Efficacy of a Web- and Text Messaging-Based Intervention to Reduce Problem Drinking in Adolescents: Results of a Cluster-Randomized Controlled Trial

• Published in: Journal of consulting and clinical psychology 2017-02, Vol.85 (2), p.147-159
• Main Authors: Haug, Severin, Paz Castro, Raquel, Kowatsch, Tobias, Filler, Andreas, Dey, Michelle, Schaub, Michael P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior - psychology; Adult; Alcohol Abuse; Alcohol use; Alcoholism; Alcoholism - prevention & control; Alcoholism - psychology; Behavior modification; Behavior Therapy - methods; Blood alcohol level; Clinical trials; Cluster Analysis; Computer Applications; Confidence intervals; Drinking behavior; Drinks; Feedback; Feedback, Psychological; Female; Follow-Up Studies; Human; Humans; Intervention; Male; Mobile Phones; Motivation; Norms; Peer Group; Prevalence; Risk assessment; Self Concept; Self-efficacy; Social motivation; Social norms; Switzerland; Teenagers; Telemedicine; Telemedicine - methods; Text Messaging; Treatment Outcome; Underage Drinking - prevention & control; Underage Drinking - psychology; Young Adult; Youth
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/ccp0000138

Objective: To test the efficacy of a combined web- and text messaging-based intervention to reduce problem drinking in young people compared to assessment only. Method: Two-arm, parallel-group, cluster-randomized controlled trial with assessments at baseline and 6-month follow up. The automated intervention included online feedback, based on the social norms approach, and individually tailored text messages addressing social norms, outcome expectations, motivation, self-efficacy, and planning processes, provided over 3 months. The main outcome criterion was the prevalence of risky single-occasion drinking (RSOD, defined as drinking at least 5 standard drinks on a single occasion in men and 4 in women) in the past 30 days. Irrespective of alcohol consumption, 1,355 students from 80 Swiss vocational and upper secondary school classes, all of whom owned a mobile phone, were invited to participate in the study. Of these, 1,041 (76.8%) students participated in the study. Results: Based on intention-to-treat analyses, RSOD prevalence decreased by 5.9% in the intervention group and increased by 2.6% in the control group, relative to that of baseline assessment (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.44-0.87). No significant group differences were observed for the following secondary outcomes: RSOD frequency, quantity of alcohol consumed, estimated peak blood alcohol concentration, and overestimation of peer drinking norms. Conclusions: The intervention program reduced RSOD, which is a major indicator of problem drinking in young people, effectively. What is the public health significance of this article? The participation rate for the automated intervention approach was high, and the intervention could be implemented for large groups of students easily within a school setting.