A Text Message Alcohol Intervention for Young Adult Emergency Department Patients: A Randomized Clinical Trial

Suffoletto, Brian; Kristan, Jeffrey; Callaway, Clifton; Kim, Kevin H.; Chung, Tammy; Monti, Peter M.; Clark, Duncan B.

doi:10.1016/j.annemergmed.2014.06.010

Cited by 151Substance Abuse Treatment and OutcomesMobile Health and mHealth ApplicationsDigital Mental Health Interventions

A Text Message Alcohol Intervention for Young Adult Emergency Department Patients: A Randomized Clinical Trial

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Suffoletto, Brian, Kristan, Jeffrey, Callaway, Clifton, Kim, Kevin H., Chung, Tammy, Monti, Peter M., Clark, Duncan B.·2014·Annals of Emergency Medicine

DOI 10.1016/j.annemergmed.2014.06.010PMC PMC4254153

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Abstract

Study objective Opportunistic brief in-person emergency department (ED) interventions can be effective at reducing hazardous alcohol use in young adult drinkers, but require resources frequently unavailable. Mobile telephone text messaging (short message service [SMS]) could sustainably deliver behavioral support to young adult patients, but efficacy remains unknown. We report 3-month outcome data of a randomized controlled trial testing a novel SMS-delivered intervention in hazardous-drinking young adults. Methods We randomized 765 young adult ED patients who screened positive for past hazardous alcohol use to one of 3 groups: SMS assessments+feedback (SA+F) intervention who were asked to respond to drinking-related queries and received real-time feedback through SMS each Thursday and Sunday for 12 weeks (n=384), SMS assessments (SA) who were asked to respond to alcohol consumption queries each Sunday but did not receive any feedback (N=196), and a control group who did not participate in any SMS (n=185). Primary outcomes were self-reported number of binge drinking days and number of drinks per drinking day in the past 30 days, collected by Web-based timeline follow-back method and analyzed with regression models. Secondary outcomes were the proportion of participants with weekend binge episodes and most drinks consumed per drinking occasion during 12 weekends, collected by SMS. Results With Web-based data, there were decreases in the number of self-reported binge drinking days from baseline to 3 months in the SA+F group (-0.51 [95% confidence interval {CI} -0.10 to -0.95]), whereas there were increases in the SA group (0.90 [95% CI 0.23 to 1.6]) and the control group (0.41 [95% CI -0.20 to 1.0]). There were also decreases in the number of self-reported drinks per drinking day from baseline to 3 months in the SA+F group (-0.31 [95% CI -0.07 to -0.55]), whereas there were increases in the SA group (0.10 [95% CI -0.27 to 0.47]) and the control group (0.39 [95% CI 0.06 to 0.72]). With SMS data, there was a lower mean proportion of SA+F participants reporting a weekend binge during 12 weeks (30.5% [95% CI 25% to 36%) compared with the SA participants (47.7% [95% CI 40% to 56%]). There was also a lower mean drinks consumed per weekend during 12 weeks in the SA+F group (3.2 [95% CI 2.6 to 3.7]) compared to the SA group (4.8 [95% CI 4.0 to 5.6]). Conclusion A text message intervention can produce small reductions in self-reported binge drinking and the number of drinks consumed per drinking day in hazardous-drinking young adults after ED discharge.

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In global settings, mobile health technology is widely available and promising, but its impact must be balanced by process complexity, feasibility and equitable access.
“In global settings, mobile health technology is widely available and promising, but the impact of this technology must be balanced by the process complexity, feasibility and equitable access [17,18].”
From Effectiveness of a brief intervention and text-based booster in the emergency department to reduce harmful and hazardous alcohol use: A pragmatic randomized adaptive clinical trial in Moshi, Tanzania (2025) · cites this paper as [17]
The Introduction (Background; page unavailable) describes SMS as promising and reports high mobile-phone ownership among young adults. The Limitations and Discussion (pages unavailable) note restricted generalizability and declining participation, but the paper does not assess global availability, process complexity, feasibility, or equitable access as the claim states. (LLM, conf=0.86)
Experimental — accuracy not yet measured
There is controversy around the best implementation strategy for a BI, such as the usefulness of boosters and the integration of mobile health technology for LMICs.
“There is also controversy around the best implementation strategy for a BI, such as the usefulness of boosters that serve as scheduled reminders post-BNI [28–30] and the integration of mobile health technology for LMICs [31,32].”
From Feasibility of a pragmatic randomized adaptive clinical trial to evaluate a brief negotiational interview for harmful and hazardous alcohol use in Moshi, Tanzania (2023) · cites this paper as [31]

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New steps for treating alcohol use disorder
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Participatory development of MIDY (Mobile Intervention for Drinking in Young people)
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Review article: Effectiveness of ultra‐brief interventions in the emergency department to reduce alcohol consumption: A systematic review
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Using online crowdsourcing to understand young adult attitudes toward expert-authored messages aimed at reducing hazardous alcohol consumption and to collect peer-authored messages
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Efficacy of a Just-in-Time Adaptive Intervention to Promote HIV Risk Reduction Behaviors Among Young Adults Experiencing Homelessness: Pilot Randomized Controlled Trial
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“…psychological symptoms management [63], and real-time messaging has improved risk behaviors, including long-term smoking cessation [64], binge drinking among young adults with hazardous alcohol use [65], and sexual risk behaviors and sexually transmitted infection (STI) testing among youth [66].”
Alcohol Use Disorder and Comorbid Depression: A Randomized Controlled Trial Investigating the Effectiveness of Supportive Text Messages in Aiding Recovery
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Identification of Behavior Change Techniques From Successful Web-Based Interventions Targeting Alcohol Consumption, Binge Eating, and Gambling: Systematic Review
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Texting to Increase Contraceptive Initiation Among Adolescents in the Emergency Department
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A systematic review and behaviour change technique analysis of remotely delivered alcohol and/or substance misuse interventions for adults.
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Project CHOICE: Choosing Healthy Options in Coping with Emotions, an EMA/EMI Plus In-Person Intervention for Alcohol Use
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Smartphone Application for Unhealthy Alcohol Use: A Pilot Study
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A Randomized Controlled Trial of a Telephone Intervention for Alcohol Misuse With Injured Emergency Department Patients
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Self-guided Change: The most common form of long-term, maintained health behavior change
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The Association Between Daily Posttraumatic Stress Symptoms and Pain Over the First 14 Days After Injury: An Experience Sampling Study
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Feasibility of a pragmatic randomized adaptive clinical trial to evaluate a brief negotiational interview for harmful and hazardous alcohol use in Moshi, Tanzania
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PRACT: a pragmatic randomized adaptive clinical trial protocol to investigate a culturally adapted brief negotiational intervention for alcohol use in the emergency department in Tanzania
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Optimizing a Text Message Intervention to Reduce Heavy Drinking in Young Adults: Focus Group Findings
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Beyond Basic Feedback in Mobile Brief Interventions: Designing SMS Message Content for Delivery to Young Adults During Risky Drinking Events
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Patterns of Change in Weekend Drinking Cognitions Among Non–Treatment-Seeking Young Adults During Exposure to a 12-Week Text Message Intervention
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Text message intervention to reduce frequency of binge drinking among disadvantaged men: the TRAM RCT
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A Qualitative Assessment to Understand the Barriers and Enablers Affecting Contraceptive Use Among Adolescent Male Emergency Department Patients
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Emotion- versus Reasoning-Based Drivers of Misinformation Sharing: A Field Experiment Using Text Message Courses in KenyaPreprint
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Global outreach and user preferences of a smartphone application developed for drinkers
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Consumer Health Information Technology in the Prevention of Substance Abuse: Scoping Review
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Effects of Text4Hope-Addiction Support Program on Cravings and Mental Health Symptoms: Results of a Longitudinal Cross-sectional Study
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Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review
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An Overview of Internet- and Smartphone-Delivered Interventions for Alcohol and Substance Use Disorders
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Engaging Adolescents With Sexual Health Messaging: A Qualitative Analysis
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Effectiveness of an Ecological Momentary Intervention for Reducing Risky Alcohol Consumption Among Young Adults: Protocol for a Three-Arm Randomized Controlled Trial
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Health behavior change following a diagnosis of ductal carcinoma in situ: An opportunity to improve health outcomes
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A systematic review of the effectiveness of alcohol brief interventions for the UK military personnel moving back to civilian life
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Technological Interventions for the Treatment of Substance Use Disorders
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Mobile phone text message intervention to reduce binge drinking among young adults: study protocol for a randomized controlled trial
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Text‐Message‐Based Drinking Assessments and Brief Interventions for Young Adults Discharged from the Emergency Department
Suffoletto, B. P., Callaway, C. W., Kristan, J., Kraemer, K. L., & Clark, D. B. (2011) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2011.01646.x · Cited by 190 · see citing works
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An Interactive Text Message Intervention to Reduce Binge Drinking in Young Adults: A Randomized Controlled Trial with 9-Month Outcomes
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Mobile phone text-message–based drinking brief interventions for young adults discharged from the emergency department
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Self-citation
Effectiveness of text message interventions with different behavior change techniques on alcohol consumption among young adults: a five‐arm randomized controlled trial
Suffoletto, B. P., Pacella‐LaBarbara, M. L., Huber, J., & Chung, T. A. (2022) · Addiction · doi:10.1111/add.16074 · Cited by 23 · see citing works
Self-citation

Authors: Suffoletto, B., Kristan, J., Callaway, C., Kim, K. H., Chung, T., Monti, P. M., & Clark, D. B.
Affiliations: University of Pittsburgh (US)
Brown University (US)
Corresponding author: Suffoletto, Brian
ORCID: Suffoletto, Brian
Kristan, Jeffrey
Callaway, Clifton
Kim, Kevin H.
Chung, Tammy
Monti, Peter M.
Clark, Duncan B.
Venue: Annals of Emergency Medicine
Publisher: Elsevier BV
Published: 2014-12
Volume: 64
Issue: 6
Pages: 664-672.e4
ISSN: 0196-0644 (ISSN-L)
DOI: 10.1016/j.annemergmed.2014.06.010
PMC: PMC4254153
OpenAlex: W2139415566
Cited by: 151
References: 51
Citations by year: 2026: 3 · 2025: 10 · 2024: 9 · 2023: 9 · 2022: 9 · 2021: 14 · 2020: 11 · 2019: 15 · 2018: 21 · 2017: 20 · 2016: 16 · 2015: 11 · 2014: 3
FWCI: 12.63
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Annals of Emergency Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Rutgers University Community Repository (Rutgers University) (submittedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (K23AA023284, K02AA018195, P01AA019072, K05AA019681, R01AA016482)
National Institute on Drug Abuse (P50-DA 05605, P50DA005605)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords: text messaging intervention, mobile health, young adults, hazardous drinking, binge drinking, emergency department, brief alcohol intervention, real-time feedback, alcohol consumption monitoring, weekend drinking
MeSH terms: Adolescent, Adult, Alcoholic Intoxication, Emergency Service, Hospital, Female, Health Promotion, Humans, Male, Young Adult, Text Messaging, Binge Drinking

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A Text Message Alcohol Intervention for Young Adult Emergency Department Patients: A Randomized Clinical Trial

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