Text Message Intervention for Alcohol Consumption

(ASPIRE Trial)

Overseen By Brian Suffoletto, MD, MS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: College enrollment, Military, Pregnancy, Prisoner, Substance treatment

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 months

300 Participants Needed

Trial Summary

What is the purpose of this trial?

This project aims to test the efficacy of a text message intervention, ASPIRE, designed to address cognitive and behavioral elements and modify exposure to peers that influence drinking behaviors. Young adults who are contemplating reducing their drinking will be recruited from a national sample and randomized to ASPIRE versus a text message intervention focused solely on cognitive and behavioral elements. We will measure effectiveness at 3, 6, and 12 months, study mechanisms driving behavior change, and identify which subgroups stand to benefit most.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, it does exclude those who are currently in treatment for alcohol or substance use disorder.

What data supports the effectiveness of the treatment ASPIRE for reducing alcohol consumption?

Research shows that supportive text messaging can help reduce alcohol consumption, as seen in studies where text messages improved outcomes for people with alcohol use disorder and those who have completed detoxification. ^{1 2 3 4 5}

Is the text message intervention for alcohol consumption safe for humans?

Research on text message interventions for alcohol consumption suggests they are generally safe, as studies focus on their feasibility and acceptability without reporting significant safety concerns. ^{6 7 8 9 10}

How is the ASPIRE text message treatment for alcohol consumption different from other treatments?

The ASPIRE text message treatment is unique because it uses mobile phone text messages to provide real-time, cost-effective support for reducing alcohol consumption, especially targeting younger adults and university students who may not seek traditional help. This approach is novel as it offers continuous, adaptive goal support in a non-intrusive way, unlike standard treatments that often require in-person sessions. ^{10 11 12 13 14}

Research Team

Brian Suffoletto, MD

Principal Investigator

Stanford University

Eligibility Criteria

The ASPIRE trial is for young adults aged 18-25 in the U.S. who want to cut down on drinking and own a mobile phone with SMS. They must read English and have had days in the past month with heavy drinking (4+ drinks for women, 5+ for men).

Inclusion Criteria

I live in the U.S.

I can read and understand English.

I own a mobile phone capable of sending and receiving texts.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive text message interventions designed to address cognitive, behavioral, and peer influences on drinking behaviors

12 months

Ongoing virtual engagement through text messages

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Treatment Details

Interventions

• ASPIRE

Trial Overview ASPIRE tests a text message intervention aimed at reducing alcohol consumption by addressing how thinking, behavior, and peers influence drinking. Participants are randomly assigned to ASPIRE or a control group focusing only on cognitive and behavioral aspects.

Participant Groups

Group I: A text message alcohol intervention focused on cognitive, behavioral, and peer influences Experimental Treatment 1 Intervention

Group II: A text message alcohol intervention focused on cognitive and behavioral influences Active Control 1 Intervention

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials

865

Recruited

1,091,000+

Findings from Research

In a study of 54 participants with depression and alcohol use disorder, those receiving supportive text messages showed significantly lower depression scores after three months compared to the control group, indicating improved mood.

While the text message group also tended to have longer periods of abstinence from alcohol, the difference was not statistically significant, suggesting that supportive messaging may help but further research is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial. Agyapong, VI., Ahern, S., McLoughlin, DM., et al.[2022]

A 1-year SMS intervention significantly reduced heavy drinking among 462 patients with alcohol dependence after detoxification, with 22.2% in the intervention group compared to 32.3% in the treatment as usual group.

The SMS intervention showed an odds ratio of 1.68 for reducing heavy drinking, indicating it was effective in promoting better drinking outcomes compared to standard treatment alone.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a 1-year short message service in detoxified alcohol-dependent patients: a multi-center, open-label randomized controlled trial. Lucht, M., Quellmalz, A., Mende, M., et al.[2021]

A study involving 59 patients with alcohol use disorder showed that supportive text messaging after treatment can significantly extend the time before a patient has their first drink, with the intervention group averaging about 60 days compared to 26 days for the control group.

The text messaging intervention also demonstrated small to moderate improvements in cumulative abstinence duration and alcohol consumption, indicating it could be a valuable follow-up care tool for patients after residential treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized controlled pilot trial of supportive text messaging for alcohol use disorder patients. Agyapong, VIO., Juhás, M., Mrklas, K., et al.[2019]

In a 12-week pilot study with 152 participants, daily remote text messaging interventions significantly reduced alcohol consumption and heavy drinking days compared to weekly self-tracking messages, indicating their potential as effective stand-alone tools for problem drinkers.

Among the different types of messages tested, tailored adaptive texts showed the largest effect sizes in reducing drinking frequency and quantity, suggesting that personalized messaging may enhance the effectiveness of alcohol reduction strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Pilot Trial of Different Mobile Messaging Interventions for Problem Drinking Compared to Weekly Drink Tracking. Muench, F., van Stolk-Cooke, K., Kuerbis, A., et al.[2022]

The text message-based aftercare program for alcohol outpatients was well accepted, with participants responding to 88.1% of prompts, indicating high engagement with the intervention.

At follow-up, the program showed a trend towards reduced at-risk alcohol use (28.6% in the intervention group vs. 41.7% in the control group), suggesting potential effectiveness that warrants further testing in a larger trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot study on the feasibility and acceptability of a text message-based aftercare treatment programme among alcohol outpatients. Haug, S., Lucht, MJ., John, U., et al.[2015]

The smartphone-based intervention aimed at reducing risky drinking in young adults did not significantly decrease risky drinking behaviors or related harms, based on a pilot study involving 45 participants.

However, the intervention successfully increased the use of protective behavioral strategies among users, and participants rated the app as highly usable, indicating potential for future improvements in harm-minimization approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Delivering Personalized Protective Behavioral Drinking Strategies via a Smartphone Intervention: a Pilot Study. O'Donnell, R., Richardson, B., Fuller-Tyszkiewicz, M., et al.[2020]

In a study involving 26 patients with alcohol use disorder and depression, 75% reported that supportive text messages helped remind them to stay abstinent from alcohol.

83% of participants felt that these text messages were useful for improving their mental health, motivating their recovery, and preventing relapse.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perception of patients with alcohol use disorder and comorbid depression about the usefulness of supportive text messages. Agyapong, VI., Milnes, J., McLoughlin, DM., et al.[2015]

An automated text messaging system was tested with 39 adolescents and young adults in a pilot study, showing high feasibility with 63% enrollment and 89.7% retention after baseline assessments.

Participants reported a positive experience with the text messages, especially those that were supportive and empowering, indicating that text messaging can effectively complement substance use interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Text message reminders as an adjunct to a substance use intervention for adolescents and young adults: Pilot feasibility and acceptability findings. Schwebel, FJ., Larimer, ME.[2022]

A meta-analysis of studies published between 2010 and 2018 found that mobile phone text messaging interventions were not effective in reducing alcohol intake among youth and younger adults.

The analysis included randomized control trials and pre-post studies that focused on problem drinking criteria set by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of Mobile Phone-Based Text Messaging to Intervene with Problem Drinking in Youth and Younger Adult Population: A Meta-Analysis. Bastola, MM., Locatis, C., Maisiak, R., et al.[2021]

The TRAC2 text message intervention effectively engaged nontreatment-seeking young adults, with an average response rate of 82% to ecological momentary assessments (EMAs) during the first 4-week block, indicating strong participant involvement.

Participants showed high commitment to drinking limit goals (96% commitment rate) and achieved their goals 89% of the time, suggesting that the intervention successfully supported self-regulation and reduced alcohol consumption over a 3-month follow-up period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Text Message Intervention with Adaptive Goal Support to Reduce Alcohol Consumption Among Non-Treatment-Seeking Young Adults: Non-Randomized Clinical Trial with Voluntary Length of Enrollment. Suffoletto, B., Chung, T., Muench, F., et al.[2020]

An 8-week SMS-based intervention for alcohol-dependent patients after detoxification showed good feasibility and acceptability, with 57.14% of participants responding to at least half of the prompts.

While 55.7% of patients in the SMS group achieved low-risk alcohol consumption compared to 40% in the treatment as usual group, the difference was not statistically significant, indicating the need for further research with larger sample sizes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A surveillance tool using mobile phone short message service to reduce alcohol consumption among alcohol-dependent patients. Lucht, MJ., Hoffman, L., Haug, S., et al.[2017]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Effect of a 1-year short message service in detoxified alcohol-dependent patients: a multi-center, open-label randomized controlled trial. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Randomized controlled pilot trial of supportive text messaging for alcohol use disorder patients. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Pilot Trial of Different Mobile Messaging Interventions for Problem Drinking Compared to Weekly Drink Tracking. [2022]

5. England pubmed.ncbi.nlm.nih.gov

A pilot study on the feasibility and acceptability of a text message-based aftercare treatment programme among alcohol outpatients. [2015]

6. England pubmed.ncbi.nlm.nih.gov

Delivering Personalized Protective Behavioral Drinking Strategies via a Smartphone Intervention: a Pilot Study. [2020]

7. England pubmed.ncbi.nlm.nih.gov

Automated, tailored adaptive mobile messaging to reduce alcohol consumption in help-seeking adults: A randomized controlled trial. [2023]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Perception of patients with alcohol use disorder and comorbid depression about the usefulness of supportive text messages. [2015]

9. England pubmed.ncbi.nlm.nih.gov

Comment on the paper by Suffoletto et al. entitled: Text-message-based assessments and brief intervention for young adults discharged from the emergency department. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Text message reminders as an adjunct to a substance use intervention for adolescents and young adults: Pilot feasibility and acceptability findings. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

The Effectiveness of Mobile Phone-Based Text Messaging to Intervene with Problem Drinking in Youth and Younger Adult Population: A Meta-Analysis. [2021]

12. Canada pubmed.ncbi.nlm.nih.gov

A Text Message-Based Intervention Targeting Alcohol Consumption Among University Students: User Satisfaction and Acceptability Study. [2023]

13. Canada pubmed.ncbi.nlm.nih.gov

A Text Message Intervention with Adaptive Goal Support to Reduce Alcohol Consumption Among Non-Treatment-Seeking Young Adults: Non-Randomized Clinical Trial with Voluntary Length of Enrollment. [2020]

14. England pubmed.ncbi.nlm.nih.gov

A surveillance tool using mobile phone short message service to reduce alcohol consumption among alcohol-dependent patients. [2017]