adults after Emergency Department discharge, as well as provide immediate feedback and ongoing support to them. The researchers found that text messaging is effective on both levels.
“Each day in the U.S., more than 50,000 adults 18 to 24 years of age visit hospital Emergency Departments, and more than one-third report current alcohol abuse or dependence,” said Dr. Brian Suffoletto of the department of emergency medicine at the University of Pittsburgh and corresponding author for the study. “Thus, Emergency Departments provide a unique opportunity to both identify young adults with harmful or hazardous drinking behavior and intervene to reduce future injury and illness.”
Unfortunately, emergency-care providers rarely have the time or expertise to screen for or discuss problematic alcohol use.
Further, the current health care delivery model in the U.S. does not encourage hospitals to have counselors on duty for Emergency Department intervention, nor are patients with acute drinking issues necessarily interested in having those discussions immediately.
“Given that mobile phones are essentially ubiquitous among young adults, and texting in particular is a heavily used communication tool, we sought to build and test an automated text messaging system that could conduct a health dialogue with young adults after discharge,” said Suffoletto.
“We believe that our study is the first to test a text-messaging-based behavioral intervention to reduce alcohol consumption.”
Researchers believe admittance to the Emergency Department can be used as a teachable moment or behavior-change point for those at risk for an illness — alcohol-induced injury or organ destruction.
“This is a first step. I can envision other tools – such as phone apps and social media sites – being deployed eventually,” said Dr. Donald M. Yealy, professor of emergency medicine, medicine, and clinical and translational sciences at the University of Pittsburgh School of Medicine.
Suffoletto and his colleagues identified 45 18-to-24-year olds (24 women, 21 men) from three urban hospitals as hazardous drinkers based on their Alcohol Use Disorders Identification Test-Consumption scores.
The young adults were randomly assigned for a 12-week period to either weekly text messaging feedback with goal setting (Intervention), weekly text messaging drinking assessments without feedback (Assessment), or the Control group.
“First, we were able to show that young adults will interact with an automated text messaging system to both provide weekly drinking reports and respond to goal-setting challenges,” said Suffoletto.
“Second, our preliminary findings suggest that young adults who are exposed to our intervention reduce the number of drinks they consume as well as the number of binge episodes.”
More specifically, at the end of the three-month period, participants in the text messaging group had 3.4 fewer heavy drinking days in the preceding month, and 2.1 fewer drinks per drinking day when compared to baseline.
Suffoletto suggested that the use of alternative interventions, such as text messaging, is an effective method for physicians to reach young adults after they are discharged from the Emergency Department.
“Our study findings are preliminary, yet encouraging, evidence that ecological assessments tied to real-time feedback using mobile communication technology can effect change in young adults with harmful or hazardous drinking behavior,” he said. “Future work should focus on ways to optimize patient participation in programs and the integration of mobile communication with traditional interventions.”
Both Suffoletto and Yealy see additional uses for these findings.
“Clinicians who care for young adults and adolescents in other care settings may [also] decide to use mobile technologies to support and extend already existing resources to reduce the burden of alcohol use and alcohol-related risks,” said Suffoletto.
“Researchers interested in behavior change [for other] substance-use disorders may decide to build and test similar behavioral interventions using mobile communication devices, such as apps, to effect change.”
“I could envision beginning such a program in other populations — like those with heart failure, or high blood pressure, or an infection — to aid compliance with agreed-on plans,” added Yealy.
“The average person who either is struggling with an alcohol-use disorder or knows someone who is might be encouraged to know that researchers are exploring non-traditional approaches to supporting self-change,” said Suffoletto, “and finding ways that make it easier for an individual to get help.”
Results will be published in a forthcoming issue of the journal Alcoholism: Clinical & Experimental Research .