Text Messaging Intervention for Postpartum Alcohol Use: Micro-Randomized Trial Supports Feasibility, Acceptability,...

Area of Science:

• Reproductive Health
• Behavioral Science
• Digital Health Interventions

Background:

• Postpartum women with at-risk alcohol use require effective interventions.
• Text messaging interventions show promise but need tailoring for this population.
• Micro-randomized trial (MRT) designs offer a feasible approach for adaptive interventions.

Purpose of the Study:

• Evaluate the feasibility and acceptability of an MRT design in postpartum mothers.
• Compare the preliminary impacts of drinking-focused versus maternal-focused text messages.
• Inform the development of a tailored, just-in-time adaptive text messaging intervention.

Main Methods:

• A 28-day pilot micro-randomized trial (MRT) involving 65 postpartum mothers.
• Ecological momentary assessment (EMA) surveys collected multiple times daily.
• Randomization to receive maternal-focused, drinking-focused, or no text message after surveys.

Main Results:

• High compliance (>70%) with surveys, indicating low burden and feasibility.
• Maternal-focused messages were rated more helpful and evoked more positive feelings than drinking-focused messages.
• Intervention messages increased drinking self-efficacy (DSE) compared to no message; maternal message effects decreased over time.

Conclusions:

• The MRT design is feasible and acceptable for postpartum mothers with at-risk drinking.
• Findings support tailoring text message content for this population.
• Results inform the development of adaptive text messaging interventions for postpartum alcohol use.