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Texting to Reduce Alcohol Misuse (TRAM): main findings from a randomized controlled trial of a text message
Iain K Crombie1, Linda Irvine1, Brian Williams2
1Division of Population Health Sciences, University of Dundee, Dundee, UK.
Aims:
To test the effectiveness of a theoretically based text-message intervention to reduce binge drinking among socially disadvantaged men.
Design:
A multi-centre parallel group, pragmatic, individually randomized controlled trial.
Setting:
Community-based study conducted in four regions of Scotland.
Participants:
A total of 825 men aged 25-44 years recruited from socially disadvantaged areas who had two or more episodes of binge drinking (> 8 UK units on a single occasion) in the preceding 28 days: 411 men were randomized to the intervention and 414 to the control.
Intervention And Comparator:
A series of 112 interactive text messages was delivered by mobile phone during a 12-week period. The intervention was structured around the Health Action Process Approach, a comprehensive model which allows integration of a range of evidence-based behaviour change techniques. The control group received 89 texts on general health, with no mention of alcohol or use of behaviour change techniques.
Measurements:
The primary outcome measure was the proportion of men consuming > 8 units on three or more occasions (in the previous 28 days) at 12 months post-intervention.
Findings:
The proportion of men consuming > 8 units on three or more occasions (in the previous 28 days) was 41.5% in the intervention group and 47.8% in the control group. Formal analysis showed that there was no evidence that the intervention was effective [odds ratio (OR) = 0.79, 95% confidence interval (CI) = 0.57-1.08; absolute reduction 5.7%, 95% CI = -13.3 to 1.9]. The Bayes factor for this outcome was 1.3, confirming that the results were inconclusive. The retention was high and similar in intervention (84.9%) and control (86.5%) groups. Most men in the intervention group engaged with the text messages: almost all (92%) replied to text messages and 67% replied more than 10 times.
Conclusions:
A theoretically based text-messaging intervention aimed at reducing binge drinking in disadvantaged men was not found to reduce prevalence of binge drinking at 12-month follow-up.
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