Smartphones and health apps are ubiquitous globally, representing an innovative means to scale access to low-threshold strategies that help individuals reduceharmful alcohol use. This randomized trial tested a tailored, adaptive text-messaging intervention to see if it could help.
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The majority of treatments to address alcohol use disorder are designed for those with more severe profiles and largely intended to help individuals achieve complete abstinence. However, the vast majority of people who meet criteria have mild forms of the disorder and do not perceive a need for more formal alcohol treatment. Even among those that do perceive a need, barriers such as stigma, cost, and accessibility may prevent people from engaging with these services. Innovative, scalable approaches for those interested in quitting or cutting down on their drinking but who have not or will not receive formal treatment can more comprehensively reduce the public health burden of harmful and hazardous alcohol use.
One promising approach for offering low-threshold drinking reduction interventions at scale to at-risk drinkers is via smartphone-based text messaging, as most people have access to a smartphone with text-messaging capabilities. Though only a small number of clinical studies evaluating text messaging interventions for reducing harmful drinking have been conducted, evidence suggests that these interventions produce modest effects for reducing binge drinking and negative alcohol use consequences that generally hold up after access to the study intervention has ended.
Technology-based interventions like text messaging offer the ability to tailor intervention content based on participant baseline characteristics (e.g., demographics, self-efficacy), as well as adapted to their changing goals over time (i.e., abstinence vs. lower-risk alcohol use). In preliminary work, a tailored, adapted text message intervention produced greater reductions in drinking outcomes at 12 weeks compared to a more straightforward drink tracking intervention. The present study sought to extend this work by comparing two types of tailored text messaging interventions to daily tracking for reducing drinking outcomes over 6 months among adults who intended to reduce their drinking.
This was a 3-arm randomized clinical trial in which individuals (N =723) who reported consuming at least 9 and 11 standard drinks per week (for women and men, respectively) and intended to reduce their drinking to lower-risk levels were randomly assigned to receive 6 months of one of 3 text messaging interventions: 1) drink tracking only, an active comparison condition (n=244), 2) daily text messages that were tailored ‘statically’ (see below; n=240), or 3) daily text messages that were tailored and ‘adaptive’ (see below; n=239). Those initially interested in abstinence were ineligible to participate.
The comparison condition consisted of a weekly assessment administered each Sunday throughout the study period via text message asking participants to track past-week drinking. An email with results from each assessment was sent to the participant.
The condition with tailored, but static messages consisted of personalized daily text messages that were tailored to the participant’s baseline assessment (e.g., age, gender, self-efficacy). For example, participants below the median cut-off score for self-efficacy received text messages reminding them to be compassionate with themselves and to avoid situations in which engaging in heavy drinking might be a temptation. The “branch” of messages received in this condition depended only on baseline assessment factors.
Those in the condition with messages adaptively tailored, in addition to all the features of the other two conditions, received text messages that could change based on participants preferred drinking goals (i.e., if they chose later to abstain vs. engage in lower-risk drinking) and whether they were meeting these goals or not. After 1 month of study participation, this group was asked also to engage in a 30-day abstinence trial, after which, they were given the option to choose abstinence or moderation-focused messages. This group was also asked each week to indicate whether they had met their drinking goals for the previous week, and based on their response, text messages were adapted accordingly. Finally, the adaptive condition was also able to actively seek support or encouragement by texting certain keywords. After 6 months, all conditions continued to receive the daily tracking text messages for 6 more months (i.e., until 12 months post-baseline). Participants in intervention groups started receiving text messages associated with their study condition within 1 day of randomization and all text messages were automatically disabled after 6 months.
Drinking outcomes were assessed at 1-, 3-, 6-, and 12-months post-randomization. The primary outcome in this study was total drinks each week derived from the average number of days alcohol was consumed per week multiplied by the average number of drinks per drinking day at the 6-month follow-up, using the US definition of a standard drink (14 grams of ethanol; i.e., 12 oz beer, 5 oz wine, or 1.5 oz liquor). Secondary outcomes included number of drinking days, drinks per drinking day, number of heavy drinking days (4+ drinks), largest number of drinks in one sitting, low-risky drinking (defined in this study as 7 or fewer drinks per week for women or 14 or fewer drinks per week for men), drinking-related self-efficacy, and alcohol-related consequences.
The primary hypothesis was that the adaptive intervention group would experience greater reductions in drinking outcomes at 6-month follow-up compared to the comparison group; they did not make any predictions regarding the adaptive versus the static intervention, though there was an implied hypothesis that the adaptive intervention would outperform both other conditions.
Adaptive text messaging outperformed drink tracking comparison, but not static text messaging
The primary hypothesis that the adaptive intervention would result in greater reductions in drinking outcomes at 6-month follow-up relative to the comparison group was largely supported. Participants in the adaptive text messaging group reduced their weekly number of drinks between baseline and 6-month follow-up more than the comparison, from 28.7 to 12.5 weekly drinks (16.2 drink reduction), though this reduction was similar to the static text message intervention. Regarding secondary outcomes, adaptive text messaging resulted in greater decreases in drinks per drinking day and number of drinking days relative to comparison. Again, however, the adaptive and static interventions had similar outcomes on these measures.
Overall, both the adaptive and static text messaging interventions produced larger decreases in weekly number of drinks relative to comparison at 1 and 3-month follow-ups, with the adaptive intervention also showing greater reductions at 6-month follow-up. That said – the comparison group – where participants were prompted just once a week about their alcohol use in the prior week – also had noteworthy reductions in their drinking from 25 to 15 weekly drinks, a 40% reduction (see Figure below).
Also worth noting, in this study of individuals without severe alcohol use disorder who were explicitly interested in reducing – but not quitting – drinking, only 4.6% of participants in the adaptive condition – where participants could change their drinking goal – opted into abstinence-focused messages.
Adaptive text messaging advantages over drink tracking messages do not sustain over time
The personalized text message groups had modest sized advantages over the comparison drink tracking on drinking reductions from baseline to 3-month follow-up; over time, however, the text intervention groups maintained gains while the comparison group experienced a slight further improvement. At 12-month follow-up, there were no notable differences in weekly alcohol use with participants across all 3 groups drinking 15 drinks per week, on average, down from 25-30 at baseline.
In this randomized controlled trial for individuals with risky drinking interested in reducing but not quitting alcohol use, an adaptive text message intervention did slightly better, initially, than daily drink tracking alone. This study adds to existing evidence suggesting that personalized, adaptive digital support shows promise for helping individuals to quit or cut down on their drinking. On the whole, however, a static intervention – where content was determined by factors measured at the beginning of the study – was just as helpful in reducing hazardous and harmful alcohol use as an adaptive intervention which tailored content to participant goals and functioning as they changed over time. Even more, in this group of participants interested in reducing their alcohol use, those receiving only a text reminder to document their prior week’s alcohol use as well as an email with follow-up with results – had a 40% reduction in weekly drinks over the course of the study.
It may be that the very nature of ongoing text messages with some level of personalization accounts for the benefits from both the static and adaptive tailored text messaging, such that additional features (e.g., tailoring for meeting one’s weekly goals or not) do not add further benefit. There appear to be helpful aspects of any reminders to self-monitor alcohol use. It seems unlikely, however, that general encouragement to track alcohol use (e.g., by a primary care physician) would produce similar benefits. Text reminders, especially in context of a study involving multiple assessments over time, may help drive or reinforce participant efforts to reduce their alcohol use. While there may be room for improvement with these tailored text message interventions, it is encouraging that these text message interventions, even those with relatively simple personalization or straightforward reminders to track drinking, all had large reductions in weekly alcohol use that were maintained over time.
Of note, the largest drinking reductions occurred within the first 3 months, after which the changes leveled off. Prior work has shown that ongoing recovery support provided via text messaging can be beneficial for promoting improved outcomes up to 12 months. As a whole, findings from this study underscore the potential for digital technologies to deliver remote, personalized, scalable, potentially cost-effective solutions that can more comprehensively address varied patterns of drinking associated with alcohol use disorder, especially for those with mild alcohol use disorder or with hazardous drinking but not meeting clinical criteria.
This randomized controlled trial showed that either adaptive or static, tailored text-messages produced somewhat greater reductions in number of weekly drinks and other drinking outcomes than a text-message reminder to track one’s alcohol use. However, the group receiving reminders to track their weekly alcohol use experienced quite similar reductions on alcohol use as the other groups across 1 year. Overall, this suggests that text messages facilitating reflection about one’s alcohol use hold promise as low-threshold, scalable, cost-effective public health solutions to address risky alcohol use. However, more research is needed to better understand the ways in which text-messaging interventions can be delivered to maximize effectiveness, as well as ways to provide continued superior benefits up to 1 year and beyond.
Muench, F., Madden, S. P., Oommen, S., Forthal, S., Srinagesh, A., Stadler, G., … & Morgenstern, J. (2023). Automated, tailored adaptive mobile messaging to reduce alcohol consumption in help‐seeking adults: A randomized controlled trial. Addiction, 119(3), 530-543. doi.org/10.1111/add.16391
l
The majority of treatments to address alcohol use disorder are designed for those with more severe profiles and largely intended to help individuals achieve complete abstinence. However, the vast majority of people who meet criteria have mild forms of the disorder and do not perceive a need for more formal alcohol treatment. Even among those that do perceive a need, barriers such as stigma, cost, and accessibility may prevent people from engaging with these services. Innovative, scalable approaches for those interested in quitting or cutting down on their drinking but who have not or will not receive formal treatment can more comprehensively reduce the public health burden of harmful and hazardous alcohol use.
One promising approach for offering low-threshold drinking reduction interventions at scale to at-risk drinkers is via smartphone-based text messaging, as most people have access to a smartphone with text-messaging capabilities. Though only a small number of clinical studies evaluating text messaging interventions for reducing harmful drinking have been conducted, evidence suggests that these interventions produce modest effects for reducing binge drinking and negative alcohol use consequences that generally hold up after access to the study intervention has ended.
Technology-based interventions like text messaging offer the ability to tailor intervention content based on participant baseline characteristics (e.g., demographics, self-efficacy), as well as adapted to their changing goals over time (i.e., abstinence vs. lower-risk alcohol use). In preliminary work, a tailored, adapted text message intervention produced greater reductions in drinking outcomes at 12 weeks compared to a more straightforward drink tracking intervention. The present study sought to extend this work by comparing two types of tailored text messaging interventions to daily tracking for reducing drinking outcomes over 6 months among adults who intended to reduce their drinking.
This was a 3-arm randomized clinical trial in which individuals (N =723) who reported consuming at least 9 and 11 standard drinks per week (for women and men, respectively) and intended to reduce their drinking to lower-risk levels were randomly assigned to receive 6 months of one of 3 text messaging interventions: 1) drink tracking only, an active comparison condition (n=244), 2) daily text messages that were tailored ‘statically’ (see below; n=240), or 3) daily text messages that were tailored and ‘adaptive’ (see below; n=239). Those initially interested in abstinence were ineligible to participate.
The comparison condition consisted of a weekly assessment administered each Sunday throughout the study period via text message asking participants to track past-week drinking. An email with results from each assessment was sent to the participant.
The condition with tailored, but static messages consisted of personalized daily text messages that were tailored to the participant’s baseline assessment (e.g., age, gender, self-efficacy). For example, participants below the median cut-off score for self-efficacy received text messages reminding them to be compassionate with themselves and to avoid situations in which engaging in heavy drinking might be a temptation. The “branch” of messages received in this condition depended only on baseline assessment factors.
Those in the condition with messages adaptively tailored, in addition to all the features of the other two conditions, received text messages that could change based on participants preferred drinking goals (i.e., if they chose later to abstain vs. engage in lower-risk drinking) and whether they were meeting these goals or not. After 1 month of study participation, this group was asked also to engage in a 30-day abstinence trial, after which, they were given the option to choose abstinence or moderation-focused messages. This group was also asked each week to indicate whether they had met their drinking goals for the previous week, and based on their response, text messages were adapted accordingly. Finally, the adaptive condition was also able to actively seek support or encouragement by texting certain keywords. After 6 months, all conditions continued to receive the daily tracking text messages for 6 more months (i.e., until 12 months post-baseline). Participants in intervention groups started receiving text messages associated with their study condition within 1 day of randomization and all text messages were automatically disabled after 6 months.
Drinking outcomes were assessed at 1-, 3-, 6-, and 12-months post-randomization. The primary outcome in this study was total drinks each week derived from the average number of days alcohol was consumed per week multiplied by the average number of drinks per drinking day at the 6-month follow-up, using the US definition of a standard drink (14 grams of ethanol; i.e., 12 oz beer, 5 oz wine, or 1.5 oz liquor). Secondary outcomes included number of drinking days, drinks per drinking day, number of heavy drinking days (4+ drinks), largest number of drinks in one sitting, low-risky drinking (defined in this study as 7 or fewer drinks per week for women or 14 or fewer drinks per week for men), drinking-related self-efficacy, and alcohol-related consequences.
The primary hypothesis was that the adaptive intervention group would experience greater reductions in drinking outcomes at 6-month follow-up compared to the comparison group; they did not make any predictions regarding the adaptive versus the static intervention, though there was an implied hypothesis that the adaptive intervention would outperform both other conditions.
Adaptive text messaging outperformed drink tracking comparison, but not static text messaging
The primary hypothesis that the adaptive intervention would result in greater reductions in drinking outcomes at 6-month follow-up relative to the comparison group was largely supported. Participants in the adaptive text messaging group reduced their weekly number of drinks between baseline and 6-month follow-up more than the comparison, from 28.7 to 12.5 weekly drinks (16.2 drink reduction), though this reduction was similar to the static text message intervention. Regarding secondary outcomes, adaptive text messaging resulted in greater decreases in drinks per drinking day and number of drinking days relative to comparison. Again, however, the adaptive and static interventions had similar outcomes on these measures.
Overall, both the adaptive and static text messaging interventions produced larger decreases in weekly number of drinks relative to comparison at 1 and 3-month follow-ups, with the adaptive intervention also showing greater reductions at 6-month follow-up. That said – the comparison group – where participants were prompted just once a week about their alcohol use in the prior week – also had noteworthy reductions in their drinking from 25 to 15 weekly drinks, a 40% reduction (see Figure below).
Also worth noting, in this study of individuals without severe alcohol use disorder who were explicitly interested in reducing – but not quitting – drinking, only 4.6% of participants in the adaptive condition – where participants could change their drinking goal – opted into abstinence-focused messages.
Adaptive text messaging advantages over drink tracking messages do not sustain over time
The personalized text message groups had modest sized advantages over the comparison drink tracking on drinking reductions from baseline to 3-month follow-up; over time, however, the text intervention groups maintained gains while the comparison group experienced a slight further improvement. At 12-month follow-up, there were no notable differences in weekly alcohol use with participants across all 3 groups drinking 15 drinks per week, on average, down from 25-30 at baseline.
In this randomized controlled trial for individuals with risky drinking interested in reducing but not quitting alcohol use, an adaptive text message intervention did slightly better, initially, than daily drink tracking alone. This study adds to existing evidence suggesting that personalized, adaptive digital support shows promise for helping individuals to quit or cut down on their drinking. On the whole, however, a static intervention – where content was determined by factors measured at the beginning of the study – was just as helpful in reducing hazardous and harmful alcohol use as an adaptive intervention which tailored content to participant goals and functioning as they changed over time. Even more, in this group of participants interested in reducing their alcohol use, those receiving only a text reminder to document their prior week’s alcohol use as well as an email with follow-up with results – had a 40% reduction in weekly drinks over the course of the study.
It may be that the very nature of ongoing text messages with some level of personalization accounts for the benefits from both the static and adaptive tailored text messaging, such that additional features (e.g., tailoring for meeting one’s weekly goals or not) do not add further benefit. There appear to be helpful aspects of any reminders to self-monitor alcohol use. It seems unlikely, however, that general encouragement to track alcohol use (e.g., by a primary care physician) would produce similar benefits. Text reminders, especially in context of a study involving multiple assessments over time, may help drive or reinforce participant efforts to reduce their alcohol use. While there may be room for improvement with these tailored text message interventions, it is encouraging that these text message interventions, even those with relatively simple personalization or straightforward reminders to track drinking, all had large reductions in weekly alcohol use that were maintained over time.
Of note, the largest drinking reductions occurred within the first 3 months, after which the changes leveled off. Prior work has shown that ongoing recovery support provided via text messaging can be beneficial for promoting improved outcomes up to 12 months. As a whole, findings from this study underscore the potential for digital technologies to deliver remote, personalized, scalable, potentially cost-effective solutions that can more comprehensively address varied patterns of drinking associated with alcohol use disorder, especially for those with mild alcohol use disorder or with hazardous drinking but not meeting clinical criteria.
This randomized controlled trial showed that either adaptive or static, tailored text-messages produced somewhat greater reductions in number of weekly drinks and other drinking outcomes than a text-message reminder to track one’s alcohol use. However, the group receiving reminders to track their weekly alcohol use experienced quite similar reductions on alcohol use as the other groups across 1 year. Overall, this suggests that text messages facilitating reflection about one’s alcohol use hold promise as low-threshold, scalable, cost-effective public health solutions to address risky alcohol use. However, more research is needed to better understand the ways in which text-messaging interventions can be delivered to maximize effectiveness, as well as ways to provide continued superior benefits up to 1 year and beyond.
Muench, F., Madden, S. P., Oommen, S., Forthal, S., Srinagesh, A., Stadler, G., … & Morgenstern, J. (2023). Automated, tailored adaptive mobile messaging to reduce alcohol consumption in help‐seeking adults: A randomized controlled trial. Addiction, 119(3), 530-543. doi.org/10.1111/add.16391
l
The majority of treatments to address alcohol use disorder are designed for those with more severe profiles and largely intended to help individuals achieve complete abstinence. However, the vast majority of people who meet criteria have mild forms of the disorder and do not perceive a need for more formal alcohol treatment. Even among those that do perceive a need, barriers such as stigma, cost, and accessibility may prevent people from engaging with these services. Innovative, scalable approaches for those interested in quitting or cutting down on their drinking but who have not or will not receive formal treatment can more comprehensively reduce the public health burden of harmful and hazardous alcohol use.
One promising approach for offering low-threshold drinking reduction interventions at scale to at-risk drinkers is via smartphone-based text messaging, as most people have access to a smartphone with text-messaging capabilities. Though only a small number of clinical studies evaluating text messaging interventions for reducing harmful drinking have been conducted, evidence suggests that these interventions produce modest effects for reducing binge drinking and negative alcohol use consequences that generally hold up after access to the study intervention has ended.
Technology-based interventions like text messaging offer the ability to tailor intervention content based on participant baseline characteristics (e.g., demographics, self-efficacy), as well as adapted to their changing goals over time (i.e., abstinence vs. lower-risk alcohol use). In preliminary work, a tailored, adapted text message intervention produced greater reductions in drinking outcomes at 12 weeks compared to a more straightforward drink tracking intervention. The present study sought to extend this work by comparing two types of tailored text messaging interventions to daily tracking for reducing drinking outcomes over 6 months among adults who intended to reduce their drinking.
This was a 3-arm randomized clinical trial in which individuals (N =723) who reported consuming at least 9 and 11 standard drinks per week (for women and men, respectively) and intended to reduce their drinking to lower-risk levels were randomly assigned to receive 6 months of one of 3 text messaging interventions: 1) drink tracking only, an active comparison condition (n=244), 2) daily text messages that were tailored ‘statically’ (see below; n=240), or 3) daily text messages that were tailored and ‘adaptive’ (see below; n=239). Those initially interested in abstinence were ineligible to participate.
The comparison condition consisted of a weekly assessment administered each Sunday throughout the study period via text message asking participants to track past-week drinking. An email with results from each assessment was sent to the participant.
The condition with tailored, but static messages consisted of personalized daily text messages that were tailored to the participant’s baseline assessment (e.g., age, gender, self-efficacy). For example, participants below the median cut-off score for self-efficacy received text messages reminding them to be compassionate with themselves and to avoid situations in which engaging in heavy drinking might be a temptation. The “branch” of messages received in this condition depended only on baseline assessment factors.
Those in the condition with messages adaptively tailored, in addition to all the features of the other two conditions, received text messages that could change based on participants preferred drinking goals (i.e., if they chose later to abstain vs. engage in lower-risk drinking) and whether they were meeting these goals or not. After 1 month of study participation, this group was asked also to engage in a 30-day abstinence trial, after which, they were given the option to choose abstinence or moderation-focused messages. This group was also asked each week to indicate whether they had met their drinking goals for the previous week, and based on their response, text messages were adapted accordingly. Finally, the adaptive condition was also able to actively seek support or encouragement by texting certain keywords. After 6 months, all conditions continued to receive the daily tracking text messages for 6 more months (i.e., until 12 months post-baseline). Participants in intervention groups started receiving text messages associated with their study condition within 1 day of randomization and all text messages were automatically disabled after 6 months.
Drinking outcomes were assessed at 1-, 3-, 6-, and 12-months post-randomization. The primary outcome in this study was total drinks each week derived from the average number of days alcohol was consumed per week multiplied by the average number of drinks per drinking day at the 6-month follow-up, using the US definition of a standard drink (14 grams of ethanol; i.e., 12 oz beer, 5 oz wine, or 1.5 oz liquor). Secondary outcomes included number of drinking days, drinks per drinking day, number of heavy drinking days (4+ drinks), largest number of drinks in one sitting, low-risky drinking (defined in this study as 7 or fewer drinks per week for women or 14 or fewer drinks per week for men), drinking-related self-efficacy, and alcohol-related consequences.
The primary hypothesis was that the adaptive intervention group would experience greater reductions in drinking outcomes at 6-month follow-up compared to the comparison group; they did not make any predictions regarding the adaptive versus the static intervention, though there was an implied hypothesis that the adaptive intervention would outperform both other conditions.
Adaptive text messaging outperformed drink tracking comparison, but not static text messaging
The primary hypothesis that the adaptive intervention would result in greater reductions in drinking outcomes at 6-month follow-up relative to the comparison group was largely supported. Participants in the adaptive text messaging group reduced their weekly number of drinks between baseline and 6-month follow-up more than the comparison, from 28.7 to 12.5 weekly drinks (16.2 drink reduction), though this reduction was similar to the static text message intervention. Regarding secondary outcomes, adaptive text messaging resulted in greater decreases in drinks per drinking day and number of drinking days relative to comparison. Again, however, the adaptive and static interventions had similar outcomes on these measures.
Overall, both the adaptive and static text messaging interventions produced larger decreases in weekly number of drinks relative to comparison at 1 and 3-month follow-ups, with the adaptive intervention also showing greater reductions at 6-month follow-up. That said – the comparison group – where participants were prompted just once a week about their alcohol use in the prior week – also had noteworthy reductions in their drinking from 25 to 15 weekly drinks, a 40% reduction (see Figure below).
Also worth noting, in this study of individuals without severe alcohol use disorder who were explicitly interested in reducing – but not quitting – drinking, only 4.6% of participants in the adaptive condition – where participants could change their drinking goal – opted into abstinence-focused messages.
Adaptive text messaging advantages over drink tracking messages do not sustain over time
The personalized text message groups had modest sized advantages over the comparison drink tracking on drinking reductions from baseline to 3-month follow-up; over time, however, the text intervention groups maintained gains while the comparison group experienced a slight further improvement. At 12-month follow-up, there were no notable differences in weekly alcohol use with participants across all 3 groups drinking 15 drinks per week, on average, down from 25-30 at baseline.
In this randomized controlled trial for individuals with risky drinking interested in reducing but not quitting alcohol use, an adaptive text message intervention did slightly better, initially, than daily drink tracking alone. This study adds to existing evidence suggesting that personalized, adaptive digital support shows promise for helping individuals to quit or cut down on their drinking. On the whole, however, a static intervention – where content was determined by factors measured at the beginning of the study – was just as helpful in reducing hazardous and harmful alcohol use as an adaptive intervention which tailored content to participant goals and functioning as they changed over time. Even more, in this group of participants interested in reducing their alcohol use, those receiving only a text reminder to document their prior week’s alcohol use as well as an email with follow-up with results – had a 40% reduction in weekly drinks over the course of the study.
It may be that the very nature of ongoing text messages with some level of personalization accounts for the benefits from both the static and adaptive tailored text messaging, such that additional features (e.g., tailoring for meeting one’s weekly goals or not) do not add further benefit. There appear to be helpful aspects of any reminders to self-monitor alcohol use. It seems unlikely, however, that general encouragement to track alcohol use (e.g., by a primary care physician) would produce similar benefits. Text reminders, especially in context of a study involving multiple assessments over time, may help drive or reinforce participant efforts to reduce their alcohol use. While there may be room for improvement with these tailored text message interventions, it is encouraging that these text message interventions, even those with relatively simple personalization or straightforward reminders to track drinking, all had large reductions in weekly alcohol use that were maintained over time.
Of note, the largest drinking reductions occurred within the first 3 months, after which the changes leveled off. Prior work has shown that ongoing recovery support provided via text messaging can be beneficial for promoting improved outcomes up to 12 months. As a whole, findings from this study underscore the potential for digital technologies to deliver remote, personalized, scalable, potentially cost-effective solutions that can more comprehensively address varied patterns of drinking associated with alcohol use disorder, especially for those with mild alcohol use disorder or with hazardous drinking but not meeting clinical criteria.
This randomized controlled trial showed that either adaptive or static, tailored text-messages produced somewhat greater reductions in number of weekly drinks and other drinking outcomes than a text-message reminder to track one’s alcohol use. However, the group receiving reminders to track their weekly alcohol use experienced quite similar reductions on alcohol use as the other groups across 1 year. Overall, this suggests that text messages facilitating reflection about one’s alcohol use hold promise as low-threshold, scalable, cost-effective public health solutions to address risky alcohol use. However, more research is needed to better understand the ways in which text-messaging interventions can be delivered to maximize effectiveness, as well as ways to provide continued superior benefits up to 1 year and beyond.
Muench, F., Madden, S. P., Oommen, S., Forthal, S., Srinagesh, A., Stadler, G., … & Morgenstern, J. (2023). Automated, tailored adaptive mobile messaging to reduce alcohol consumption in help‐seeking adults: A randomized controlled trial. Addiction, 119(3), 530-543. doi.org/10.1111/add.16391
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