1
|
Vadhan NP, Padovano HT, Muench FJ, Levak S, Allen N. Self-reported alcohol consumption during participation in a text messaging-based online drinking moderation platform. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39177720 DOI: 10.1111/acer.15414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/15/2024] [Accepted: 07/15/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Many individuals with excessive alcohol consumption desire moderation but do not seek formalized treatment. Commercially available, technology-assisted options are flexible and highly accessible, yet often not empirically validated. METHODS Individuals desiring alcohol moderation (age 21+) self-selected to use Sunnyside®, a web application with tailored and adaptive text messaging. The evaluable dataset included 46,411 members who completed a baseline assessment, enrolled in the program, and tracked their drinking at least once. An adaptive and customizable weekly plan was generated from typical drinking patterns, goals, and weekly reported progress. Personalized daily messages included reminders for real-time drink tracking, plans, and available interactive messaging with peer coaches. Generalized mixed-effect growth models characterized change in drinks per week and daily drinking for 12 weeks after enrollment. Models allowed for nonlinear change and individual variability across members and weeks. RESULTS A majority (64.3%) of members reported typically drinking 7 of 7 days per week at baseline. During tracking, drinks per week decreased most in the initial weeks and slowed thereafter, with an overall 33% reduction in weekly drink counts. More severe alcohol-use patterns and concern over drinking at baseline were associated with greater relative benefit. CONCLUSIONS Drinking patterns appeared amenable to change during 12 weeks of daily drink tracking with Sunnyside®, a tailored web program to reduce drinking and improve overall wellness. Overall, the findings of this naturalistic study, one of the first of its kind, supplement data from randomized clinical trials and support the use of adaptive, technology-assisted tools for alcohol moderation.
Collapse
Affiliation(s)
- Nehal P Vadhan
- Northwell, New Hyde Park, New York, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra University, Hempstead, New York, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, New York, USA
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Hayley Treloar Padovano
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA
- Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island, USA
| | - Frederick J Muench
- Northwell, New Hyde Park, New York, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra University, Hempstead, New York, USA
- Clear30 LLC, Hastings on Hudson, New York, USA
| | - Svetlana Levak
- Northwell, New Hyde Park, New York, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra University, Hempstead, New York, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | | |
Collapse
|
2
|
Suffoletto B, Lee CM, Mason M. A text message intervention aimed at nurturing peer outreach to help meet drinking limit goals: A remote pilot randomized trial in non-collegiate young adults. Addict Behav 2024; 154:108020. [PMID: 38552400 DOI: 10.1016/j.addbeh.2024.108020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Scalable interventions attempting to nurture peer outreach to help young adults meet drinking limit goals remain under-developed. To address this gap, we developed ASPIRE, a text message intervention focused on coaching individuals to engage with close peers to assist them in meeting drinking limit goals. METHOD Non-collegiate young adults who had reported one or more heavy drinking days in the preceding month and were at least contemplating change were recruited through social media. Participants were randomly assigned to one of three 6-week text message interventions: Control, Goal Support, or ASPIRE. All groups completed baseline assessments and received weekly text message assessments on Thursdays and Sundays. Control and ASPIRE groups were prompted to complete web-based outcome assessments at 6- and 12-weeks. RESULTS We enrolled 92 young adults from 31 US states (65% female; 73% White). All groups had high text response rates but intervention usability was sub-optimal. Follow-up rates were 87% at 6-weeks and 79% at 12-weeks. Compared to Control, ASPIRE participants reported significantly more peer support and less peer pressure to drink. ASPIRE exhibited higher goal confidence compared to the Goal Support group. Using multiple imputation, there were no significant differences in drinking outcomes between groups. CONCLUSIONS Preliminary findings from this pilot study suggest that a text message intervention focused on nurturing peer outreach to help meet drinking limit goals holds promise in altering peer support and pressure as well as boosting drinking limit goal confidence. Design improvements are needed to reduce alcohol consumption.
Collapse
Affiliation(s)
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | |
Collapse
|
3
|
Lowik A, Mniszak C, Pang M, Ziafat K, Karamouzian M, Knight R. A sex- and gender-based analysis of alcohol treatment intervention research involving youth: A methodological systematic review. PLoS Med 2024; 21:e1004413. [PMID: 38829916 PMCID: PMC11182506 DOI: 10.1371/journal.pmed.1004413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 06/17/2024] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND While there is widespread consensus that sex- and gender-related factors are important for how interventions are designed, implemented, and evaluated, it is not currently known how alcohol treatment research accounts for sex characteristics and/or gender identities and modalities. This methodological systematic review documents and assesses how sex characteristics, gender identities, and gender modalities are operationalized in alcohol treatment intervention research involving youth. METHODS AND FINDINGS We searched MEDLINE, Embase, Cochrane Central Registry of Controlled Trials, PsycINFO, CINAHL, LGBT Life, Google Scholar, Web of Science, and grey literature from 2008 to 2023. We included articles that reported genders and/or sexes of participants 30 years of age and under and screened participants using AUDIT, AUDIT-C, or a structured interview using DSM-IV criteria. We limited the inclusion to studies that enrolled participants in alcohol treatment interventions and used a quantitative study design. We provide a narrative overview of the findings. Of 8,019 studies screened for inclusion, 86 articles were included in the review. None of the studies defined, measured, and reported both sex and gender variables accurately. Only 2 studies reported including trans participants. Most of the studies used gender or sex measures as a covariate to control for the effects of sex or gender on the intervention but did not discuss the rationale for or implications of this procedure. CONCLUSIONS Our findings identify that the majority of alcohol treatment intervention research with youth conflate sex and gender factors, including terminologically, conceptually, and methodologically. Based on these findings, we recommend future research in this area define and account for a spectrum of gender modalities, identities, and/or sex characteristics throughout the research life cycle, including during study design, data collection, data analysis, and reporting. It is also imperative that sex and gender variables are used expansively to ensure that intersex and trans youth are meaningfully integrated. TRIAL REGISTRATION Registration: PROSPERO, registration number: CRD42019119408.
Collapse
Affiliation(s)
- A.J. Lowik
- British Columbia Centre on Substance Use, Vancouver, Canada
- Institute for Gender, Race, Sexuality and Social Justice, University of British Columbia, Vancouver, Canada
| | - Caroline Mniszak
- British Columbia Centre on Substance Use, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Michelle Pang
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Kimia Ziafat
- British Columbia Centre on Substance Use, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, Canada
- Université de Montréal, École de santé publique, Montréal, Canada
- Centre de recherche en santé publique (CReSP), Montréal, Canada
| |
Collapse
|
4
|
Ulfsdotter Gunnarsson K, Henriksson M, Bendtsen M. Digital Alcohol Interventions Could Be Part of the Societal Response to Harmful Consumption, but We Know Little About Their Long-Term Costs and Health Outcomes. J Med Internet Res 2024; 26:e44574. [PMID: 38536228 PMCID: PMC11007605 DOI: 10.2196/44574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/19/2023] [Accepted: 02/13/2024] [Indexed: 04/13/2024] Open
Abstract
Alcohol consumption causes both physical and psychological harm and is a leading risk factor for noncommunicable diseases. Digital alcohol interventions have been found to support those looking for help by giving them tools for change. However, whether digital interventions can help tackle the long-term societal consequences of harmful alcohol consumption in a cost-effective manner has not been adequately evaluated. In this Viewpoint, we propose that studies of digital alcohol interventions rarely evaluate the consequences of wider dissemination of the intervention under study, and that when they do, they do not take advantage of modeling techniques that allow for appropriately studying consequences over a longer time horizon than the study period when the intervention is tested. We argue that to help decision-makers to prioritize resources for research and dissemination, it is important to model long-term costs and health outcomes. Further, this type of modeling gives important insights into the context in which interventions are studied and highlights where more research is required and where sufficient evidence is available. The viewpoint therefore invites the researcher not only to reflect on which interventions to study but also how to evaluate their long-term consequences.
Collapse
Affiliation(s)
| | - Martin Henriksson
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
5
|
Muench F, Madden SP, Oommen S, Forthal S, Srinagesh A, Stadler G, Kuerbis A, Leeman RF, Suffoletto B, Baumel A, Haslip C, Vadhan NP, Morgenstern J. Automated, tailored adaptive mobile messaging to reduce alcohol consumption in help-seeking adults: A randomized controlled trial. Addiction 2024; 119:530-543. [PMID: 38009576 PMCID: PMC10872985 DOI: 10.1111/add.16391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 10/10/2023] [Indexed: 11/29/2023]
Abstract
AIMS To test differential outcomes between three 6-month text-messaging interventions to reduce at-risk drinking in help-seeking adults. DESIGN A three-arm single-blind randomized controlled trial with 1-, 3-, 6- and 12-month follow-ups. SETTING United States. A fully remote trial without human contact, with participants recruited primarily via social media outlets. PARTICIPANTS Seven hundred and twenty-three adults (mean = 39.9 years, standard deviation = 10.0; 62.5% female) seeking to reduce their drinking were allocated to 6 months of baseline 'tailored statically' messaging (TS; n = 240), 'tailored adaptive' messaging (TA; n = 239) or 'drink tracking' messaging (DT; n = 244). INTERVENTIONS TS consisted of daily text messages to reduce harmful drinking that were tailored to demographics and alcohol use. TA consisted of daily, tailored text messages that were also adapted based on goal achievement and proactive prompts. DT consisted of a weekly assessment for self-reported drinking over the past 7 days. MEASUREMENTS The primary outcome measure was weekly sum of standard drinks (SSD) at 6-month follow-up. Secondary outcome measures included drinks per drinking day (DDD), number of drinking days (NDD) per week and heavy drinking days (HDD) at 1-, 3-, 6- and 12-month follow-ups. FINDINGS At 6 months, compared with DT, TA resulted in significant SSD reductions of 16.2 (from 28.7 to 12.5) drinks [adjusted risk ratio (aRR) = 0.80, 95% confidence interval (CI) = 0.71, 0.91] using intent-to-treat analysis. TA also resulted in significant improvements in DDD (aRR = 0.84; 95% CI = 0.77-0.92) and drinking days per week (b = -0.39; 95% CI = -0.67, -0.10), but not HDD compared with DT at 6 months. TA was not significantly different from TS at any time-point, except DDD at 6 months. All groups made improvements in SSD at 12-month follow-up compared with baseline with an average reduction of 12.9 drinks per week across groups. CONCLUSIONS Automated tailored mobile messaging interventions are scalable solutions that can reduce weekly alcohol consumption in remote help-seeking drinkers over time.
Collapse
Affiliation(s)
| | - Sean P Madden
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | | | | | | | - Alexis Kuerbis
- Silberman School of Social Work, Hunter College at CUNY, The Graduate Center at CUNY, New York, NY, USA
| | - Robert F Leeman
- Department of Health Sciences, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | | | - Amit Baumel
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Cameron Haslip
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Nehal P Vadhan
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Jon Morgenstern
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| |
Collapse
|
6
|
Bonar EE, Tan CY, Fernandez AC, Goldstick JE, Chapman L, Florimbio AR, Walton MA. A social media intervention for high-intensity drinking among emerging adults: a pilot randomized controlled trial. Alcohol Alcohol 2024; 59:agae005. [PMID: 38364317 PMCID: PMC10872155 DOI: 10.1093/alcalc/agae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/09/2023] [Accepted: 12/26/2023] [Indexed: 02/18/2024] Open
Abstract
AIMS High-intensity drinking (HID) is a pattern of risky drinking defined as at least 8 drinks (for women) or 10 drinks (for men) in a single episode. Individuals engaged in HID may be at greater risk for consequences, necessitating tailored interventions. Herein, we report the feasibility and acceptability of a social media-delivered 8-week intervention for emerging adults with recent HID. METHODS Using social media advertising, we recruited 102 emerging adults who reported past-month HID. Average age was 20.0 year-olds (SD = 2.0); 51.0% were male. Most identified as White (64.7%; 14.7% Black/African American, 13.7% multiracial) and 26.5% identified as Hispanic/Latinx. Participants were randomized to an 8-week intervention delivered via Snapchat by health coaches (N = 50) or to a control condition (psychoeducational website referral; N = 52). Follow-ups occurred at 2 and 4 months post-baseline. RESULTS The intervention was acceptable (85.1% liked it/liked it a lot) and there were high follow-up rates. Participants rated coaches as supportive (91.5%) and respectful (93.6%). Descriptively, helpfulness ratings were higher for non-alcohol-related content (e.g. stress; 59.6% very/extremely helpful) than alcohol-related content (40.4% very/extremely helpful). Regarding engagement, 86.0% engaged approximately weekly and 59.6% indicated they saved intervention snaps. Descriptive data showed reductions over time in several measures of alcohol consumption and consequences as well as cannabis-impaired driving and mental health symptoms. CONCLUSIONS This 8-week social media intervention for HID was feasible and acceptable among emerging adults, supporting the benefit of future testing in a fully powered trial.
Collapse
Affiliation(s)
- Erin E Bonar
- Michigan Innovations in Addiction Care through Research & Education Program, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, United States
| | - Chiu Y Tan
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
| | - Anne C Fernandez
- Michigan Innovations in Addiction Care through Research & Education Program, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
| | - Jason E Goldstick
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, United States
- Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, United States
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Lyndsay Chapman
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
| | - Autumn R Florimbio
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
| | - Maureen A Walton
- Michigan Innovations in Addiction Care through Research & Education Program, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, United States
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, United States
| |
Collapse
|
7
|
Anderson JC, Nguyen MU, Huynh W, Sharif K, Moret JED. Enhancing Campus Safety: Exploring Student Perspectives on a Text Message-Delivered Intervention for Addressing Sexual Violence and Alcohol Use. JOURNAL OF FORENSIC NURSING 2024; 20:30-42. [PMID: 38019029 PMCID: PMC10922041 DOI: 10.1097/jfn.0000000000000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Alcohol-related sexual violence, including sexual coercion, nonconsensual contact, and rape, is prevalent on college campuses. AIM The purpose of the study was to investigate college students' feedback and recommendations regarding content for a text-message-delivered harm reduction intervention to jointly address alcohol use and alcohol's role in sexual violence risk. METHODS This qualitative thematic study used focus groups and individual interviews to collect feedback from 61 college students between February 2019 and July 2020. RESULTS Targeted recruitment resulted in a sample that was nearly half queer/ lesbian, gay, bisexual (46.2%) or trans* (9.8%) identified students. Participants endorsed text messaging as an effective way to reach college students but diverged in specific content they felt was relevant and appropriate for a universal education intervention. Students preferred content describing individual strategies versus those requiring collaboration from friends or potential sex partners. Students also preferred content phrased as suggestions or questions versus declarative statements. Although most participants recognized the value of content related to consent, sexual violence, sexual health, and resources, a few male-identifying participants failed to recognize that content as important to their experience. Maintaining brevity while discussing consent in the overlapping settings of drinking and interpersonal relationships was described as a particular challenge. IMPACT OF THIS WORK ON CAMPUS SEXUAL ASSAULT AND FORENSIC NURSING Students in our sample highlighted the challenges of sharing sexual violence and alcohol-related harm reduction text messaging because of the complexities of rape culture, consent, and interpersonal dynamics during college student drinking events.
Collapse
Affiliation(s)
- Jocelyn C. Anderson
- Associate Professor; College of Nursing, University of Arkansas for Medical Science; 4301 West Markhan Street, Slot 529, Little Rock, AR 72205
| | - Meghan U. Nguyen
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Wendy Huynh
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Khadeeja Sharif
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Jessica E. Draughon Moret
- Associate Professor; Betty Irene Moore School of Nursing, University of California, Davis @DrDraughon
| |
Collapse
|
8
|
Braciszewski JM, Hecht LM, Barnett NP, Moore RS, Carlin AM, Haley EN, Miller-Matero LR. Preventing alcohol use post-bariatric surgery: patient perspectives on a technology-based approach. Surg Endosc 2023; 37:8263-8268. [PMID: 37670188 PMCID: PMC11215496 DOI: 10.1007/s00464-023-10407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/14/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Nearly two-thirds of patients engage in alcohol use after bariatric surgery, while a substantial number meet criteria for alcohol use disorder after their procedure. Given that pre-surgical education may not be sufficient, alternative methods of preventing post-surgical drinking are needed. We sought feedback on a proposed technology-based intervention to reduce alcohol use for individuals who have undergone bariatric surgery. METHODS Twenty patients who consumed alcohol post-surgery completed qualitative interviews where they provided opinions on sample intervention content, delivery method, timing, and other aspects of a two-session web-based intervention followed by tailored text messaging for 6 months. Interviews were recorded, transcribed, and coded using thematic analysis principles. RESULTS Participants strongly endorsed using technology to deliver an alcohol intervention, citing the interactivity and personal tailoring available in the proposed software. Education about the effects of post-surgical drinking and learning new coping strategies for social situations were the two most salient themes to emerge from questions about intervention content. Throughout the interviews, participants strongly highlighted the importance of measuring patient readiness to change alcohol use and matching intervention content to such motivation levels. Respondents felt that text messages could extend what they had learned, but also requested additional non-alcohol content (e.g., recipes, exercise tips). Most participants agreed that an online forum consisting of peers and professionals with whom they could ask questions and interact would be useful. CONCLUSION Web- and text message-based interventions may be an acceptable approach to prevent alcohol use post-bariatric surgery.
Collapse
Affiliation(s)
- Jordan M Braciszewski
- Center for Health Policy and Health Services Research, Henry Ford Health, One Ford Place, Suite 5E, Detroit, MI, 48202, USA.
| | - Leah M Hecht
- Center for Health Policy and Health Services Research, Henry Ford Health, One Ford Place, Suite 5E, Detroit, MI, 48202, USA
| | - Nancy P Barnett
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, Providence, USA
| | - Roland S Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, USA
| | | | - Erin N Haley
- Center for Health Policy and Health Services Research, Henry Ford Health, One Ford Place, Suite 5E, Detroit, MI, 48202, USA
- Behavioral Health, Henry Ford Health, Detroit, USA
| | - Lisa R Miller-Matero
- Center for Health Policy and Health Services Research, Henry Ford Health, One Ford Place, Suite 5E, Detroit, MI, 48202, USA
- Behavioral Health, Henry Ford Health, Detroit, USA
| |
Collapse
|
9
|
O'Logbon J, Wickersham A, Williamson C, Leightley D. The effectiveness of digital health technologies for reducing substance use among young people: a systematic review & meta-analysis. J Ment Health 2023:1-29. [PMID: 37664884 DOI: 10.1080/09638237.2023.2245902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/22/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Substance use amongst young people poses developmental and clinical challenges, necessitating early detection and treatment. Considering the widespread use of technology in young people, delivering interventions digitally may help to reduce and monitor their substance use. AIMS We conducted a systematic review and two meta-analyses to assess the effectiveness of digital interventions for reducing substance use (alcohol, smoking, and other substances) among young people aged 10 to 24 years old. METHOD Embase, Global Health, Medline, PsychINFO, Web of Science and reference lists of relevant papers were searched in November 2020. Studies were included if they quantitatively evaluated the effectiveness of digital health technologies for treating substance use. A narrative synthesis and meta-analysis were conducted. RESULTS Forty-two studies were included in the systematic review and 18 in the meta-analyses. Digital interventions showed small, but statistically significant reductions in weekly alcohol consumption compared to controls (SMD= -0.12, 95% CI= -0.17 to -0.06, I2=0%), but no overall effect was seen on 30-day smoking abstinence (OR = 1.12, 95% CI = 0.70 to 1.80, I2=81%). The effectiveness of digital interventions for reducing substance use is generally weak, however, promising results such as reducing alcohol use were seen. Large-scale studies should investigate the viability of digital interventions, collect user feedback, and determine cost-effectiveness. PRISMA/PROSPERO This systematic review was conducted following Cochrane methodology PRISMA guidelines. The review was registered with PROSPERO in November 2020 (CRD42020218442).
Collapse
Affiliation(s)
| | - Alice Wickersham
- Department of Psychological Medicine, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - Charlotte Williamson
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| | - Daniel Leightley
- Department of Psychological Medicine, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| |
Collapse
|
10
|
Walton MA, Carter PM, Seewald L, Ngo Q, Battisti KA, Pearson C, Blow FC, Cunningham RM, Bourque C, Kidwell KM. Adaptive interventions for alcohol misuse and violent behaviors among adolescents and emerging adults in the emergency department: A sequential multiple assignment randomized controlled trial protocol. Contemp Clin Trials 2023; 130:107218. [PMID: 37148999 PMCID: PMC10947472 DOI: 10.1016/j.cct.2023.107218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023]
Abstract
Alcohol use and violent behaviors among youth are associated with morbidity and mortality. An emergency department (ED) visit provides an opportunity to initiate prevention efforts. Despite promising findings from our single session SafERteens brief intervention (BI), impact is limited by modest effect sizes, with data lacking on optimal boosters to enhance effects. This paper describes the protocol for a sequential, multiple assignment, randomized trial (SMART). Adolescents and emerging adults (ages 14-20) in the ED screening positive for alcohol use and violent behaviors (physical aggression) were randomly assigned to: 1) SafERteens BI + Text Messaging (TM), or 2) SafERteens BI + remote Health Coach (HC). Participants completed weekly surveys over 8 weeks after the ED visit to tailor intervention content and measure mechanisms of change. At one-month, intervention response/non-response is determined (e.g., binge drinking or violent behaviors). Responders are re-randomized to continued intervention condition (e.g., maintenance) or minimized condition (e.g., stepped down). Non-responders are re-randomized to continued condition (e.g., maintenance), or intensified condition (e.g., stepped up). Outcomes were measured at 4 and 8 months, including primary outcomes of alcohol consumption and violence, with secondary outcomes of alcohol consequences and violence consequences. Although the original goal was to enroll 700 participants, COVID-19 impacts on research diminished recruitment in this trial (enrolled n = 400). Nonetheless, the proposed SMART is highly innovative by blending real-time assessment methodologies with adaptive intervention delivery among teens with comorbid alcohol misuse and violent behaviors. Findings will inform the content and timing booster interventions to alter risk behavior trajectories. Trial Registration:ClinicalTrials.govNCT03344666. University of Michigan # HUM00109156.
Collapse
Affiliation(s)
- Maureen A Walton
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA.
| | - Patrick M Carter
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd Bldg 10-G080, Ann Arbor, MI 48109-2800, USA
| | - Laura Seewald
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd Bldg 10-G080, Ann Arbor, MI 48109-2800, USA
| | - Quyen Ngo
- Hazelden Betty Ford Foundation, 15251 Pleasant Valley Road, Center City, MN 55012, USA
| | - Katherine A Battisti
- Department of Pediatrics, Central Michigan University and Covenant Hospital, Saginaw, MI 48602, USA
| | - Claire Pearson
- Wayne State University, Department of Emergency Medicine, and St. John Hospital, Detroit, MI 48109, USA
| | - Frederic C Blow
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Rebecca M Cunningham
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd Bldg 10-G080, Ann Arbor, MI 48109-2800, USA
| | - Carrie Bourque
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Kelley M Kidwell
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, USA
| |
Collapse
|
11
|
Gex KS, Mun EY, Barnett NP, McDevitt-Murphy ME, Ruggiero KJ, Thurston IB, Olin CC, Voss AT, Withers AJ, Murphy JG. A randomized pilot trial of a mobile delivered brief motivational interviewing and behavioral economic alcohol intervention for emerging adults. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:462-474. [PMID: 35482647 PMCID: PMC9614412 DOI: 10.1037/adb0000838] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Mobile health (mHealth) interventions show potential to broaden the reach of efficacious alcohol brief motivational interventions (BMIs). However, efficacy is mixed and may be limited by low participant attention and engagement. The present study examined the feasibility, acceptability, and preliminary efficacy of a live text-message delivered BMI in a pilot randomized clinical trial. METHOD Participants were 66 college students (63.6% women; 61.9% White; Mage = 19.95, SD = 1.66) reporting an average of 11.88 (SD = 8.74) drinks per week, 4.42 (SD = 3.59) heavy drinking episodes (HDEs), and 8.44 (SD = 5.62) alcohol-related problems in the past month. Participants were randomized to receive either (a) education or (b) an alcohol BMI plus behavioral economic substance-free activity session (SFAS), each followed by 4 weeks of mini sessions. All sessions were administered via live text-message. Participants completed assessments postintervention (after the 4th mini session) and at 3-month follow-up. RESULTS 90.9% completed both initial full-length sessions and at least two of the four mini sessions with 87.9% retention at 3-month follow-up. Participants found the interventions useful, interesting, relevant, and effective, with no between-group differences. There were no statistically significant group differences in drinks per week or alcohol-related problems at follow-up, but BMI + SFAS participants reported fewer past-month HDEs than those who received education. CONCLUSIONS Live text-messaging to deliver the BMI + SFAS is feasible and well-received. The preliminary efficacy results should be interpreted cautiously due to the small sample size but support further investigation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Kathryn S. Gex
- Department of Psychiatry and Behavioral Sciences, Medical
University of South Carolina, Charleston, SC 29425
| | - Eun-Young Mun
- Department of Health Behavior and Health Systems,
University of North Texas Health Science Center, Fort Worth, TX 76107
| | - Nancy P. Barnett
- Department of Behavioral and Social Sciences and Center for
Alcohol and Addiction Studies, Brown University, Providence, RI 02912
| | | | - Kenneth J. Ruggiero
- Department of Psychiatry and Behavioral Sciences, Medical
University of South Carolina, Charleston, SC 29425
- Department of Nursing, Medical University of South
Carolina, Charleston, SC 29425
| | - Idia B. Thurston
- Department of Psychological & Brain Sciences, Texas A
& M University, College Station, TX 77843
- Department of Health Promotion & Community Health
Sciences, Texas A&M Health, College Station, TX 77843
| | - Cecilia C. Olin
- Department of Psychology, University of Memphis, 400
Innovation Drive, Memphis, TN 38152
| | - Andrew T. Voss
- Department of Psychology, University of Memphis, 400
Innovation Drive, Memphis, TN 38152
| | - Alton J. Withers
- Department of Psychology, University of Memphis, 400
Innovation Drive, Memphis, TN 38152
| | - James G. Murphy
- Department of Psychology, University of Memphis, 400
Innovation Drive, Memphis, TN 38152
| |
Collapse
|
12
|
Suffoletto B, Chung T. Desire to get drunk partially mediates effects of a combined text message-based alcohol intervention for young adults. Drug Alcohol Depend 2023; 246:109848. [PMID: 36989707 DOI: 10.1016/j.drugalcdep.2023.109848] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND This study aimed to test the causal effect of different text message interventions on reducing alcohol consumption indirectly by altering desire to get drunk. METHODS Participants were young adults randomized to interventions with different behavior change techniques: self-monitoring alone (TRACK); pre-drinking plan feedback (PLAN); post-drinking alcohol consumption feedback (USE); pre- and post-drinking goal feedback (GOAL); and a combination of techniques (COMBO) who completed at least 2 days of both pre- and post-drinking assessments over 12 weeks of intervention exposure. On the two days per week they planned to drank alcohol, participants were asked to report desire to get drunk (0 "none" to 8 "completely"). The next day, participants reported drinking quantity. Outcomes included binge drinking (defined as 4+ drinks for a woman and 5+ drinks for a man) and drinks per drinking day. Mediation was tested using path models of simultaneous between-person and within-person effects using maximum likelihood estimation. RESULTS At the between-person level, controlling for race and baseline AUDIT-C and within-person associations, 35.9 % of the effects of USE and 34.4 % of the effects of COMBO on reducing binge drinking were mediated through desire to get drunk. 60.8 % of the effects of COMBO on reducing drinks per drinking day were mediated through desire to get drunk. We did not find significant indirect effects for any other text-message intervention. DISCUSSION Findings support the hypothesized mediation model where desire to get drunk partially mediates the effects of a text message intervention using a combination of behavior change techniques on reducing alcohol consumption.
Collapse
Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, United States.
| | - Tammy Chung
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, United States
| |
Collapse
|
13
|
Bendtsen M, Garnett C, Toner P, Shorter GW. The effect of question order on outcomes in the orbital core outcome set for alcohol brief interventions among online help-seekers (QOBCOS): Findings from a randomised factorial trial. Digit Health 2023; 9:20552076231155684. [PMID: 36798888 PMCID: PMC9926362 DOI: 10.1177/20552076231155684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Objective A core outcome set (COS) has been developed in alcohol brief intervention (ABI) research through international consensus. This study aimed to estimate order effects among questions in the COS. Methods Individuals aged 18 or older who searched online for alcohol-related help were invited to complete the COS. The order of questions was randomised following a factorial design. Primary outcomes were order effects among the COS items and patterns of attrition. Results Between 21/10/2020 and 26/11/2020, we randomised 7334 participants, of which 5256 responded to at least one question and were available for analyses. Current non-drinkers were excluded. We found evidence of higher self-reported average consumption and odds of harmful and hazardous drinking was found among those who first answered questions on recent consumption and impact of alcohol use. Lower self-reported recent consumption was found among those first asked about average consumption. Quality of life (QoL) was reported lower among those who first responded to when questions on impact of alcohol use were asked first, which in turn was lower among those who first answered question on when average consumption and QoL were asked first. Attrition was lowest when average consumption was asked first, and highest when QoL or impact of alcohol use was asked first. Median completion time for the COS was 4.3 min. Conclusions Question order affects outcomes and attrition. If the aim is to minimize attrition, consumption measures should be asked before QoL and impact of alcohol use; however, this order impacts self-reported alcohol consumption and so researchers should be guided by study priorities. At a minimum, all participants should be asked the same questions in the same order. Trial registration The trial was prospectively registered (ISRCTN17954645).
Collapse
Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Marcus Bendtsen, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, London, UK
| | - Paul Toner
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Gillian W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK,Drug and Alcohol Research Network, Queen's University Belfast, Belfast, UK
| |
Collapse
|
14
|
Suffoletto B, Pacella M, Huber J, Chung T. Effectiveness of text message interventions with different behavior change techniques on alcohol consumption among young adults: a five-arm randomized controlled trial. Addiction 2023; 118:265-275. [PMID: 36305694 DOI: 10.1111/add.16074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 10/05/2022] [Indexed: 01/05/2023]
Abstract
AIMS This studys aim is to test the effectiveness of five interventions each utilizing a unique set of behavior change techniques on reducing alcohol consumption at 3 and 6 months among young adults with hazardous drinking. DESIGN, SETTING AND PARTICIPANTS This study used a five-arm parallel randomized controlled trial with 3- and 6-month follow-ups. Recruitment occurred at four emergency departments in Pittsburgh, PA, USA. Participants were non-treatment-seeking young adults (mean age = 22.1 years; 68.5% female; 37.1% black) who reported hazardous drinking. INTERVENTIONS Participants were randomized to one of five automated text message interventions for 12 weeks that interacted with participants on the 2 days per week that they typically drank: assisted self-monitoring (TRACK: control condition; n = 245), pre-drinking cognition feedback (PLAN; n = 226), alcohol consumption feedback (USE; n = 235), adaptive goal support (GOAL; n = 214) and a combination of interventions (COMBO; n = 221). MEASUREMENTS Primary outcome was number of past month binge drinking days at 3-month post-randomization calculated from a 30-day time-line follow-back. Primary intention-to-treat analysis compared PLAN, USE, GOAL and COMBO against TRACK (control condition). The four active conditions were not compared against each other. A secondary outcome, durability of effects, was measured at 6 months. FINDINGS From baseline to 3-month follow-up (retention = 81.1%), compared with TRACK, in which past-month mean binge drinking days increased from 2.7 to 3.4, mean binge drinking days decreased in COMBO from 3.0 to 2.3 [adjusted β = -0.52; 95% confidence interval (CI) = -0.77, -0.26], GOAL from 3.0 to 2.6 (adjusted β = -0.34; 95% CI = -0.59, -0.10) and USE from 3.3 to 2.9 (adjusted β = -0.38; 95% CI = -0.62, -0.14). At 6 months (retention = 73.8%), COMBO, GOAL, USE and PLAN had significantly lower mean binge drinking days compared with TRACK. CONCLUSION Text message interventions incorporating feedback on either drinking plans and/or alcohol consumption and/or drinking limit goal support produced small yet durable reductions in binge drinking days in non-treatment-seeking young adults with hazardous drinking.
Collapse
Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Stanford, CA, USA.,Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Pacella
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - James Huber
- University of West Virginia School of Medicine, Morgantown, WV, USA
| | - Tammy Chung
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| |
Collapse
|
15
|
Staton CA, Minnig MC, Phillips AJ, Kozhumam AS, Pesambili M, Suffoletto B, Mmbaga BT, Ngowi K, Vissoci JRN. Feasibility of SMS booster for alcohol reduction in injury patients in Tanzania. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000410. [PMID: 36962731 PMCID: PMC10022354 DOI: 10.1371/journal.pgph.0000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 10/29/2022] [Indexed: 12/02/2022]
Abstract
Alcohol use is associated with 3 million annual deaths globally. Harmful alcohol use, which is associated with a high burden of disease in low- and middle-income countries (LMICs), often increases the probability of traumatic injury. Treatments for harmful alcohol use in LMICs, such as Tanzania, lack trained personnel and adequate infrastructure. The aim of this study was to assess the feasibility of using SMS boosters to augment a hospital based brief negotiational intervention (BNI) in this low resourced setting. We conducted a three stage, four arm feasibility trial of a culturally adapted BNI for injury patients with harmful and hazardous drinking admitted to Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. Post hospital discharge, two of the four arms included patients receiving either a standard or personalized short message service (SMS) booster to enhance and or perpetuate the effect of the in-hospital BNI. Text messages were sent weekly throughout a 3-month follow-up period. SMS feasibility was assessed according to the TIDier checklist evaluating what, when, how much, tailoring processes, modifications and how well (intervention fidelity). Data was collected with SMS logs and short answer surveys to participants. A total of 41 study participants were assigned to each receive 12 SMS over a three-month period; 38 received messages correctly, 3 did not receive intended messages, and 1 received a message who was not intended to. Of the 258 attempted texts, 73% were successfully sent through the messaging system. Of the messages that failed delivery, the majority were not able to be sent due to participants traveling out of cellular service range or turning off their phones. Participants interviewed in both booster arms reported that messages were appropriate, and that they would appreciate the continuation of such reminders. At 6-month follow-up, 100% (n = 11) of participants interviewed believed that the boosters had a positive impact on their behavior, with 90% reporting a large impact. This study demonstrated feasibility and acceptability of the integration of SMS mobile health technology to supplement this type of nurse-led BNI. SMS booster is a practical tool that can potentially prolong the impact of a brief hospital based intervention to enact behavioral change in injury patients with AUD.
Collapse
Affiliation(s)
- Catherine A. Staton
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Mary Catherine Minnig
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Ashley J. Phillips
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Arthi S. Kozhumam
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | | | - Brian Suffoletto
- Department of Emergency Medicine, Stanford University, California, United States of America
| | - Blandina T. Mmbaga
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Kennedy Ngowi
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Joao Ricardo Nickenig Vissoci
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| |
Collapse
|
16
|
Suffoletto B, Pacella-LaBarbara ML, Huber J, Delgado MK, McDonald C. Effectiveness of a Text Message Intervention to Reduce Texting While Driving Among Targeted Young Adults: A Randomized Controlled Trial. J Adolesc Health 2022; 71:423-431. [PMID: 35725538 DOI: 10.1016/j.jadohealth.2022.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This randomized clinical trial tested the efficacy of a 6-week text message program to reduce texting while driving (TWD) for young adults. METHODS Eligible individuals recruited from four emergency departments from December 2019 to June 2021 were aged 18-25 years who reported TWD in the past 2 weeks. Participants were randomly assigned 1:1 to intervention:assessment control. The intervention arm (n = 57) received an automated interactive text message program, including weekly queries about TWD for 6 weeks with feedback and goal support to promote cessation of TWD. The assessment control arm (n = 55) received identical weekly TWD queries but no additional feedback. Outcomes were collected via web-based self-assessments at 6- and 12 weeks and analyzed under intent-to-treat models, presented as adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS The mean (SD) age was 21.7 (2.1) years, 73 (65%) were female, and 40 (36%) were White. The 6-week follow-up rate was 77.7% (n = 87) and 12-week follow-up rate was 64.3% (n = 72). At 6 weeks, 52.6% (95% CI, 39.0%-66.0%) of intervention participants reported TWD versus 63.6% (95% CI, 49.6%-76.2%) of control participants (adjusted OR, 0.71; 95% CI, 0.32-1.59). At 12 weeks, 38.2% (95% CI, 22.8%-53.5%) of intervention participants reported TWD versus 69.3% (95% CI, 53.8%-84.7%) of control participants (adjusted OR, 0.29; 95% CI, 0.11-0.80). DISCUSSION An interactive text message intervention was more effective at reducing self-reported TWD among young adults than assessment control at 12 weeks.
Collapse
Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, California; Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | | | - James Huber
- University of West Virginia School of Medicine, Morgantown, West Virginia
| | - M Kit Delgado
- Department of Emergency Medicine and Department of Biostastistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania; PENN Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Catherine McDonald
- Department of Family & Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania; PENN Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
17
|
Suffoletto B, Pacella-LaBarbara ML, Huber J, Delgado MK, McDonald C. Effectiveness of a Text Message Intervention Promoting Seat Belt Use Among Young Adults: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2231616. [PMID: 36129713 PMCID: PMC9494210 DOI: 10.1001/jamanetworkopen.2022.31616] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE Approximately 1 in 10 adults do not always wear a seat belt, with the lowest use rates reported among young adults. OBJECTIVE To determine the efficacy of a 6-week automated behavioral text message program promoting seat belt use compared with an attention control. DESIGN, SETTING, AND PARTICIPANTS This parallel, 2-group, single-blind, individually randomized clinical trial included a convenience sample of patients recruited from 4 emergency departments in 2 cities in Pennsylvania from December 2019 to September 2021, with follow-ups at 6 and 12 weeks after randomization. Patients in stable condition aged 18 to 25 years who, in standardized screening, reported driving or being a passenger in a car without always using a seat belt in the past 2 weeks were eligible for recruitment. Participants who completed a 2-week trial run-in phase were randomly assigned 1:1 to the intervention or the assessment control. Data were analyzed from October 2019 to January 2020. INTERVENTIONS The intervention group received Safe Vehicle Engagement (SAVE), a 6-week automated interactive text message program, including weekly seat belt use queries with feedback and goal support to promote consistent use of a seat belt. The control group received identical weekly seat belt use queries but no additional feedback. MAIN OUTCOMES AND MEASURES The primary outcome was the proportion of young adults reporting always wearing a seat belt over the past 2 weeks, collected at 6 weeks (after a 2-week run-in) via web-based self-assessments and analyzed under intent-to-treat models using multiple imputation procedures. Sensitivity analyses included complete-case analyses of ordered categorical outcomes by vehicle seat position. Secondary outcomes included seatbelt use at 12 weeks and select cognitive constructs related to seat belt use. RESULTS A total of 218 participants (mean [SD] age, 21.5 [2.1] years; 139 [63.8%] women) were randomized, with 110 randomized to SAVE and 108 randomized to the control group. A total of 158 individuals (72.4%) were included in the 6-week follow-up. The rate of always using a seat belt over the past 2 weeks at the 6-week follow-up was 41.3% (95% CI, 30.6%-52.0%) among SAVE participants and 20.0% (95% CI, 10.6%-29.3%) among control participants (odds ratio [OR], 2.8; 95% CI, 1.4-5.8; P = .005). A total of 140 individuals (64.2%) participated in the 12-week follow-up. At 12 weeks, the rate of always using a seat belt over the past 2-weeks was 42.8% (95% CI, 31.2%-54.2%) among SAVE participants and 30.7% (95% CI, 19.6%-41.6%) among control participants (OR, 1.7; 95% CI, 0.9-3.4; P = .13). When examining ordered categories of seat belt use by seat position, there were significantly greater odds of wearing a seat belt at 6 and 12 weeks among SAVE participants vs control participants (eg, 6 weeks for driver: OR, 5.2; 95% CI, 2.6-10.5; 6 weeks for front passenger: OR, 4.3; 95% CI, 2.2-8.2; 6 weeks for back passenger: OR, 4.3; 95% CI, 2.2-8.2). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, an interactive text message intervention was more effective at promoting seat belt use among targeted young adults than an attention control at 6 weeks. There was no significant difference between groups in always wearing a seat belt at 12 weeks. These findings, if replicated in a larger sample, suggest a scalable approach to improve seat belt use. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03833713.
Collapse
Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, California
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - James Huber
- University of West Virginia School of Medicine, Morgantown
| | - M. Kit Delgado
- Department of Family & Community Health, University of Pennsylvania School of Nursing, Philadelphia
| | | |
Collapse
|
18
|
Patrick ME, Terry-McElrath YM, Bonar EE. Patterns and predictors of high-intensity drinking and implications for intervention. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:581-594. [PMID: 36066869 PMCID: PMC9449141 DOI: 10.1037/adb0000758] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Efforts to intervene with subgroups at particularly high risk for alcohol use require information on factors that differentiate drinking intensity levels. This article summarizes existing research and provides new findings on sociodemographics and risk factors that differentiate high-intensity drinking (HID) to provide context for developing and delivering interventions for the highest-risk drinkers. Cross-sectional data were obtained in 2019 from participants who reported past 30-day alcohol use in 2018 as part of the nationally representative 12th grade Monitoring the Future study. Among past 2-week drinkers in 2019 (N = 601; modal age 19; 57.0% male; 67.4% non-Hispanic White), bivariate associations between drinking intensity (moderate drinking [1-4 drinks for women/1-5 drinks for men], binge-only drinking [4-7/5-9 drinks], and HID [8+/10+ drinks]) and a range of sociodemographic characteristics, risk factors, and alcohol-related consequences were examined. Results showed binge-drinking norms, social and enhancement drinking motives, nicotine vaping, and use of limiting/stopping drinking and manner of drinking protective behavioral strategies differentiated all drinking intensity levels, lending support to HID and binge-only drinking having an overlapping risk profile. However, there were also risk factors uniquely associated with HID, including sex, college attendance, employment, HID norms, use of serious harm reduction protective behavioral strategies, family history of drinking problems, any cigarette or drug use other than marijuana, and depression symptoms. Therefore, risk factors differentiate young adult drinking intensity. These results can inform efforts to adapt interventions for young adults who report HID. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
- Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor
| | | | - Erin E. Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor
- Injury Prevention Center, University of Michigan, Ann Arbor
| |
Collapse
|
19
|
Conley CS, Raposa EB, Bartolotta K, Broner SE, Hareli M, Forbes N, Christensen KM, Assink M. The Impact of Mobile Technology-Delivered Interventions on Youth Well-being: Systematic Review and 3-Level Meta-analysis. JMIR Ment Health 2022; 9:e34254. [PMID: 35904845 PMCID: PMC9377434 DOI: 10.2196/34254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Rates of mental health problems among youth are high and rising, whereas treatment seeking in this population remains low. Technology-delivered interventions (TDIs) appear to be promising avenues for broadening the reach of evidence-based interventions for youth well-being. However, to date, meta-analytic reviews on youth samples have primarily been limited to computer and internet interventions, whereas meta-analytic evidence on mobile TDIs (mTDIs), largely comprising mobile apps for smartphones and tablets, have primarily focused on adult samples. OBJECTIVE This study aimed to evaluate the effectiveness of mTDIs for a broad range of well-being outcomes in unselected, at-risk, and clinical samples of youth. METHODS The systematic review used 5 major search strategies to identify 80 studies evaluating 83 wellness- and mental health-focused mTDIs for 19,748 youth (mean age 2.93-26.25 years). We conducted a 3-level meta-analysis on the full sample and a subsample of the 38 highest-quality studies. RESULTS Analyses demonstrated significant benefits of mTDIs for youth both at posttest (g=0.27) and follow-up (range 1.21-43.14 weeks; g=0.26) for a variety of psychosocial outcomes, including general well-being and distress, symptoms of diverse psychological disorders, psychosocial strategies and skills, and health-related symptoms and behaviors. Effects were significantly moderated by the type of comparison group (strongest for no intervention, followed by inert placebo or information-only, and only marginal for clinical comparison) but only among the higher-quality studies. With respect to youth characteristics, neither gender nor pre-existing mental health risk level (not selected for risk, at-risk, or clinical) moderated effect sizes; however, effects increased with the age of youth in the higher-quality studies. In terms of intervention features, mTDIs in these research studies were effective regardless of whether they included various technological features (eg, tailoring, social elements, or gamification) or support features (eg, orientation, reminders, or coaching), although the use of mTDIs in a research context likely differs in important ways from their use when taken up through self-motivation, parent direction, peer suggestion, or clinician referral. Only mTDIs with a clear prescription for frequent use (ie, at least once per week) showed significant effects, although this effect was evident only in the higher-quality subsample. Moderation analyses did not detect statistically significant differences in effect sizes based on the prescribed duration of mTDI use (weeks or sessions), and reporting issues in primary studies limited the analysis of completed duration, thereby calling for improved methodology, assessment, and reporting to clarify true effects. CONCLUSIONS Overall, this study's findings demonstrate that youth can experience broad and durable benefits of mTDIs, delivered in a variety of ways, and suggest directions for future research and development of mTDIs for youth, particularly in more naturalistic and ecologically valid settings.
Collapse
Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | | | - Kate Bartolotta
- Department of Psychology, Fordham University, Bronx, NY, United States
| | - Sarah E Broner
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Maya Hareli
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Nicola Forbes
- Department of Psychology, Fordham University, Bronx, NY, United States
| | - Kirsten M Christensen
- Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Mark Assink
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
20
|
Kuerbis A, Behrendt S, Arora V, Muench FJ. Acceptability and preliminary effectiveness of a text messaging intervention to reduce high-risk alcohol use among adults 50 and older: an exploratory study. ADVANCES IN DUAL DIAGNOSIS 2022. [DOI: 10.1108/add-11-2021-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Prevalence rates of older adults (OA, 50+) with high-risk alcohol use are rapidly growing. Barriers to intervention persist for OA. Mobile interventions, specifically short message service (SMS, also known as text messaging), provide an opportunity to overcome such barriers. The purpose of this paper is to explore the acceptability and preliminary effectiveness of four SMS intervention conditions compared to mobile assessment only among OA (50–65 years old, n = 49) who drink at high-risk levels compared to younger adults (YA, 21–49 years old, n = 102).
Design/methodology/approach
Within and between age group differences at baseline and end-of-treatment (12 weeks) were explored. Generalized linear modeling was used to test age by receipt of any SMS intervention (compared to assessment only) effects across health outcomes. Effect sizes and visual analyses were generated to assess for age by type of SMS interactions.
Findings
Both age groups reported intervention satisfaction. Two-thirds elected to continue receiving SMSs after treatment concluded. Descriptively, SMS groups demonstrated reduced drinking across age groups at end-of-treatment compared to mobile assessment only, though slightly larger effects were found for YA than for OA. Age significantly moderated the receipt of any SMS intervention only for depression (i.e., older age weakened the therapeutic effect). Of all the SMS types, tailored messages outperformed the other conditions on drinking outcomes for both age groups. Depression, craving and alcohol problems responded to gain-framed messages among OA and loss-framed messages among YA.
Research limitations/implications
The findings of this paper suggest that SMS is acceptable and potentially effective across age groups. Further adaptation of SMS across age groups could enhance its effectiveness.
Originality/value
This is the first paper to explore the impact of older age on the efficacy of text messaging as an intervention for hazardous alcohol use.
Collapse
|
21
|
Middleton T, Constantino M, McGill M, D'Souza M, Twigg SM, Wu T, Thiagalingam A, Chow C, Wong J. An Enhanced SMS Text Message-Based Support and Reminder Program for Young Adults With Type 2 Diabetes (TEXT2U): Randomized Controlled Trial. J Med Internet Res 2021; 23:e27263. [PMID: 34524102 PMCID: PMC8569538 DOI: 10.2196/27263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/24/2021] [Accepted: 07/21/2021] [Indexed: 01/15/2023] Open
Abstract
Background Clinic attendance, metabolic control, engagement in self-management, and psychological health are suboptimal in young-onset (age of onset <40 years) type 2 diabetes. Objective We examined the effectiveness of an enhanced SMS text message–based support and reminder program in improving clinic attendance, metabolic control, engagement in self-management, and psychological health in young-onset type 2 diabetes. Methods A 12-month, parallel-arm, randomized controlled trial comparing an enhanced, semipersonalized SMS text message–based intervention (incorporating 1-8 supportive and/or informative text messages per month) against standard care was conducted in a specialized clinic for young adult type 2 diabetes. The primary outcome was maintenance of 100% attendance at scheduled quarterly clinical appointments. Secondary outcomes included (1) metabolic indices, (2) pathology and self-monitored blood glucose (SMBG) data availability, and (3) psychosocial well-being. Results A total of 40 participants were randomized, and 32 completed their 12-month study visit. The average participant age was 32.7 (SD 5.1) years, 50% (20/40) were male, and baseline glycated hemoglobin A1c (HbA1c) was 7.3% (SD 1.9%) (56 mmol/mol, SD 20). A higher proportion of the intervention group achieved 100% attendance (12/21, 57%, vs 5/19, 26%, for the control group); Kaplan-Meier analysis demonstrated significantly greater cumulative attendance in the intervention group (P=.04). There were no between-group differences in HbA1c, BMI, lipids, or availability of pathology and SMBG data. Odds of recording an improvement in the Diabetes Empowerment Scale–Short Form score were higher in the intervention group at 6 months (odds ratio [OR] 4.3, 95% CI 1.1-17), with attenuation of this effect at study end (OR 3.1, 95% CI 0.9-11). Program acceptability was high; >90% of participants would recommend the program to new patients. Conclusions An enhanced SMS text message–based support and reminder program doubled scheduled clinic attendance rates for patients with young-onset type 2 diabetes. The program was highly acceptable and provided early support for patient empowerment but had no significant effect on measures of metabolic control or self-management. Trial Registration Australian and New Zealand Clinical Trials Registry (ACTRN12618000479202); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373579
Collapse
Affiliation(s)
- Timothy Middleton
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.,Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Maria Constantino
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.,Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Margaret McGill
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.,Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Mario D'Souza
- Sydney Local Health District Clinical Research Centre, Camperdown, Australia
| | - Stephen M Twigg
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.,Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Ted Wu
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.,Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Aravinda Thiagalingam
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Department of Cardiology, Westmead Hospital, Westmead, Australia.,Westmead Applied Research Centre, The University of Sydney, Westmead, Australia
| | - Clara Chow
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Department of Cardiology, Westmead Hospital, Westmead, Australia.,Westmead Applied Research Centre, The University of Sydney, Westmead, Australia.,Cardiovascular Division, The George Institute for Global Health, Sydney, Australia
| | - Jencia Wong
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.,Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| |
Collapse
|
22
|
Lucht M, Quellmalz A, Mende M, Broda A, Schmiedeknecht A, Brosteanu O, Höppner-Buchmann J, Langosch J, Stuppe M, Schomerus G, Klauer T, Grabe HJ, Freyberger HJ, John U, Meyer C. Effect of a 1-year short message service in detoxified alcohol-dependent patients: a multi-center, open-label randomized controlled trial. Addiction 2021; 116:1431-1442. [PMID: 33155711 DOI: 10.1111/add.15313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/11/2020] [Accepted: 10/27/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Existing evidence suggests that text message interventions can help people to reduce their alcohol consumption. However, studies with alcohol-dependent patients are lacking. In this study a 1-year automatic mobile phone-based short messaging service (SMS) intervention on alcohol consumption in patients after alcohol detoxification in hospital was compared with treatment as usual. DESIGN Multi-center, randomized, controlled, two parallel-group, observer-blinded trial. SETTING AND PARTICIPANTS Primary and secondary care: four hospitals and community (1 million residents, 7600 km2 area in Germany). A total of 462 patients with alcohol dependence (ICD-10) were included during inpatient detoxification treatment. Patients were randomly assigned (1 : 1) to an SMS intervention and treatment as usual (SMS + TAU; n = 230; mean age: 45.4 years; 22.6% women) or TAU alone (n = 232 mean age: 44.5 years; 22.8% women). Planned, automated messages were sent to patients over 1 year to record assistance needs. A 'yes' or missing response triggered a telephone call from a hospital therapist. Outcome was assessed by an independent survey center. MEASUREMENTS The primary end-point was a three-category alcohol consumption measure covering months 10-12 after discharge: abstinence, non-heavy drinking, heavy drinking [men > 60 g/day; women > 40 g/day equal to World Health Organization (WHO) criteria: high risk and very high risk, mean consumption]. Secondary end-points were number of abstinent days over 12 months and frequency of abstinence. RESULTS The arms differed primarily in the heavy drinking category (intervention group 22.2%, TAU-only group 32.3%) in months 9-12. This is reflected by an odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.11-2.54, P = 0.015 for heavy drinking versus non-heavy drinking/abstinence. No difference between treatments was found with respect to any drinking versus abstinence (OR = 1.13). These results were confirmed by models adjusting for randomization strata. CONCLUSIONS In Germany, a 12-month mobile phone short messaging service-based intervention enhanced the reduction in heavy drinking for 1 year in routine care among adults with alcohol dependence discharged from inpatient alcohol detoxification.
Collapse
Affiliation(s)
- Michael Lucht
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany.,Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Anne Quellmalz
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany
| | - Meinhard Mende
- Clinical Trial Center (CTC) Leipzig, University of Leipzig, Leipzig, Germany
| | - Anja Broda
- Clinical Trial Center (CTC) Leipzig, University of Leipzig, Leipzig, Germany
| | | | - Oana Brosteanu
- Clinical Trial Center (CTC) Leipzig, University of Leipzig, Leipzig, Germany
| | - Jacqueline Höppner-Buchmann
- Hospital of Geriatric Psychiatry; Helios Hospital Schwerin, Schwerin, Germany and Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Jens Langosch
- Bethanien Hospital for Psychiatry, Psychosomatics, and Psychotherapy, Greifswald, Germany
| | - Markus Stuppe
- Hospital of Addiction Medicine; Helios Hospital Schwerin, Schwerin, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Thomas Klauer
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Harald J Freyberger
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany.,Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Ulrich John
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
| | - Christian Meyer
- Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
| |
Collapse
|
23
|
Bendtsen M, McCambridge J, Åsberg K, Bendtsen P. Text messaging interventions for reducing alcohol consumption among risky drinkers: systematic review and meta-analysis. Addiction 2021; 116:1021-1033. [PMID: 33047865 PMCID: PMC8247265 DOI: 10.1111/add.15294] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/20/2020] [Accepted: 10/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIMS The global growth of mobile phone use has led to new opportunities for health interventions, including through text messaging. We aimed to estimate the effects of text messaging interventions on alcohol consumption among risky drinkers. METHODS Systematic review and meta-analysis of reports on randomized controlled trials (RCTs) published in English. Searches were conducted on 23 May 2019 in PubMed; PubMed Central; CENTRAL; CDSR; DARE; NHS-EED; Scopus; PsycINFO; PsycARTICLES; CINAHL; and Web of Science. Measurements included number of episodes of heavy drinking (HED) per month and weekly alcohol consumption (WAC) in grams. Trials among risky drinkers who were not receiving co-interventions were included in the review (n = 3481, mean age 29 years, 41% female). Data were extracted from reports and authors were contacted for additional data. RESULTS Ten trials were included and all analyses were based on random-effects models. Primary analyses, including seven trials (n = 2528) for HED and five trials (n = 2236) for WAC, found that the interventions may reduce self-reported HED [-0.33 episodes per month; 95% confidence interval (CI) = -0.79, 0.12] and WAC (-18.62 g per week; 95% CI = -39.61, 2.38), although both estimates included the null. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality of evidence was judged to be low for both HED and WAC, primarily due to risk of attrition and performance bias, heterogeneity and influence of pilot trials on estimates. CONCLUSIONS Text messaging alcohol interventions may reduce alcohol consumption compared with no or basic health information; however, there are doubts about the overall quality of the evidence.
Collapse
Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring SciencesLinköping UniversitySweden
| | | | - Katarina Åsberg
- Department of Health, Medicine and Caring SciencesLinköping UniversitySweden
| | - Preben Bendtsen
- Department of Health, Medicine and Caring SciencesLinköping UniversitySweden,Department of Medical SpecialistMotalaSweden
| |
Collapse
|
24
|
Skouteris H, Savaglio M. The Use of Social Media for Preconception Information and Pregnancy Planning among Young Women. J Clin Med 2021; 10:jcm10091892. [PMID: 33925520 PMCID: PMC8123806 DOI: 10.3390/jcm10091892] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/14/2021] [Accepted: 04/25/2021] [Indexed: 01/21/2023] Open
Abstract
Young women of reproductive age (18–25 years) often seek and engage with health-related information via social media. However, the extent to which this population group seek preconception and pregnancy-related information has not been explored. Therefore, this study aimed to: (1) examine the proportion, type, and frequency of social media use to seek general health, preconception, and pregnancy-related information or advice among young women; and (2) explore the relationship between age, education status, relationship status, and planning a pregnancy on social media use for preconception and pregnancy-related health information. Ninety-one Australian women aged 18–25 years completed an online survey about their patterns and preferences of social media use for this information. Forty percent of women used social media for general health information (most often daily), 32% for preconception health advice (most commonly weekly), and 20% for pregnancy-related information (most often weekly), with Facebook the most frequently used platform. Planning a pregnancy within the next 5 years and younger age were associated with greater likelihood of using social media for such information. It is necessary that social media platforms are leveraged to disseminate preconception and pregnancy planning health advice, support, and education to provide better health promotion and preventive care to young women.
Collapse
Affiliation(s)
- Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
- Warwick Business School, The University of Warwick, Coventry CV4 7AL, UK
- Correspondence:
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| |
Collapse
|
25
|
Gass JC, Funderburk JS, Shepardson R, Kosiba JD, Rodriguez L, Maisto SA. The use and impact of self-monitoring on substance use outcomes: A descriptive systematic review. Subst Abus 2021; 42:512-526. [PMID: 33617740 DOI: 10.1080/08897077.2021.1874595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Self-Monitoring (SM), the act of observing ones' own behavior, has been used in substance use treatment because SM may bring conscious awareness to automatized substance use behaviors. Empirical findings regarding SM's effectiveness are mixed. The aim of this study was to synthesize the literature for the efficacy of SM on substance use. Method: A literature search was conducted using MEDLINE/PubMed. Results: Out of 2,659 citations, 41 studies with 126 analyses were included. Among analyses from studies rated Moderate (n = 24) or Strong (n = 3) quality, SM was shown to have a helpful effect (e.g., reducing substance use) 29% of the time; to have no effect 63.0% of the time; and to be detrimental in 8.0% of analyses. SM's helpful effects were associated with methodological characteristics including longer monitoring and Phone/IVR and EMA/Computer methodologies compared to Paper/Pencil. SM was more helpful in non-treatment-seekers (35.0% of analyses showed SM to be helpful compared to 25.0% of analyses with treatment-seekers). Conclusions: Results of this study suggest that SM, under certain circumstances, as the potential to be a low-cost, low-risk research and early intervention strategy for substance users.
Collapse
Affiliation(s)
- Julie C Gass
- VA Center for Integrated Healthcare, Western New York VA Healthcare System, Buffalo, NY, USA.,Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Jennifer S Funderburk
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychology, Syracuse University, Syracuse, NY, USA.,Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Robyn Shepardson
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Jesse D Kosiba
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Lauren Rodriguez
- VA Center for Integrated Healthcare, Western New York VA Healthcare System, Buffalo, NY, USA.,Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Stephen A Maisto
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychology, Syracuse University, Syracuse, NY, USA
| |
Collapse
|
26
|
Sheehan DM, De La Cruz Y, Ramírez-Ortiz D, Swendeman D, Muñoz-Laboy M, Duncan DT, Cano MÁ, Devieux JG, Trepka MJ. A qualitative study of antiretroviral therapy adherence interruptions among young Latino men who have sex with men with HIV: Project D.A.I.L.Y. AIDS Care 2021; 33:962-969. [PMID: 33486977 DOI: 10.1080/09540121.2021.1874277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Consistent antiretroviral therapy (ART) adherence is necessary for HIV viral suppression. However, adherence may fluctuate around daily routines and life events, warranting intervention support. We examined reasons for ART adherence interruptions, using in-depth, semi-structured qualitative interviews, among young (18-34-year-old) Latino men who have sex with men (YLMSM) with HIV. Interviews (n = 24) were guided by the Theory of Planned Behavior, the Information-Motivation-Behavioral Skills Theory, and the Socio-Ecological Model. Two coders independently coded transcripts using NVivo 12 software and synthesized codes into themes using Thematic Content Analysis. Results suggested 4 primary influences on ART adherence interruptions: (1) HIV diagnosis denial, (2) breaks in daily routine, (3) substance use, and (4) HIV status disclosure. Participant quotes highlighted routinization of pill-taking and planning ahead for breaks in routine as critically important. The narrative suggested modification of pill-taking routines during alcohol use, and that periods most vulnerable for long-term interruptions in ART adherence were following an HIV diagnosis and during periods of drug use. Support at the time of HIV diagnosis, including a plan for routinization of pill taking, and adaptive interventions incorporating real-time support during breaks in routines and substance use episodes may be one way to help YLMSM adhere to ARTs.
Collapse
Affiliation(s)
- Diana M Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.,Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA.,Research Centers in Minority Institutions (RCMI), Florida International University, Miami, FL, USA
| | - Yazmine De La Cruz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Dallas Swendeman
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Miguel Muñoz-Laboy
- Community Health and Social Medicine Department, The City College of New York, New York, NY, USA
| | - Dustin T Duncan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.,Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA
| | - Jessy G Devieux
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.,Research Centers in Minority Institutions (RCMI), Florida International University, Miami, FL, USA
| |
Collapse
|
27
|
Weerakoon SM, Jetelina KK, Knell G. Longer time spent at home during COVID-19 pandemic is associated with binge drinking among US adults. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 47:98-106. [DOI: 10.1080/00952990.2020.1832508] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Sitara M. Weerakoon
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) and Children’s Health System of Texas, Dallas, TX, USA
| | - Katelyn K. Jetelina
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) and Children’s Health System of Texas, Dallas, TX, USA
| | - Gregory Knell
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) and Children’s Health System of Texas, Dallas, TX, USA
- Children’s Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX, USA
| |
Collapse
|
28
|
Bendtsen M, Garnett C, Toner P, Shorter GW. The Effect of Question Order on Outcomes in the Core Outcome Set for Brief Alcohol Interventions Among Online Help-Seekers: Protocol for a Factorial Randomized Trial. JMIR Res Protoc 2020; 9:e24175. [PMID: 33242024 PMCID: PMC7728524 DOI: 10.2196/24175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022] Open
Abstract
Background A core outcome set (COS) for trials and evaluations of the effectiveness and efficacy of alcohol brief interventions (ABIs) has recently been established through international consensus to address the variability of outcomes evaluated. Objective This is a protocol for studies to assess if there are order effects among the questions included in the COS. Methods The 10 items of the COS are organized into 4 clusters. A factorial design will be used with 24 arms, where each arm represents 1 order of the 4 clusters. Individuals searching online for help will be asked to complete a questionnaire, and consenting participants will be randomized to 1 of the 24 arms (double-blind with equal allocation). Participants will be included if they are 18 years or older. The primary analyses will (1) estimate how the order of the clusters of outcomes affects how participants respond and (2) investigate patterns of abandonment of the questionnaire. Results Data collection is expected to commence in November 2020. A Bayesian group sequential design will be used with interim analyses planned for every 50 participants completing the questionnaire. Data collection will end no more than 24 months after commencement, and the results are expected to be published no later than December 2023. Conclusions Homogenizing the outcomes evaluated in studies of ABIs is important to support synthesis, and the COS is an important step toward this goal. Determining whether there may be issues with the COS question order may improve confidence in using it and speed up its dissemination in the research community. We encourage others to adopt the protocol as a study within their trial as they adopt the ORBITAL (Outcome Reporting in Brief Intervention Trials: Alcohol) COS to build a worldwide repository and provide materials to support such analysis. Trial Registration ISRCTN Registry ISRCTN17954645; http://www.isrctn.com/ISRCTN17954645 International Registered Report Identifier (IRRID) PRR1-10.2196/24175
Collapse
Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Paul Toner
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom
| | - Gillian W Shorter
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom
| |
Collapse
|
29
|
Kennedy TM, Walther CAP, Pedersen SL, McKone KMP, Gnagy EM, Pelham WE, Molina BSG. Beers with Peers: Childhood ADHD and Risk for Correlated Change in Perceived Peer and Personal Alcohol Use Across Young Adulthood. Alcohol Clin Exp Res 2020; 44:2350-2360. [PMID: 32966613 PMCID: PMC7680395 DOI: 10.1111/acer.14467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 09/14/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND ADHD poses risk for problematic alcohol use through adulthood. Perceived peer alcohol use, one of the strongest correlates of individuals' own alcohol use, is especially salient for adolescents with ADHD. The extent to which this risk extends into young adulthood is unknown, as well as how change in these constructs is associated throughout young adulthood. METHODS In the Pittsburgh ADHD Longitudinal Study, 358 individuals with childhood-diagnosed ADHD and 239 without were prospectively followed from ages 18 to 29. Piecewise, bivariate longitudinal growth modeling was used to examine the change in both peer alcohol use and individuals' heavy drinking (binge-drinking frequency), their between-person associations, and differences by ADHD group. The addition of structured residuals probed within-person year-to-year change in peer and personal alcohol use and their prospective associations. RESULTS Perceived peer alcohol use and individuals' heavy drinking frequencies changed together over time concurrently-from ages 18 to 21 (piece 1) and 21 to 29 (piece 2). Prospectively, individuals who increased the most in heavy drinking from ages 18 to 21 reported more friends using alcohol at age 29, regardless of ADHD history. Within-person increases in personal alcohol use likewise predicted increased perceived peer use the subsequent year within each age group (piece), regardless of ADHD history. However, while decreasing perceived peer use from ages 21 to 29 was related to more frequent heavy drinking at age 29 for those without ADHD, increasing perceived peer use from ages 18 to 21 predicted more frequent heavy drinking at age 29 for those with ADHD. CONCLUSIONS Young adult heavy drinking changes in tandem with perceived peer alcohol use across individuals and predicts selection of alcohol-using peers from year to year within individuals, further into adulthood than previously documented. Findings suggest the centrality of relationships with alcohol-consuming friends in relation to one's heavy drinking, especially for young adults with ADHD histories, through the twenties.
Collapse
Affiliation(s)
- Traci M Kennedy
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
| | | | - Sarah L Pedersen
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
| | - Kirsten M P McKone
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
| | | | - William E Pelham
- Florida International University, (EMG, WEP), Miami, Florida, USA
| | - Brooke S G Molina
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
| |
Collapse
|
30
|
Carreiro S, Newcomb M, Leach R, Ostrowski S, Boudreaux ED, Amante D. Current reporting of usability and impact of mHealth interventions for substance use disorder: A systematic review. Drug Alcohol Depend 2020; 215:108201. [PMID: 32777691 PMCID: PMC7502517 DOI: 10.1016/j.drugalcdep.2020.108201] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/10/2020] [Accepted: 07/19/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Connected interventions use data collected through mobile/wearable devices to trigger real-time interventions and have great potential to improve treatment for substance use disorder (SUD). This review aims to describe the current landscape, effectiveness and usability of connected interventions for SUD. METHODS A systematic review was conducted to identify articles evaluating connected health interventions for SUD in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three databases (PubMed, IEEE, and Scopus) were searched over a five-year period. Included articles described a connected health intervention targeting SUD and provided outcomes data. Data were extracted using a standardized reporting tool. RESULTS A total of 1676 unique articles were identified during the initial search, with 32 articles included in the final analysis. Seven articles of the 32 were derived from two large studies. The most commonly studied SUD was alcohol use disorder. Sixteen articles reported at least one statistically significant result with respect to reduced craving and/or substance use. The majority of articles used ecological momentary assessment to trigger interventions, while four used biologic/physiologic data. Two articles used a wearable device. Common intervention types included craving management, coping assistance, and tailored feedback. Twenty-three articles measured usability factors, and acceptability was generally reported as high. CONCLUSION Identified themes included a focus on AUD, use of smart phones, use of EMA for intervention delivery, positive effects on SUD related outcomes, and overall high acceptability. Wearables that directly monitor biologic data and predictive analytics using integrated data streams represent understudied opportunities for new research.
Collapse
Affiliation(s)
- Stephanie Carreiro
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Mark Newcomb
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Rebecca Leach
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Simon Ostrowski
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Edwin D Boudreaux
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Daniel Amante
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| |
Collapse
|
31
|
Smith SW, Alhabash S, Kanver D, Tan PN, Viken G. Celebration Drinking around the Clock. HEALTH COMMUNICATION 2020; 35:1307-1315. [PMID: 31161811 DOI: 10.1080/10410236.2019.1625007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The fact that St. Patrick's Day (SPD) celebration drinking occurs during a specified, public, and socially-acceptable time frame which spans the better part of a day and evening makes it an important time to understand and attempt to influence celebration drinking behaviors among young adults. SPD has been identified as the celebration during which college students consume more alcohol than any other point during the school year. Intervention opportunities can be more successful with an understanding of the factors associated with alcohol consumption at specific times on particular celebrations. This study examined the factors associated with celebration drinking at different time periods on SPD which included perceived descriptive and injunctive norms, the numbers of close friends and acquaintances present, social media relationships, demographic variables, past drinking behavior, and intent to drink on SPD at the three time points of interest. Findings showed variability in the predictive factors on SPD celebration drinking at different times of the day. The theoretical and practical intervention implications of the findings are discussed.
Collapse
Affiliation(s)
- Sandi W Smith
- Department of Communication, Michigan State University
| | | | - Duygu Kanver
- Advertising and Public Relations, Michigan State University
| | | | - Greg Viken
- Communication Studies Department, Campbell University
| |
Collapse
|
32
|
Chavez K, Palfai TP. Reducing Heavy Episodic Drinking among College Students Using a Combined Web and Interactive Text Messaging Intervention. ALCOHOLISM TREATMENT QUARTERLY 2020. [DOI: 10.1080/07347324.2020.1784067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Kathryn Chavez
- Department of Psychological and Brain Sciences, Boston University, Bosto, Massachusetts, USA
| | - Tibor P. Palfai
- Department of Psychological and Brain Sciences, Boston University, Bosto, Massachusetts, USA
| |
Collapse
|
33
|
Pot AL, Le Faou AL, Airagnes G, Limosin F. [Not Available]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2020; 32:315-327. [PMID: 33512098 DOI: 10.3917/spub.204.0315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Given the high prevalence of alcohol use disorder (AUD) amongst patients in Emergency Rooms (ER), it is recommended to carry out a systematized screening of at-risk drinkers, followed if necessary by a brief intervention (BI) to prevent AUD-related damages. This intervention has been the subject of numerous efficacy and feasibility studies. The purpose of this review of the literature is to identify optimal strategies for systematic screening and BI that can be deployed in the ER. METHODS We selected randomized controlled trials, meta-analysis and reviews of the literature published between July 2014 and March 2019 evaluating the effectiveness of BI in the ER on reducing alcohol consumption. RESULTS Thirteen articles were included. There is a significant heterogeneity of the methodologies used and the interventions carried out. The majority of studies conclude in the effectiveness of BI on reducing alcohol consumption, with however differences between the studies in effect size, and an effectiveness that seems to decrease over time. CONCLUSION The BI in the ER appears to be effective on reducing alcohol consumption but with a modest effect size and heterogeneity of the interventions tested, so that the optimal modalities of its implementation remain to be defined. Further studies to compare different interventions and identify at-risk subgroups would be needed to optimize the use of BI in the ER.
Collapse
|
34
|
The Efficacy of an Event-Specific, Text Message, Personalized Drinking Feedback Intervention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:873-883. [PMID: 30054777 DOI: 10.1007/s11121-018-0939-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Tailgating drinking prior to a football game is a type of event-specific drinking associated with increased alcohol use and related problems. Personalized drinking feedback interventions (PFI) are efficacious in reducing alcohol use and problems. The current study aimed to advance understanding of event-specific interventions by examining: (1) the efficacy of an event-specific, text message PFI on tailgating alcohol outcomes, and (2) the extent to which intervention effects generalize to "typical" alcohol outcomes at 1-month follow-up. College students (N = 130; 71% female; 92% white) who reported tailgating within the past 30 days and binge drinking when tailgating in the past year completed assessments on tailgating and typical alcohol use. They were randomly assigned to one of two text message conditions delivered on the morning of a home football game: event-specific PFI (TXT PFI) or a control condition. Multilevel modeling examined the association of treatment condition on tailgating and 1-month alcohol outcomes. When tailgating, participants in TXT PFI reported lower estimated peak blood alcohol concentration (eBAC) and consumed less drinks than the control condition. At the 1-month "typical" drinking follow-up, participants in TXT PFI reported lower peak eBAC and fewer alcohol-related problems than the control condition. Perceived tailgating drinking norms were found to statistically mediate the relationship between condition and alcohol outcome at tailgating and 1-month follow-ups. Findings provide preliminary support for the efficacy of an event-specific, text message PFI in reducing both tailgating and typical drinking alcohol outcomes. Event-specific TXT PFI can be used for prevention/intervention of alcohol misuse.
Collapse
|
35
|
Wright C, Dietze PM, Kuntsche E, Livingston M, Agius PA, Room R, Raggatt M, Hellard M, Lim MSC. Effectiveness of an Ecological Momentary Intervention for Reducing Risky Alcohol Consumption Among Young Adults: Protocol for a Three-Arm Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e14190. [PMID: 32229471 PMCID: PMC7157500 DOI: 10.2196/14190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/16/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022] Open
Abstract
Background Recent research has investigated the utility of mobile phone–delivered interventions for reducing risky single-occasion drinking, also known as binge drinking. In the past five years, focus has been placed on ecological momentary interventions (EMIs), which aim to deliver intervention content in correspondence to real-time assessments of behavior, also known as ecological momentary assessments (EMAs). Objective This study aims to assess the effect of a fully automated, tailored, mobile phone–delivered EMI termed Mobile Intervention for Drinking in Young people (MIDY) on young people's risky single-occasion drinking behavior. Methods We will use a three-armed randomized controlled trial design to determine the impact of MIDY on peak consumption of alcohol among young people. A list of mobile telephone numbers for random digit dialing will be generated, and researchers will telephone potential participants to screen for eligibility. Participants will be randomized into one of three intervention groups. For 6 weeks, EMI, EMA, and attention control groups will complete hourly EMA surveys on their mobile phones on Friday and Saturday nights. EMI participants will receive personalized feedback in the form of text messages corresponding to their EMA survey responses, which focus on alcohol consumption, spending, and mood. EMA participants will not receive feedback. A third group will also complete EMA and receive feedback text messages at the same time intervals, but these will be focused on sedentary behavior and technology use. All groups will also complete a short survey on Saturday and Sunday mornings, with the primary outcome measure taken on Sunday mornings. A more detailed survey will be sent on the final Sunday of the 6-week period, and then again 1 year after recruitment. Results The primary outcome measure will be an observed change (ie, reduction) in the mean peak number of drinks consumed in a single night over the 6-week intervention period between the EMI and attention control groups as measured in the weekly EMA. We expect to see a greater reduction in mean peak drinking in the EMI group compared to that in the attention control group. As a secondary aim, we will assess whether mean peak drinking is reduced in the EMA group compared to the attention control group. We will use a random-effects mixed-modeling approach using maximum-likelihood estimation to provide estimates of differences in peak drinking across time periods between those receiving the intervention (EMI) and attention control participants. An intention-to-treat approach will be taken for the analysis. Individuals and study groups will be modeled as random and fixed factors, respectively. Conclusions This study extends our previous work investigating the efficacy of a mobile EMI (MIDY) for reducing risky drinking among young adults in Australia, and will add to the expanding literature on the use of mobile interventions for reducing risky alcohol consumption. Trial Registration Australian New Zealand Clinical Trials Registration (ANZCTR): ACTRN12617001509358p; http://www.anzctr.org.au/ACTRN12617001509358p.aspx International Registered Report Identifier (IRRID) DERR1-10.2196/14190
Collapse
Affiliation(s)
- Cassandra Wright
- Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Michelle Raggatt
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Margaret Hellard
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
| |
Collapse
|
36
|
Glasner S, Chokron Garneau H, Ang A, Ray L, Venegas A, Rawson R, Kalichman S. Preliminary Efficacy of a Cognitive Behavioral Therapy Text Messaging Intervention Targeting Alcohol Use and Antiretroviral Therapy Adherence: A Randomized Clinical Trial. PLoS One 2020; 15:e0229557. [PMID: 32163431 PMCID: PMC7067560 DOI: 10.1371/journal.pone.0229557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/05/2020] [Indexed: 12/21/2022] Open
Abstract
TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov, NCT02603471.
Collapse
Affiliation(s)
- Suzette Glasner
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States of America
- School of Nursing, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Helene Chokron Garneau
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Alfonso Ang
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Lara Ray
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Alexandra Venegas
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States of America
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Richard Rawson
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States of America
- Department of Psychiatry, Center for Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
| | - Seth Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Mansfield, Connecticut, United States of America
| |
Collapse
|
37
|
Bastola MM, Locatis C, Maisiak R, Fontelo P. The Effectiveness of Mobile Phone-Based Text Messaging to Intervene with Problem Drinking in Youth and Younger Adult Population: A Meta-Analysis. Telemed J E Health 2020; 26:270-277. [PMID: 30985258 PMCID: PMC7071024 DOI: 10.1089/tmj.2018.0307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Mobile phone-based text messages have been used to address alcohol use disorder in younger populations by promoting abstinence, decreased alcohol intake, and moderation. Methods: A meta-analysis was conducted to summarize the effectiveness of mobile phone text messaging to address problem drinking by youth and younger adults. Results: Authors systematically searched PubMed, Embase, CINAHL, Web of Science, APA PsycNET, and the Cochrane Central Registry of Controlled Trials for literature published in the past 8 years (2010-2018). Randomized control trials and pre-post studies of younger people that used the problem drinking criteria of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) were included in the meta-analysis. Conclusions: The meta-analysis suggests that text message-based interventions might not be effective in decreasing alcohol intake in the younger populations.
Collapse
Affiliation(s)
- Mrigendra M. Bastola
- National Library of Medicine, National Institutes of Health, Rockville, Maryland
| | - Craig Locatis
- National Library of Medicine, National Institutes of Health, Rockville, Maryland
| | - Richard Maisiak
- School of Medicine, University of Alabama, Birmingham, Alabama
| | - Paul Fontelo
- National Library of Medicine, National Institutes of Health, Rockville, Maryland
| |
Collapse
|
38
|
McCarthy DM, Curtis LM, Courtney DM, Cameron KA, Lank PM, Kim HS, Opsasnick LA, Lyden AE, Gravenor SJ, Russell AM, Eifler MR, Hur SI, Rowland ME, Walton SM, Montague E, Kim KYA, Wolf MS. A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMC 2 Randomized Controlled Trial. Acad Emerg Med 2019; 26:1311-1325. [PMID: 31742823 DOI: 10.1111/acem.13860] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The study objective was to evaluate the effect of an Electronic Medication Complete Communication (EMC2 ) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. METHODS This was a three-arm prospective, randomized controlled pragmatic trial with randomization occurring at the physician level. Consecutive discharged patients at an urban academic ED (>88,000 visits) with new hydrocodone-acetaminophen prescriptions received one of three care pathways: 1) usual care, 2) EMC2 intervention, or 3) EMC2 + short message service (SMS) text messaging. The ED EMC2 intervention triggered two patient-facing educational tools (MedSheet, literacy-appropriate prescription wording [Take-Wait-Stop]) and three provider-facing reminders to counsel (directed to ED physician, dispensing pharmacist, follow-up physician). Patients in the EMC2 + SMS arm additionally received one text message/day for 1 week. Follow-up at 1 to 2 weeks assessed "demonstrated safe use" (primary outcome). Secondary outcomes including patient knowledge and actual safe use (via medication diaries) were assessed 2 to 4 days and 1 month following enrollment. RESULTS Among the 652 enrolled, 343 completed follow-up (57% women; mean ± SD age = 42 ± 14.0 years). Demonstrated safe opioid use occurred more often in the EMC2 group (adjusted odds ratio [aOR] = 2.46, 95% confidence interval [CI] = 1.19 to 5.06), but not the EMC2 + SMS group (aOR = 1.87, 95% CI = 0.90 to 3.90) compared with usual care. Neither intervention arm improved medication safe use as measured by medication diary data. Medication knowledge, measured by a 10-point composite knowledge score, was greater in the EMC2 + SMS group (β = 0.57, 95% CI = 0.09 to 1.06) than usual care. CONCLUSIONS The study found that the EMC2 tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
Collapse
Affiliation(s)
| | - Laura M Curtis
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
| | - D Mark Courtney
- Department of Emergency Medicine, Northwestern University, Chicago, IL
| | - Kenzie A Cameron
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Patrick M Lank
- Department of Emergency Medicine, Northwestern University, Chicago, IL
| | - Howard S Kim
- Department of Emergency Medicine, Northwestern University, Chicago, IL
| | - Lauren A Opsasnick
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
| | - Abbie E Lyden
- College of Pharmacy, Rosalind Franklin School of Medicine and Science, Chicago, IL
| | | | - Andrea M Russell
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
| | - Morgan R Eifler
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
| | - Scott I Hur
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
| | - Megan E Rowland
- Department of Emergency Medicine, Northwestern University, Chicago, IL
| | - Surrey M Walton
- Department of Pharmacy Administration, University of Illinois at Chicago, Chicago, IL
| | - Enid Montague
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
- School of Computing, DePaul University, Chicago, IL
| | - Kwang-Youn A Kim
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Michael S Wolf
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL
| |
Collapse
|
39
|
Suffoletto B, Huber J, Kirisci L, Clark D, Chung T. The effect of SMS behavior change techniques on event-level desire to get drunk in young adults. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:320-326. [PMID: 31750698 DOI: 10.1037/adb0000534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Text messaging (SMS) interventions incorporating a combination of behavior change techniques can assist reductions in alcohol consumption among young adult hazardous drinkers, but mechanisms of action remain unknown. In this secondary analysis, we test the hypothesis that desire to get drunk (DD) recorded prior to drinking episodes would mediate SMS intervention effects on the likelihood of event-level heavy drinking (4 +/5 + drinks for women/men). We recruited young adult hazardous drinkers to a trial where they were randomized to 1 of 5 SMS interventions: TRACK (self-monitoring of alcohol use), PLAN (feedback on drinking plans and DD), USE (postdrinking feedback on alcohol consumed), GOAL (goal prompts/support), and COMBO (i.e., 4 interventions combined). Up to 3 days per week for 14 weeks, when participants reported a plan to drink, they were asked to report DD on a scale from 0 (none) to 8 (completely) and next day asked to recall drink quantity. Multilevel structural equation models showed that DD mediated the treatment effect of GOAL on heavy drinking. This work illustrates the importance of goal support features in digital alcohol interventions and the utility of measuring desire to get drunk as a key mediator in alcohol studies. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
|
40
|
Teeters JB, Soltis KE, Murphy JG. A Mobile Phone-Based Brief Intervention With Personalized Feedback and Text Messaging Is Associated With Reductions in Driving After Drinking Among College Drinkers. J Stud Alcohol Drugs 2019. [PMID: 30422784 DOI: 10.15288/jsad.2018.79.710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Driving after drinking (DAD) among college students remains a significant public health concern and is perhaps the single riskiest drinking-related behavior. Counselor-delivered and web-based Brief Alcohol Interventions (BAIs) have been shown to reduce DAD among college students, but to date no study has evaluated the efficacy of a single-session mobile phone-based BAI specific to DAD. The present study examined whether a driving-specific BAI delivered via mobile phone would significantly decrease DAD among college students compared to an informational control. METHOD Participants were 84 college students (67.1% women; average age = 23; 52.4% White) who endorsed driving after drinking two or more drinks at least twice in the past 3 months. After completing baseline measures, participants were randomly assigned to receive either (a) DAD information or (b) DAD mobile BAI that included personalized feedback and interactive text messaging. Participants completed outcome measures at 3-month follow-up. RESULTS Repeated-measures mixed modeling analyses revealed that students receiving the mobile phone-based BAI reported significantly greater reductions in likelihood of DAD (three or more drinks) and the number of drinks consumed before driving than students in the information condition at 3-month follow-up. CONCLUSIONS These findings provide preliminary support for the short-term efficacy of a mobile phone-based BAI for reducing DAD among college students.
Collapse
Affiliation(s)
- Jenni B Teeters
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky.,Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Kathryn E Soltis
- Department of Psychology, The University of Memphis, Memphis Tennessee
| | - James G Murphy
- Department of Psychology, The University of Memphis, Memphis Tennessee
| |
Collapse
|
41
|
Chavez K, Palfai TP. Feasibility of a Mobile Messaging-Enhanced Brief Intervention for High Risk Heavy Drinking MSM: A Pre-Pilot Study. ALCOHOLISM TREATMENT QUARTERLY 2019; 38:87-105. [PMID: 32982032 PMCID: PMC7518379 DOI: 10.1080/07347324.2019.1653240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this project was to assess the feasibility of an in-person session + mobile messaging intervention approach to reduce heavy drinking and condomless anal intercourse among heavy drinking men who have sex with men at high risk for HIV. Participant (n = 8) engagement rates, retention and satisfaction ratings were used to measure feasibility and acceptability of the 4-week intervention. Paired t-tests were used to assess additional secondary outcomes. Results support the feasibility and acceptability of this novel treatment approach among this population. Pre-post intervention effect sizes on alcohol, sex risk and process variable secondary outcomes are discussed.
Collapse
Affiliation(s)
- Kathryn Chavez
- Boston University, Psychological and Brain Science, 900 Commonwealth Avenue 2 Floor, Boston, 02215, MA, USA
| | - Tibor P. Palfai
- Boston University, Psychological and Brain Science, 900 Commonwealth Avenue 2 Floor, Boston, 02215, MA, USA
| |
Collapse
|
42
|
Puddephatt JA, Leightley D, Palmer L, Jones N, Mahmoodi T, Drummond C, Rona RJ, Fear NT, Field M, Goodwin L. A Qualitative Evaluation of the Acceptability of a Tailored Smartphone Alcohol Intervention for a Military Population: Information About Drinking for Ex-Serving Personnel (InDEx) App. JMIR Mhealth Uhealth 2019; 7:e12267. [PMID: 31127726 PMCID: PMC6555114 DOI: 10.2196/12267] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/05/2019] [Accepted: 03/30/2019] [Indexed: 02/06/2023] Open
Abstract
Background Alcohol consumption in the UK Armed Forces is higher than in the general population, and this pattern continues after leaving the service. Smartphone apps may be useful to increase ex-serving personnel’s awareness of their alcohol consumption, support self-monitoring, and prompt a change in behavior. Objective The study aimed to explore the acceptability of Information about Drinking in Ex-serving personnel (InDEx), a tailored smartphone app, combined with personalized short message service (SMS) text messaging designed to target ex-serving personnel who meet the criteria for hazardous alcohol use. Methods The InDEx intervention included 4 key modules: (1) assessment and normative feedback, (2) self-monitoring and feedback, (3) goal setting and review, and (4) personalized SMS text messaging. A semistructured telephone interview study was conducted with ex-serving personnel after using the app for a 28-day period. Interviews were used to explore the acceptability of app modules and its functionality and the perceived changes in participant’s drinking. Interview transcripts were analyzed using inductive thematic analysis. Results Overall, 94% (29/31) participants who used InDEx agreed to take part in a telephone interview. Overall, 4 themes were identified: Credibility, Meeting their needs, Simplicity, and Helpful for ex-serving personnel. The importance of credibility, functionality, and meeting the individual needs of ex-serving personnel was emphasized. Acceptability and engagement with specific modules of the app and text messages were influenced by the following: (1) if they felt it provided credible information, (2) whether the content was appropriately personalized to them, (3) the ease of use, and (4) beliefs about their own drinking behaviors. Participants recommended that the app would be most suitable for personnel about to leave the Armed Forces. Conclusions InDEx was an acceptable smartphone app for ex-serving personnel for monitoring alcohol consumption and in providing meaningful feedback to the individual. Pages that met the participant’s interests and provided real time personalized, credible feedback on their drinking and text messages tailored to participant’s interactions with the app were particularly favored.
Collapse
Affiliation(s)
- Jo-Anne Puddephatt
- Department of Psychological Sciences, Institute of Life and Human Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Leightley
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Laura Palmer
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Norman Jones
- Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Toktam Mahmoodi
- Department of Informatics, King's College London, London, United Kingdom
| | - Colin Drummond
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Roberto J Rona
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Nicola T Fear
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Laura Goodwin
- Department of Psychological Sciences, Institute of Life and Human Sciences, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
43
|
Suffoletto B, Kirisci L, Clark DB, Chung T. Which behavior change techniques help young adults reduce binge drinking? A pilot randomized clinical trial of 5 text message interventions. Addict Behav 2019; 92:161-167. [PMID: 30640148 DOI: 10.1016/j.addbeh.2019.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/27/2018] [Accepted: 01/08/2019] [Indexed: 12/22/2022]
Abstract
Text message (SMS) interventions can reduce binge drinking in young adults, but optimal behavior change techniques (BCTs) remain unknown. The present study tests the acceptability and preliminary efficacy of different combinations of SMS-delivered BCTs. 149 young adults who screened positive for hazardous drinking completed a baseline survey in the Emergency Department. For the following 2-weeks, on days they typically drank (1 to 3 days per week), participants received ecological momentary assessments (EMA) of drinking plans and desire to get drunk; the next day they were prompted to report recall of number of drinks consumed the prior day. Participants who responded to at least 50% these EMA (N = 127) were randomized to one of five 12-week interventions: Cued Self-Monitoring (TRACK); Drinking Intentions Feedback (PLAN); Drinking Performance Feedback (USE); Adaptive Goal Support (GOAL); and a combination of BCTs (COMBO). 79% of all EMA were completed over 12 weeks, which decreased from around 93% on week 1 to 65% by week 12. Using EMA data, relative to TRACK, only COMBO showed significant reductions in binge drinking and max drinks per drinking episode over time. Using TLFB data, there were no significant differences between groups from baseline to 14- and 28-weeks follow-up. Results lay the groundwork for a larger trial testing the effects of BCTs on binge drinking for young adults.
Collapse
|
44
|
Bendtsen M. Text Messaging Interventions for Reducing Alcohol Consumption Among Harmful and Hazardous Drinkers: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2019; 8:e12898. [PMID: 31012866 PMCID: PMC6658319 DOI: 10.2196/12898] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 02/19/2019] [Accepted: 02/23/2019] [Indexed: 01/23/2023] Open
Abstract
Background Mobile phone-based interventions have become popular for lifestyle behavior change, particularly the use of text messaging as it is a technology ubiquitous in mobile phones. Reviews and meta-analyses of digital interventions for reducing harmful and hazardous use of alcohol have mainly focused on Web-based interventions; thus, there is a need for a body of evidence to guide health practitioners, policy makers, and researchers with respect to the efficacy of available text messaging interventions. Objective The aim of this systematic review and meta-analysis is to assess the effectiveness of text messaging interventions for reducing the amount of alcohol consumed among harmful and hazardous drinkers; this is compared to receiving no, minimal, or unrelated health information. Specifically, we ask the following questions: (1) Can interventions consisting of only text messages be effective in reducing alcohol consumption compared to no intervention or a minimal or unrelated intervention? (2) Can interventions consisting of only text messages be effective in reducing the prevalence of risky drinking compared to no intervention or a minimal or unrelated intervention? Methods Several databases will be searched, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, the Conference Proceedings Citation Index, ClinicalTrials.gov, OpenGrey, among others. Reports of studies that evaluate text messaging interventions for reducing the amount of alcohol consumed will be included. Primary outcomes of interest will be weekly alcohol consumption and frequency of heavy episodic drinking. The Cochrane Collaboration Risk of Bias tool will be used to assess bias in reports, and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the quality of the body of evidence. A narrative review will be presented, and a meta-analysis will be conducted in case of homogeneity among included studies. Results The systematic review has not yet begun but is expected to start in May of 2019; publication of the final review and meta-analysis is expected at the end of 2019. Conclusions The technology for text messaging is ubiquitous in mobile phones; thus, the potential reach of interventions utilizing this technique is great. However, there are no meta-analyses to date that limit the scope to the use of text messaging interventions for alcohol consumption reduction. Therefore, the proposed systematic review and meta-analysis will help health practitioners, policy decision makers, researchers, and others to better understand the effects of these interventions. International Registered Report Identifier (IRRID) PRR1-10.2196/12898
Collapse
Affiliation(s)
- Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
45
|
Bendtsen M, McCambridge J. Reducing Alcohol Consumption Among Risky Drinkers in the General Population of Sweden Using an Interactive Mobile Health Intervention: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13119. [PMID: 30998221 PMCID: PMC6495288 DOI: 10.2196/13119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Harmful use of alcohol continues to be a leading contributor to premature deaths globally. Not only does harmful drinking have consequences for the individuals consuming at increased levels, but it may also result in a range of negative consequences for their family members and friends. Interventions delivered via mobile phones (mobile health [mHealth] interventions) could potentially support risky drinkers seeking help to reduce their alcohol consumption. Objective This protocol describes a randomized controlled trial that aims to validly estimate the effect of a novel mHealth intervention targeting risky drinkers in the general population of Sweden. Nested within the trial are 3 substudies that focus on methodological and user satisfaction research questions. Methods A 2-arm parallel group randomized controlled trial will be employed to estimate the effect of the novel intervention. Participants will be recruited through Web advertisements and social media. The inclusion criteria are as follows: 18 years or older, ownership of a mobile phone, and being classified as a risky drinker according to Swedish guidelines. Participants allocated to the intervention group will receive a novel mHealth intervention. The intervention consists of weekly screening, personalized feedback on current consumption, functions allowing for planning of future consumption, as well as a series of messages delivered throughout the week. Participants allocated to the control group will receive a short message regarding negative consequences of alcohol consumption and a hyperlink that offers more information. Following 2 and 4 months after randomization, both groups will be asked to complete follow-up questionnaires (2-month interval being primary). Primary outcomes are weekly alcohol consumption and heavy episodic drinking. Participants in the control group will be given access to the novel intervention after completing the 4-month follow-up. The trial includes 3 substudies: We will explore whether the mode of presenting information before participants giving informed consent affects participation rates and recall of trial parameters, investigate if the content of the short message received by the control group affects study outcomes and requests for more information, and explore user satisfaction with the intervention and reactions of the control group. Results Participant recruitment is planned to begin in April 2019 and to last for a maximum of 24 months. The first dataset will be available approximately 2 months after the final participant has been recruited, and the final dataset will be available approximately 2 months later. No participants had been recruited at the time of submitting this protocol. Conclusions If found effective, the intervention has the potential to reduce negative consequences of alcohol consumption for individuals. The technology has been designed to have potential for extensive reach among those who may benefit. Trial Registration ISRCTN Registry ISRCTN48317451; http://www.isrctn.com/ISRCTN48317451 (Archived by WebCite at http://www.webcitation.org/779tKLsu3) International Registered Report Identifier (IRRID) PRR1-10.2196/13119
Collapse
Affiliation(s)
- Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
| |
Collapse
|
46
|
Gustafson A, Jilcott Pitts SB, McQuerry K, Babtunde O, Mullins J. A Mentor-Led Text-Messaging Intervention Increases Intake of Fruits and Vegetables and Goal Setting for Healthier Dietary Consumption among Rural Adolescents in Kentucky and North Carolina, 2017. Nutrients 2019; 11:nu11030593. [PMID: 30862118 PMCID: PMC6471255 DOI: 10.3390/nu11030593] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 01/23/2023] Open
Abstract
Introduction—Text-messaging interventions hold promise for successful weight loss interventions. However, there is limited research on text-messaging interventions to improve dietary intake among rural adolescents, who are at greater risk for obesity and related risk factors. The goal of this study was to test an eight-week, mentor-led text-messaging intervention among 14–16-year-old rural adolescents: the “Go Big and Bring It Home” Project to improve fruit and vegetable and healthy beverage intake. Methods and Materials—Eight rural high schools in eastern Kentucky and eastern North Carolina participated (n = 4 were randomized as intervention schools and n = 4 were randomized as control schools). Adolescents were recruited to participate in the eight-week text-messaging intervention. The text messages were primarily affective messages, and included a weekly challenge related to consuming fruits, vegetables, or healthy/low-calorie beverages. Undergraduate nutrition students sent text messages on Tuesday and Saturday every week over the eight-week period via the “Group Me” mobile application. Delayed controls received no information or text messages during the eight-week intervention. Fruit and vegetable intake was measured with the National Cancer Institute Fruit and Vegetable screener and beverage intake was assessed using the Beverage Questionnaire-10 (BEVQ-10). Intention-to-treat analyses were conducted among all those that completed the baseline and post-intervention survey (n = 277 intervention students and n = 134 delayed control students). All linear regression models were adjusted for race and were clustered on school to control for intraclass correlation. Results—In adjusted analyses, there was a statistically significant positive intervention effect on the primary outcome of fruit and vegetable servings/day with a mean difference between intervention and control participants of 1.28 servings/day (95% Confidence Interval 1.11, 1.48). There was no intervention effect on beverage intake. There was a statistically significant increase in the odds of goal setting for healthier dietary behaviors among intervention participants relative to controls. Conclusion—An eight-week text-messaging intervention led to increases in self-reported fruit and vegetable intake and improvements in goal setting for healthier dietary behaviors. Due to the use of undergraduate students to deliver the messages, and use of an existing web application, this text-messaging intervention can be sustained in underserved, rural environments. Thus there is potential for significant reach and public health impact to improve dietary patterns.
Collapse
Affiliation(s)
- Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, 206G Funkhouser Building, Lexington, KY 40506, USA.
| | - Stephanie B Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, 115 Heart Drive, Mailstop 660, Room 2239, Greenville, NC 27834, USA.
| | - Kristen McQuerry
- Applied Statistics Lab, University of Kentucky, 305B MDS Building, Lexington, KY 40506, USA.
| | - Oyinlola Babtunde
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Health Sciences Bldg. Rm. 2437, MailStop #668, 600 Moye Blvd., Greenville, NC 27834, USA.
| | - Janet Mullins
- Department of Dietetics and Human Nutrition, University of Kentucky, 206J Funkhouser Building, Lexington, KY 40506, USA.
| |
Collapse
|
47
|
Biroscak BJ, Pantalon MV, Dziura JD, Hersey DP, Vaca FE. Use of non-face-to-face modalities for emergency department screening, brief intervention, and referral to treatment (ED-SBIRT) for high-risk alcohol use: A scoping review. Subst Abus 2019; 40:20-32. [PMID: 30829126 PMCID: PMC6579646 DOI: 10.1080/08897077.2018.1550465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The purpose of this review was to examine and chart the "scope" of strategies reported in ED-SBIRT (emergency department-based screening, brief intervention and referral to treatment) studies that employ non-face-to-face (nFtF) modalities for high-risk alcohol use (i.e., risk for alcohol-related injury, medical condition, use disorder) and to identify research gaps in the scientific literature. Methods: The scoping review population included study participants with high-risk alcohol use patterns as well as study participants targeted for primary public health prevention (e.g., adolescent ED patients). Core concepts included SBIRT components among intervention studies that incorporated some form of nFtF modality (e.g., computer-assisted brief intervention). The context encompassed ED-based studies or trauma center studies, regardless of geographic location. After screening a total of 1526 unique references, reviewers independently assessed 58 full-text articles for eligibility. Results: A total of 30 full-text articles were included. Articles covered a period of 14 years (2003-2016) and 19 journal titles. Authors reported the use of a wide range of nFtF modalities across all 3 ED-SBIRT components: "screening" (e.g., computer tablet screening), "brief intervention" (e.g., text message-based brief interventions), and "referral to treatment" (e.g., computer-generated feedback with information about alcohol treatment services). The most frequently used nFtF modality was computerized screening and/or baseline assessment. The main results were mixed with respect to showing evidence of ED-SBIRT intervention effects. Conclusions: There is an opportunity for substance use disorder researchers to explore the specific needs of several populations (e.g., ED patients with co-occurring problems such as substance use disorder and violence victimization) and on several methodological issues (e.g., ED-SBIRT theory of change). Substance use disorder researchers should take the lead on establishing guidelines for the reporting of ED-SBIRT studies-including categorization schemes for various nFtF modalities. This would facilitate both secondary research (e.g., meta-analyses) and primary research design.
Collapse
Affiliation(s)
- Brian J Biroscak
- a Department of Emergency Medicine , Yale University School of Medicine , New Haven , Connecticut , USA
| | - Michael V Pantalon
- a Department of Emergency Medicine , Yale University School of Medicine , New Haven , Connecticut , USA
| | - James D Dziura
- a Department of Emergency Medicine , Yale University School of Medicine , New Haven , Connecticut , USA
| | - Denise P Hersey
- b Department of Clinical Information Services, Cushing/Whitney Medical Library , Yale University , New Haven , Connecticut , USA
| | - Federico E Vaca
- a Department of Emergency Medicine , Yale University School of Medicine , New Haven , Connecticut , USA
| |
Collapse
|
48
|
Pradhan AM, Park L, Shaya FT, Finkelstein J. Consumer Health Information Technology in the Prevention of Substance Abuse: Scoping Review. J Med Internet Res 2019; 21:e11297. [PMID: 30698526 PMCID: PMC6372939 DOI: 10.2196/11297] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/08/2018] [Accepted: 10/20/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Addiction is one of the most rapidly growing epidemics that currently plagues nations around the world. In the United States, it has cost the government more than US $700 billion a year in terms of health care and other associated costs and is also associated with serious social, physical, and mental consequences. Increasing efforts have been made to tackle this issue at different levels, from primary prevention to rehabilitation across the globe. With the use of digital technology rapidly increasing, an effort to leverage the consumer health information technologies (CHITs) to combat the rising substance abuse epidemic has been underway. CHITs are identified as patient-focused technological platforms aimed to improve patient engagement in health care and aid them in navigating the complex health care system. OBJECTIVE This review aimed to provide a holistic and overarching view of the breadth of research on primary prevention of substance abuse using CHIT conducted over nearly past five decades. It also aimed to map out the changing landscape of CHIT over this period. METHODS We conducted a scoping review using the Arksey and O'Malley's modified methodological framework. We searched 4 electronic databases (PubMed, Cochrane, Scopus, and EMBASE). Papers were included if the studies addressed the use of CHIT for primary prevention of substance abuse and were published in English between 1809 and 2018. Studies that did not focus solely on primary prevention or assessed additional comorbid conditions were eliminated. RESULTS Forty-two papers that met our inclusion criteria were included in the review. These studies were published between 1970 and 2018 and were not restricted by geography, age, race, or sex. The review mapped studies using the most commonly used CHIT platforms for substance abuse prevention from mass media in the 1970s to mobile and social media in 2018. Moreover, 191 studies that were exclusively focused on alcohol prevention were excluded and will be addressed in a separate paper. The studies included had diverse research designs although the majority were randomized controlled trials (RCT) or review papers. Many of the RCTs used interventions based on different behavioral theories such as family interactions, social cognitive theories, and harm-minimization framework. CONCLUSIONS This review found CHIT platforms to be efficacious and cost-effective in the real-world settings. We also observed a gradual shift in the types and use of CHIT platforms over the past few decades and mapped out their progression. In addition, the review detected a shift in consumer preferences and behaviors from face-to-face interactions to technology-based platforms. However, the studies included in this review only focused on the aspect of primary prevention. Future reviews could assess the effectiveness of platforms for secondary prevention and for prevention of substance abuse among comorbid populations.
Collapse
Affiliation(s)
- Apoorva Milind Pradhan
- Department of Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, United States
| | - Leah Park
- Department of Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, United States
| | - Fadia T Shaya
- Department of Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, United States
| | | |
Collapse
|
49
|
Song T, Qian S, Yu P. Mobile Health Interventions for Self-Control of Unhealthy Alcohol Use: Systematic Review. JMIR Mhealth Uhealth 2019; 7:e10899. [PMID: 30694200 PMCID: PMC6371076 DOI: 10.2196/10899] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 10/02/2018] [Accepted: 10/30/2018] [Indexed: 12/22/2022] Open
Abstract
Background Unhealthy alcohol use (UAU) is one of the major causes of preventable morbidity, mortality, and associated behavioral risks worldwide. Although mobile health (mHealth) interventions can provide consumers with an effective means for self-control of UAU in a timely, ubiquitous, and cost-effective manner, to date, there is a lack of understanding about different health outcomes brought by such interventions. The core components of these interventions are also unclear. Objective This study aimed to systematically review and synthesize the research evidence about the efficacy of mHealth interventions on various health outcomes for consumer self-control of UAU and to identify the core components to achieve these outcomes. Methods We systematically searched 7 electronic interdisciplinary databases: Scopus, PubMed, PubMed Central, CINAHL Plus with full text, MEDLINE with full text, PsycINFO, and PsycARTICLES. Search terms and Medical Subject Headings “mHealth,” “text message,” “SMS,” “App,” “IVR,” “self-control,” “self-regulation,” “alcohol*,” and “intervention” were used individually or in combination to identify peer-reviewed publications in English from 2008 to 2017. We screened titles and abstracts and assessed full-text papers as per inclusion and exclusion criteria. Data were extracted from the included papers according to the Consolidated Standards of Reporting Trials-EHEALTH checklist (V 1.6.1) by 2 authors independently. Data quality was assessed by the Mixed Methods Appraisal Tool. Data synthesis and analyses were conducted following the procedures for qualitative content analysis. Statistical testing was also conducted to test differences among groups of studies. Results In total, 19 studies were included in the review. Of these 19 studies, 12 (63%) mHealth interventions brought significant positive outcomes in improving participants’ health as measured by behavioral (n=11), physiological (n=1), and cognitive indicators (n=1). No significant health outcome was reported in 6 studies (6/19, 32%). Surprisingly, a significant negative outcome was reported for the male participants in the intervention arm in 1 study (1/19, 5%), but no change was found for the female participants. In total, 5 core components reported in the mHealth interventions for consumer self-control of UAU were context, theoretical base, delivery mode, content, and implementation procedure. However, sound evidence is yet to be generated about the role of each component for mHealth success. The health outcomes were similar regardless of types of UAU, deployment setting, with or without nonmobile cointervention, and with or without theory. Conclusions Most studies reported mHealth interventions for self-control of UAU appeared to be improving behavior, especially the ones delivered by short message service and interactive voice response systems. Further studies are needed to gather sound evidence about the effects of mHealth interventions on improving physiological and cognitive outcomes as well as the optimal design of these interventions, their implementation, and effects in supporting self-control of UAU.
Collapse
Affiliation(s)
- Ting Song
- Centre for IT-Enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Siyu Qian
- Centre for IT-Enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for IT-Enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| |
Collapse
|
50
|
Diestelkamp S, Wartberg L, Kaess M, Bauer S, Rummel-Kluge C, Becker K, Eschenbeck H, Salize HJ, Moessner M, Baldus C, Arnaud N, Thomasius R. Effectiveness of a web-based screening and brief intervention with weekly text-message-initiated individualised prompts for reducing risky alcohol use among teenagers: study protocol of a randomised controlled trial within the ProHEAD consortium. Trials 2019; 20:73. [PMID: 30670102 PMCID: PMC6341631 DOI: 10.1186/s13063-018-3160-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 12/22/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early and excessive alcohol use is a significant threat to healthy development. Evidence supports the effectiveness of electronic alcohol interventions for young drinkers. However, effects are typically small and studies targeting under 18-year-olds are scarce. This trial is the first to evaluate the effectiveness of a single-session, brief, motivational, web-based intervention (ProWISE) plus weekly text-message-initiated individualised prompts (TIPs) in reducing alcohol consumption and alcohol-related harm among children and adolescents aged ≥ 12 years. TIPs are designed to decrease risky alcohol use by reaching youth in the contexts of their everyday lives and by providing individualised feedback on drinking intentions, actual drinking and succession in achieving personal goals for low-risk drinking or abstinence. METHODS/DESIGN The trial is part of the multicentre consortium ProHEAD testing e-interventions for mental health problems in children and adolescents. Participants in grades 6-13 aged ≥ 12 years will be recruited in schools which participate in ProHEAD (target N = 15,000). Main criterion for inclusion in the ProWISE-TIP trial is a positive screening for at-risk alcohol use in the CRAFFT-d questionnaire (target n = 1076). In a multicentre, four-arm, randomised controlled design the following groups will be compared: (A) web-based intervention plus TIPs for 12 weeks; (B) web-based intervention plus text-message-initiated assessment of alcohol consumption for 12 weeks; (C) web-based intervention only; and (D) alcohol-related psychoeducation. TIPs will be delivered shortly before and after high-risk situations for excessive alcohol use and will be tailored to age, gender, drinking motives and alcohol consumption. Study participants will be followed up at three, six and nine months in the ProWISE-TIP trial and at one and two years in the ProHEAD consortium. Primary outcome is alcohol use in the past 30 days at nine months after enrolment. Secondary outcomes are alcohol-related problems, co-occurring substance use, health service utilisation, mental health problems and quality of life. DISCUSSION Trial results will generate important evidence on how to enhance effectiveness of single-session, web-based alcohol interventions for youth. The ProWISE-TIP intervention, if effective, can be used as a stand-alone alcohol intervention or as an add-on to school-based or community-based alcohol prevention programs. TRIAL REGISTRATION German Clinical Trials Register, DRKS00014606 Registered on 20 April 2018.
Collapse
Affiliation(s)
- Silke Diestelkamp
- University Hospital Hamburg-Eppendorf, German Center for Addiction Research in Childhood and Adolescence, Martinistr. 52, W29, 20246 Hamburg, Germany
| | - Lutz Wartberg
- University Hospital Hamburg-Eppendorf, German Center for Addiction Research in Childhood and Adolescence, Martinistr. 52, W29, 20246 Hamburg, Germany
| | - Michael Kaess
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, Heidelberg University Hospital, Blumenstraße 8, 69115 Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Stöckli, 3000 Bern 60, Switzerland
| | - Stephanie Bauer
- Centre for Psychotherapy Research, University Hospital Heidelberg, Bergheimer Straße 54, 69115 Heidelberg, Germany
| | - Christine Rummel-Kluge
- Clinic and Policlinic of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Hans-Sachs-Str. 6, 35039 Marburg, Germany
| | - Heike Eschenbeck
- Department of Psychology, University of Education Schwäbisch Gmünd, Oberbettringer Str. 200, 73525 Schwäbisch Gmünd, Germany
| | - Hans-Joachim Salize
- Mental Health Services Research Group, Central Institute of Mental Health, Medical Faculty Mannheim /Heidelberg University, Germany, J5, 68159 Mannheim, Germany
| | - Markus Moessner
- Centre for Psychotherapy Research, University Hospital Heidelberg, Bergheimer Straße 54, 69115 Heidelberg, Germany
| | - Christiane Baldus
- University Hospital Hamburg-Eppendorf, German Center for Addiction Research in Childhood and Adolescence, Martinistr. 52, W29, 20246 Hamburg, Germany
| | - Nicolas Arnaud
- University Hospital Hamburg-Eppendorf, German Center for Addiction Research in Childhood and Adolescence, Martinistr. 52, W29, 20246 Hamburg, Germany
| | - Rainer Thomasius
- University Hospital Hamburg-Eppendorf, German Center for Addiction Research in Childhood and Adolescence, Martinistr. 52, W29, 20246 Hamburg, Germany
| |
Collapse
|