Effectiveness of the YourCall™ text message intervention to reduce harmful drinking in patients discharged from trauma wards: protocol for a randomised controlled trial

Effects of mobile text messaging on breast cancer and breast self-examination (BSE) knowledge, BSE self-efficacy, and BSE frequency: a randomised controlled trial

AIMS

Educating women regarding breast cancer and increasing breast self-examination uptake continues to remain a major challenge despite the intensive campaigns. An innovative, cost-effective and easily customised intervention is needed especially in under-resourced and hard to reach communities. This paper is a report examining the effects of mobile text messaging on women's knowledge of breast cancer and BSE, BSE self-efficacy and frequency of BSE.

METHODS

A randomised controlled trial design was used. The study sample consisted of 128 women of reproductive age (WRA) (64 in the experimental group and 64 in the control group) from two communities in the Philippines during the months of August to October 2018. Three to five short messages were sent to the participants in the experimental group daily for one month while the control group did not receive the messages.

RESULTS

Women who received mobile text messages had higher knowledge of breast cancer (F = 21.756, p = 0.001) and breast self-examination (F = 6.776, p = 0.010) than the control group. However, no significant improvements were seen in the BSE self-efficacy (F = 1.446, p = 0.232) and frequency of BSE (F = 3.374, p = 0.69).

CONCLUSION

Mobile text messaging significantly improved the knowledge on breast cancer and breast self-examination among women; however, it did not affect their breast self-examination self-efficacy and frequency. Mobile text messaging can be a viable tool that can be used by healthcare workers in order to educate women regarding breast cancer and breast self-examination.

Effect of a text message intervention on alcohol-related harms and behaviours: secondary outcomes of a randomised controlled trial

OBJECTIVE

Mobile Health approaches show promise as a delivery mode for alcohol screening and brief intervention. The 'YourCall' trial evaluated the effect of a low-intensity mobile phone text message brief intervention compared with usual care on hazardous drinking and alcohol-related harms among injured adults. This paper extends our previously published primary outcome analysis which revealed a significant reduction in hazardous drinking associated with the intervention at 3 months, with the effect maintained across 12 months follow-up. The objective of the current study was to evaluate the effect of the intervention on alcohol-related harms and troubles and help-seeking behaviours (secondary outcomes) at 12-months follow-up.

RESULTS

A parallel two-group, single-blind, randomised controlled trial was conducted in 598 injured inpatients aged 16-69 years identified as having medium-risk hazardous drinking. Logistic regression models applied to 12-month follow-up data showed no significant differences between intervention and control groups in self-reported alcohol-related harms and troubles and help-seeking behaviours. Although this text message intervention led to a significant reduction in hazardous alcohol consumption (previously published primary outcome), changes in self-reported alcohol-related harms and troubles and help seeking behaviours at 12-months follow up (secondary outcomes) were small and non-significant.

TRIAL REGISTRATION

ACTRN12612001220853. Retrospectively registered 19 November 2012.

Effect of a text message intervention to reduce hazardous drinking among injured patients discharged from a trauma ward: a randomized controlled trial

Screening and brief intervention for hazardous alcohol use in trauma care settings is known to reduce alcohol intake and injury recidivism, but is often not implemented due to resource constraints. Brief interventions delivered by mobile phone could overcome this challenge. This study aimed to evaluate the effect of a mobile phone text message intervention (YourCall^TM) on hazardous drinkers admitted for an injury. The parallel two-group, single-blind, randomised controlled trial enrolled 598 injured patients aged 16–69 years identified as medium-risk drinkers at recruitment. The intervention group (n = 299) received 16 text messages incorporating brief intervention principles in the 4 weeks following discharge from hospital. Controls (n = 299) received usual care and one text message acknowledging participation in the trial. The primary outcome was the difference in hazardous alcohol use (assessed using AUDIT-C) between study groups at 3 months, with the maintenance of effect examined at 6 and 12 months’ follow-up. Data were analysed using a mixed-effects model for repeated measures. Both groups had similar baseline features. Compared to controls, hazardous drinking was significantly lower in the intervention group at 3 months and maintained over the 12-month follow-up period (least squares mean difference in AUDIT-C scores: −0.322; 95% CI: −0.636, −0.008; p = 0.04). The intervention effect was similar among Māori (New Zealand’s indigenous population) and non-Māori (interaction p = 0.59), and among younger (16–29 years) and older (30–69 years) patients (p = 0.77). The effectiveness of this intervention reflects the potential of low cost, scalable mobile health technologies to overcome common barriers in implementing alcohol harm reduction strategies following injury.

Mobile phone text messages reduce dangerous patterns of alcohol consumption and could help prevent alcohol-related injuries. A trial carried out in New Zealand led by Sarah Sharpe at the University of Auckland examined the effect of sending 16 automated text messages over a four-week period to 299 adults discharged from hospital following an injury and identified as moderate risk hazardous drinkers. The messages, which encouraged patients to reduce their alcohol consumption and offered information on how to do so in an easy-to-understand and non-judgemental manner, reduced hazardous drinking throughout the 12-month follow-up period compared with a control group that received usual care. These findings suggest that text message interventions are an effective, low cost and easily scalable solution to curb harmful alcohol consumption.