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Text Messages Show Promise in Curbing Problem Drinking

December 15, 2011

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By Amanda Gardner

THURSDAY, December 15, 2011 (Health.com) — The text messaging that can drive young people to distraction—or worse, if they’re actually behind the wheel—can also be harnessed to promote better health and safety, a small new study suggests.

In the study, 15 heavy drinking young adults who sent and received weekly text messages tracking their alcohol consumption reported drinking less at the end of the 12-week program than they did at the beginning. By comparison, a group of similar 18- to 24-year-olds who sent but didn’t receive texts and a control group that sent no texts at all didn’t manage to scale back their drinking as effectively.

The findings were published today on the website of the journal Alcoholism: Clinical and Experimental Research. Although the study should be considered preliminary, given its size, the researchers say that text-message programs are a promising strategy for reducing problem drinking, as well as other dangerous or unhealthy behaviors.

Text-based interventions are an example of what’s known as “participatory health,” says lead author Brian Suffoletto, MD, an assistant professor of emergency medicine at the University of Pittsburgh. “In traditional health models, patients have been in the passenger seats in healthcare. Now…they become drivers of their own health improvement. We really think this innovation is an example of not just assisting, but engaging in self-management.”

Suffoletto and his colleagues asked the young people in the intervention group—who, like the other study participants, were identified as problem drinkers after landing in the ER—to send weekly texts tallying their drinking.

Depending on how much they drank that week, the participants received automated replies that either provided positive feedback (“Keep up the good work!”) or urged them to limit their drinks during the following week. Those who agreed to a limit received a follow-up text suggesting strategies for responsible drinking, such as counting drinks and spacing them apart.

During the last month of the study, the texters reported drinking heavily on 3.4 fewer days than they had in the month prior to the study. And when they did drink, they had about two fewer drinks, on average. (Heavy drinking was defined asconsuming five-plus drinks in a 24-hour period.)

The text messages incorporated two hallmarks of traditional alcohol counseling—self-monitoring of drinking behavior and the setting of short-term goals—but in some respects they may have improved on traditional counseling, Suffoletto says.

The study participants received immediate feedback on their drinking (instead of weekly or monthly feedback from a counselor), which may reinforce positive behaviors and provide a better picture of drinking habits. “Cell phones have become an appendage of our bodies, so for an assessment of actual drinking behavior, it potentially becomes more accurate than recalling [drinking],” Suffoletto says.

And the relative anonymity of text messaging—the participants were identified by an ID number only—may encourage candor. “Prior data has shown that youngadults are willing to disclose a lot more information through something like [a] short-message service than they would if they were face-to-face with aclinician,” Suffoletto says.

The researchers envision that text-message programs like those used in the study could be successfully applied to problematic behaviors besides drinking, such as illicit drug use or unprotected sex, and could even be used to encouragepeople to eat better, exercise more, and generally adopt and maintain healthy lifestyles.

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