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Behavioral design for reducing alcohol consumption in aging: A mobile messaging randomized controlled trial.

Michael Sobolev1, Patrycja Sleboda2, Beatriz Torre3

  • 1Behavioral Design Unit, Cedars-Sinai Medical Center, United States of America; Schaeffer Center for Health Policy and Economics, University of Southern California, United States of America.

Journal of Substance Use and Addiction Treatment
|December 9, 2025
PubMed
Summary

Mobile text messaging effectively reduced heavy drinking days and alcohol-related issues in adults aged 50 and older. The gain-framed messaging approach was most preferred by participants for moderating alcohol consumption.

Keywords:
AddictionBehavioral insightsDigital interventionDrinkingHealthy aging

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Area of Science:

  • Gerontology
  • Behavioral Science
  • Digital Health

Background:

  • Older adults (≥50) face health risks from alcohol use, necessitating tailored interventions.
  • Existing digital addiction interventions often exclude older adults.
  • Mobile messaging offers a low-burden, accessible channel for behavioral interventions in this demographic.

Purpose of the Study:

  • To assess the feasibility and preliminary effectiveness of mobile text messaging interventions for alcohol moderation in older adults.
  • To compare gain-framed, loss-framed, and hybrid messaging strategies.
  • To optimize intervention design for future research and clinical practice.

Main Methods:

  • An 8-week, single-blind randomized controlled study (NCT06126107) involving 105 adults (ages 51-78).
  • Participants received daily self-tracking prompts and tailored text messages (gain-framed, loss-framed, or hybrid).
  • Feasibility (engagement) and preliminary effectiveness (drinking days, consequences, depression) were evaluated.

Main Results:

  • Mobile messaging significantly reduced heavy drinking days, alcohol-related consequences, and geriatric depression.
  • The gain-framed messaging program was preferred by participants and showed greater perceived benefits.
  • High engagement was observed, with over 70% completion of daily self-tracking prompts.

Conclusions:

  • Mobile messaging shows promise for alcohol moderation among older adults, with gain-framed messages being most effective.
  • Further optimization of behavioral mechanisms beyond framing is needed for enhanced mobile interventions.
  • This approach supports healthy aging by addressing alcohol use in older populations.