An Ecological Momentary Intervention to Reduce Alcohol Consumption in Young Adults Delivered During Drinking Events: Protocol for a Pilot Randomized Controlled Trial

Abstract

BackgroundRisky drinking is a significant public health issue in young Australian adults. Brief interventions are one of few effective methods of reducing risky drinking but are time and cost intensive; innovative methods of delivery are therefore of interest. Mobile phones offer new opportunities to collect data and intervene during risky drinking events. Mobile phones have successfully been used for delivery of alcohol-related brief interventions and data collection but not in combination with or during drinking events.ObjectiveThis pilot study will investigate the efficacy of an ecological momentary intervention (EMI), with combined ecological momentary assessment (EMA) and brief intervention delivered by mobile phones to young adults during risky drinking events.MethodsWe will use a 3-armed randomized controlled trial to investigate the efficacy of the intervention for reducing peak single occasion drinking. Our sample is recruited from an observational cohort study of young, risky drinkers. Participants will be randomized into 1 of 3 intervention arms. On 6 nights across a 12-week study period, EMI and EMA groups will complete hourly EMA surveys on their mobile phone. EMI participants will receive tailored feedback short message service (SMS) texts corresponding to their EMA survey responses. The EMI participants will not receive feedback SMS. A third group will have no contact (no-contact control). All groups will then be contacted for a follow-up interview within 4 weeks of the 12-week study period ending.ResultsThe primary outcome is mean reduction in standard drinks consumed during their most recent heavy drinking occasion as measured at follow-up. Secondary outcomes include alcohol consumption over the previous 6 months, experiences of alcohol-related harms, attitudes toward drinking and drunkenness, hazardous drinking and use of tobacco and illicit drugs. A random effects mixed modelling approach using maximum likelihood estimation will be used to provide estimates of differences in mean drinking levels between those receiving the intervention and control participants.ConclusionsThis study is novel in that, unlike previous work, it will intervene repeatedly during single occasion drinking events. Further, it extends previous research in this area, which has applied limited tailoring of message content for SMS-based brief interventions. The findings of this study will contribute to the growing body of evidence to inform the use of mobile health interventions for reducing alcohol consumption and harms.Trial RegistrationAustralian New Zealand Clinical Trials ACTRN12616001323415; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=369534 (Archived by WebCite at http://www.webcitation.org/ 6qDqBZV9b)

Using technology to assess and intervene with illicit drug-using persons at risk for HIV

“…The use of text and mobile apps to record frequently-occurring behaviors and their situational correlates may be extended to trigger messages or activities to intervene on those behaviors in real time. These approaches, called “ecological momentary interventions” (or EMIs) [39], have been used to address anxiety [40, 41] and sex risk [42], alcohol [43, 44], smoking [45], and diet and weight loss [46, 47] behaviors. EMI approaches may be likewise used to assess drug use behaviors in real time to provide brief, targeted messages during risky drug events reported by participants.…”

Collegiate Binge Drinking and Social Media Use Among Hispanics and Non-Hispanics

“…For example, ecological momentary interventions (EMIs) can be used to intervene via mobile devices in real-time, at the "point of choice," when participants make decisions about drinking (Beckjord & Shiffman, 2014). Research is underway to determine the effectiveness of EMI in reducing episodic drinking when messages are deployed during a single occasion drinking event (Wright et al, 2017). However, studies from the pathological gambling literature have already shown that electronic harm-reduction messages are optimally effective "in the moment" when messages create an interruption in play and require active removal by the player (Ginley et al, 2017).…”

Mobile Phone-Based Ecological Momentary Intervention to Reduce Young Adults� Alcohol Use in the Event: A Three-Armed Randomized Controlled Trial (Preprint)

“…These messages were based on a different key variable each hour. Details of the tailoring are described in the protocol publication [26]. The messages used in the intervention were co-designed in the development study, and were underpinned by motivational interviewing and brief intervention theory [23,24].…”

“…The sample size estimate was calculated to test for a group-bytime interaction from a mixed repeated measures design, and a moderate correlation between subject measurements (r=0.45, estimated from earlier waves of YAAS data). Further details are reported in the published protocol [26].…”

“…Of the 314 eligible participants, 269 participants agreed to be contacted about the trial, and were randomised into three groups: EMI (n=90); EMA (n=89) and No contact control (n=90). Following receipt of the study information, 101 participants consented to participate through the online registration form (EMI=26, EMA=31, No contact=44), falling short of our target of 300 participants [26]. The primary reason for refusal was due to work/study commitments, but many also stated that they felt that their time in the YAAS cohort meant they had contributed enough to research.…”