Which behavior change techniques help young adults reduce binge drinking? A pilot randomized clinical trial of 5 text message interventions

Text message (SMS) interventions can reduce binge drinking in young adults, but optimal behavior change techniques (BCTs) remain unknown. The present study tests the acceptability and preliminary efficacy of different combinations of SMS-delivered BCTs. 149 young adults who screened positive for hazardous drinking completed a baseline survey in the Emergency Department. For the following 2-weeks, on days they typically drank (1 to 3 days per week), participants received ecological momentary assessments (EMA) of drinking plans and desire to get drunk; the next day they were prompted to report recall of number of drinks consumed the prior day. Participants who responded to at least 50% these EMA (N = 127) were randomized to one of five 12-week interventions: Cued Self-Monitoring (TRACK); Drinking Intentions Feedback (PLAN); Drinking Performance Feedback (USE); Adaptive Goal Support (GOAL); and a combination of BCTs (COMBO). 79% of all EMA were completed over 12 weeks, which decreased from around 93% on week 1 to 65% by week 12. Using EMA data, relative to TRACK, only COMBO showed significant reductions in binge drinking and max drinks per drinking episode over time. Using TLFB data, there were no significant differences between groups from baseline to 14 and 28-weeks follow-up. Results lay the groundwork for a larger trial testing the effects of BCTs on binge drinking for young adults.