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PITTSBURGH – With all of the buzz about providing interventions in the emergency department to combat excessive drinking, researchers at the University of Pittsburgh appear to have found an alternative way to do that.
Results of a trial to test a text message-based program aimed at reducing binge drinking was published online recently by PLOS ONE. It is the first to show that such an intervention can successfully produce sustained reductions in alcohol consumption in young adults.
The program was designed by lead author Brian Suffoletto, MD, an emergency physician at Pitt. A study showed that it reduced binge drinking and alcohol-related injuries when compared to a control group and a self-monitoring group, with the positive effect continuing six months after program end.
"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," Suffoletto said in a University of Pittsburgh Schools of the Health Sciences press release.
For the 12-week trial, 765 18- to 25-year-olds who were discharged from four urban emergency departments in western Pennsylvania were randomized into three groups: 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 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 participants in the full intervention program reported they were facing a heavy drinking day where they were likely to have more than five drinks during any 24-hour period for men and more than four for women, they received a text message expressing concern about those levels and asking if they would set a goal to limit their drinking below binge thresholds for the weekend.
Participants who agreed to do that received messages with positive reinforcement as well as strategies for cutting down on drinking. On the other hand, those who refused to set goals received a text message encouraging them to reflect on the decision, e.g., "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.”
Even 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 as well as a 12% reduced incidence of binge drinking. Neither the control group nor the self-monitoring group had a 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," Suffoletto said. "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."