Text Message Support for Alcohol Abuse

Overseen By Tibor Palfai, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Boston University Charles River Campus

Disqualifiers: Alcohol treatment, Delirium tremens, Bipolar, Schizophrenia

Stay on Your Current Meds You can continue your current medications while participating

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

Compensation: Varies

Number of Visits: 2

Duration: 4 weeks

129 Participants Needed

Trial Summary

What is the purpose of this trial?

Heavy alcohol use among college students is associated with a range of negative consequences. However, college students rarely seek resources or treatment to change their alcohol use. Brief alcohol interventions (BAIs) have been developed as an alternative method to address heavy alcohol use among college students and show promise in reducing hazardous alcohol use in college students. Despite the established efficacy of BAIs, effects are often small and short-lived, and additional research is needed to investigate how BAIs can become more efficacious and endure for longer periods of time, particularly for computer-delivered interventions to improve accessibility and scalability of these interventions to a wider range of college students. Boosters or adjunctive components to BAIs have been suggested as a method to enhance the magnitude and duration of intervention effects. However, there remains a need to identify and test booster approaches that are both appealing and engaging to college students and effective in reducing heavy/hazardous alcohol use above and beyond the magnitude and duration seen by BAIs alone. The purpose of the study is to develop and test a novel, text-messaging booster as an adjunct to a current, evidence-based brief intervention, eCHECKUP TO GO, aimed at reducing college student heavy/hazardous alcohol use. Participants will complete baseline measures and will then be randomized to 1 of 3 conditions, stratified by sex at birth: 1) assessment only, 2) BAI only, and 3) Enhanced Intervention (BAI + four weeks of text messaging boosters). It is hypothesized that those randomized to the enhanced intervention condition will show a greater reduction in heavy/hazardous alcohol use at 3-month follow-up compared to the BAI and assessment only groups.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, if you are currently receiving treatment for alcohol or drug use, you would not be eligible to participate.

What data supports the idea that Text Message Support for Alcohol Abuse is an effective treatment?

The available research shows that text message support can be an effective treatment for alcohol abuse. A pilot study found that a text message-based aftercare program was feasible and initially effective for alcohol outpatients. Another study highlighted that supportive text messaging could improve treatment outcomes for patients with alcohol use disorder. Additionally, a systematic review indicated that text messaging interventions are acceptable and can have a positive clinical impact for people with alcohol dependence. These findings suggest that text message support is a promising and low-cost option for helping people reduce alcohol consumption. ^{1 2 3 4 5}

What safety data exists for text message support in alcohol abuse treatment?

The available research primarily focuses on the feasibility, acceptability, and clinical impact of text messaging interventions for alcohol use disorders. While these studies indicate that text messaging can be a feasible and acceptable method to support alcohol abuse treatment, there is limited empirical evidence specifically addressing the safety of these interventions. The studies reviewed do not report significant safety concerns, but they emphasize the need for further research to establish comprehensive safety data. ^{3 5 6 7 8}

Is text message support a promising treatment for alcohol abuse?

Text message support for alcohol abuse shows some potential benefits, but it might not be very effective on its own. It can be helpful when combined with other treatments, but as a stand-alone method, it may not significantly reduce alcohol intake. ^{4 6 7 9 10}

Research Team

Bonnie Rowland, MA

Principal Investigator

Boston University Charles River Campus

Eligibility Criteria

This study is for college students who engage in heavy or hazardous drinking and are not actively seeking treatment. Participants must be willing to complete baseline measures and can't be involved in other alcohol intervention studies.

Inclusion Criteria

Own a smartphone with capability to run smartphone application

Report at least 2 heavy drinking episodes in the past month

Be enrolled in an undergraduate degree program

Exclusion Criteria

Current or past-year treatment (counseling or medication) for alcohol or drug use

History of delirium tremens and/or seizures as a result of alcohol withdrawal

Lifetime diagnosis of either bipolar disorder or schizophrenia

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete baseline measures before randomization

1 week

1 visit (virtual)

Treatment

Participants receive the brief alcohol intervention, eCHECKUP TO GO, with or without text messaging boosters

4 weeks

Text messaging boosters on Monday, Thursday-Sunday for Enhanced Intervention group

Follow-up

Participants are monitored for changes in heavy/hazardous alcohol use and alcohol-related negative consequences

3 months

1 visit (virtual)

Treatment Details

Interventions

• Text messaging boosters

Trial Overview The trial tests if a text-messaging booster can improve the effectiveness of an existing online brief alcohol intervention, eCHECKUP TO GO. Students will randomly receive either just assessments, the brief intervention alone, or the intervention with text boosters.

Participant Groups

Group I: Enhanced Intervention Experimental Treatment 2 Interventions

Brief alcohol intervention, eCHECKUP TO GO, + 4 weeks of text messaging boosters (Monday, Thursday-Sunday)

Group II: Intervention (BAI) Only Active Control 1 Intervention

Only the brief alcohol intervention, eCHECKUP TO GO, is administered to this group

Group III: Assessment Only Active Control 1 Intervention

Assessment only condition, no intervention material delivered to this group

Who Is Running the Clinical Trial?

Boston University Charles River Campus

Lead Sponsor

Trials

125

Recruited

14,100+

Findings from Research

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]

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]

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 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]

Text messaging interventions for individuals with illicit drug and alcohol dependence are both acceptable and feasible, as shown by a systematic review of 11 studies.

These interventions have been associated with improved clinical outcomes, including better medication adherence and increased engagement with support groups, while also addressing various therapeutic targets like motivation and relapse prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Tofighi, B., Nicholson, JM., McNeely, J., et al.[2019]

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]

Mobile phone systems for treating alcohol-use disorders (AUDs) are categorized into four groups, with comprehensive recovery management systems showing the strongest theoretical support and longest-lasting effects.

While text-messaging applications may offer some benefits, they are likely not sufficient as standalone interventions for AUDs, highlighting the need for more robust and evidence-based solutions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mobile Delivery of Treatment for Alcohol Use Disorders: A Review of the Literature. Quanbeck, A., Chih, MY., Isham, A., et al.[2022]

A text message program sent to 224 college students showed a high engagement rate, with 90% of queries completed, and effectively reduced weekend binge drinking over 6 weeks.

The study found that students who committed to a drinking-limit goal consumed less alcohol, with men showing greater reductions in consumption compared to women, indicating the program's potential effectiveness in promoting responsible drinking behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A text message program as a booster to in-person brief interventions for mandated college students to prevent weekend binge drinking. Suffoletto, B., Merrill, JE., Chung, T., et al.[2018]

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]

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]

References

1. 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]

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

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

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

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

4. Netherlands pubmed.ncbi.nlm.nih.gov

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

5. Australia pubmed.ncbi.nlm.nih.gov

Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. [2019]

6. 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]

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

Mobile Delivery of Treatment for Alcohol Use Disorders: A Review of the Literature. [2022]

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

A text message program as a booster to in-person brief interventions for mandated college students to prevent weekend binge drinking. [2018]

9. 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]

10. 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]