EHS 345 Article Summary Paper
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University of Massachusetts, Boston *
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Course
345
Subject
Health Science
Date
Dec 6, 2023
Type
docx
Pages
5
Uploaded by collin126
Collin Davis
3/29/23
Dr. Chiofar
Assignment 2
Effectiveness of text message interventions with different behavior change techniques on alcohol
consumption among young adults: a five-arm randomized controlled trial
Problematic alcohol use is ubiquitous in young adults in America, especially those who
attend university. This patient population is less likely to seek treatment than most other as they
are usually otherwise healthy and young. This lack of connection with the healthcare system can
make problematic drinking easier to develop into actual problems. Sometimes, the only way to
get into contact with these patients is when they present to the emergency department. The paper
Effectiveness of text message interventions with different behavior change techniques on alcohol
consumption among young adults: a five-arm randomized controlled trial
by Suffoletto (2022)
takes an interesting new approach to combating potentially problematic alcohol consumption.
Decreasing hazardous drinking seems to be the aim of this study as they claim it can provide
individual as well as public health benefits (Suffoletto et al., 2022). In this current world, texting
is the most common way to communicate with someone. Young adults are especially attached to
their phones, making a texting communication option ideal for conducting research on text-
delivered interventions.
The intervention study was designed as a quantitative study that looked at a few
outcomes. Primarily the researchers sought to reduce past-month binge drinking days at 3- and 6-
month intervals. A secondary investigation looked at prevalence of any past-month binge
drinking, as well as alcohol related consequences. Alcohol related consequences refers to a 24-
item measure of issues that can arise from alcohol use. This is scored with a yes or no. This study
was designed using five different behavioral change techniques that were implemented via text
message to the participants. Selection of these participants was from emergency departments
local to the Pittsburgh, Pennsylvania area. These were non-treatment-seeking young adults that
were screened in the emergency department and enrolled in the study if they opted to. The
selection criteria were based on an alcohol use disorder test and a few other potentially
disqualifying criteria. These disqualifiers ranged from non-interest to current psychiatric
treatment to non-ownership of a cell phone with texting. Of the over six thousand people
screened, only just over eleven hundred were entered into the study. Those studied had a
somewhat mixed demographic when it came to sex and ethnicity but were all 18-25 years old
and reported hazardous drinking behaviors. These participants were enrolled into cohorts of the
five different groups at random. The five groups are listed as TRACK, PLAN, USE, GOAL, and
COMBO. These all refer to different action plans for each intervention type. The reference
model, TRACK refers to having participants respond to text prompts for them to track their
alcohol consumption with no feedback. This was to promote the behavior change model of self-
monitoring for their consumption behaviors. The PLAN group provided feedback on the
participants drinking plans and desire to get drunk on top of the TRACK self-monitoring. USE
provided post-drinking feedback to modify drinking behaviors and outlook. GOAL utilized self-
regulation to try and limit consumption and promote limiting of drinking, self-efficacy of their
goal to drink less, and feedback on success or failure to promote continued goal direction.
COMBO as the name suggests, combined all these behavioral strategies to potentially be the
most effective arm of the study. The data was collected using an automatic text-messaging
software. This data was self-reported by the participants of the study.
The results of this study were halfway consistent with the researcher’s expectations.
Reductions in binge drinking were shown, but they did not have the expected “ordered effect”
(Suffoletto et al., 2022). At the six-month follow up relative to the TRACK condition all the
groups had significant reductions in their reports of binge drinking, number of drinks per day,
and number of negative alcohol consequences. At three months the data is not as robust. Only
COMBO, USE, and GOAL had reductions in binge drinking days. Also at three months, only
COMBO and GOAL had significant reductions in negative alcohol consequences. Surprisingly at
three months PLAN and TRACK had a slight increase in number of drinking days.
This research
is very relevant across different behavior change modalities, with applications in things such as
smoking, caffeine use, or other substance use.
These data are going to be very important for the foundation of further research into
behavior change modalities in this space. The researchers believe that when it comes to this type
of behavior change, self-monitoring is not as robust of a technique as the literature may suggest.
This can be shown in the increases in binge drinking in the TRACK condition. They believe that
their data would be reinforced if conducted over longer durations of time. A definite limiter of
this randomized controlled trial is that it took place throughout the COVID-19 pandemic, a time
in which binge drinking skyrocketed in those who were isolated in their homes. A further
experiment question I would have for the team is why they did not conduct comparisons between
the groups and only against the TRACK condition. I believe that comparisons across groups can
make the case for increased study of certain behavioral change techniques and their individual
effectiveness. This is certainly an important course of study and interventions focused on
reducing hazardous drinking behaviors in young adults is something worth continued study. As
someone who is very interested in this course of study, I wish that the researchers had included
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samples of their strategies for reduction of binge drinking. Throughout the paper there are no
examples or depictions of the actual messages sent. This would be immensely useful for anyone
reading this paper or developing further study to conceptualize the work. In summary, the
National Institute of Alcohol Abuse and Alcoholism should continue funding research in this
space as it is greatly needed.
References
1.
Suffoletto, B., Pacella, M., Huber, J., & Chung, T. (2022). Effectiveness of text message
interventions with different behavior change techniques on alcohol consumption among
young adults: A five‐arm randomized controlled trial.
Addiction
,
118
(2), 265–275.
https://doi.org/10.1111/add.16074