Pilot Study of a Text Message Platform to Reduce Risky Drinking in Young Adults
Condition: Alcohol Abuse; Alcohol Consumption; Drinking Behavior
MeSH terms: Alcoholism; Alcohol Drinking; Drinking Behavior
Study type: Interventional

Summary: 
      Young adults are in a critical period where they can be influenced to avoid a trajectory of
      high-risk drinking and harmful outcomes in the later adult years. The Emergency Department
      might offer a unique opportunity to reach young adults, if an easy to implement screening,
      brief intervention and referral to treatment was available. The investigators are
      investigating the feasibility and accuracy of ED-initiated and outpatient-continued
      assessment of drinking behavior in young adults using a computer-driven text messaging
      platform. Based on the subject's response to weekly assessments, the computer platform will
      send personalized motivational messages in real-time.
    

Detailed description: 
      Greater than 45% of young adults have heavy episodic drinking (HED; 5/4 drinks per occasion
      form men/women), resulting in significant health risks, including injury and death. Early
      identification and secondary prevention of HED using screening, brief interventions and
      referral to treatment (SBIRT) is advocated by the National Institute on Alcohol Abuse and
      Alcoholism (NIAAA) as a way to reduce injury and health consequences. Each day in the United
      States, there are over 2700 emergency department (ED) visits associated with alcohol,
      unfortunately, SBIRT is rarely performed in the ED due to time and training requirements. Our
      application seeks to solve this problem by integrating SBIRT into ED care through the use of
      ecological assessments with interventions. We will incorporate components of the NIAAA 2005
      Clinicians Guide into automated weekly assessments (EA) and branching algorithms for
      personalized interventions (EA&I) delivered in real-time through mobile phone text messaging
      to young adults with a history of at-risk drinking behavior. We will assess the feasibility
      of EA&I to study young adults with a history of at-risk drinking and assess the variability
      in outcomes in patients undergoing EA&I, EA or standard care. We expect to find that this
      ED-initiated and outpatientcontinued platform will improve collection of drinking behavior,
      delivery of real-world motivational feedback and follow-up in young adults with at-risk
      drinking histories. We anticipate that short-term HED will be reduced in those subjects
      randomized to EA&I. We will use this information to support further studies with adequate
      power to show ED-initiated EA&I reduce long-term HED and its adverse consequences in young
      adults.
    

Intervention name(s): Motivational and Normative Feedback; Self-Awareness
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Weekly feedback based on their frequency and degree of at-risk drinking behavior using normative, educational and motivational feedback; Weekly queries to raise awareness and allow self-reflection about drinking habits
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Screening
Keywords: Alcohol; Abuse; Drinking; Behavior; Text; Computer