A randomized pilot trial of a mobile delivered brief motivational interviewing and behavioral economic alcohol intervention for emerging adults.

Abstract

Objective: Mobile health (mHealth) interventions show potential to broaden the reach of efficacious alcohol brief motivational interventions (BMIs). However, efficacy is mixed and may be limited by low participant attention and engagement. The present study examined the feasibility, acceptability, and preliminary efficacy of a live text-message delivered BMI in a pilot randomized clinical trial. Method: Participants were 66 college students (63.6% women; 61.9% White; M age = 19.95, SD = 1.66) reporting an average of 11.88 (SD = 8.74) drinks per week, 4.42 (SD = 3.59) heavy drinking episodes (HDEs), and 8.44 (SD = 5.62) alcohol-related problems in the past month. Participants were randomized to receive either (a) education or (b) an alcohol BMI plus behavioral economic substance-free activity session (SFAS), each followed by 4 weeks of mini sessions. All sessions were administered via live text-message. Participants completed assessments postintervention (after the 4th mini session) and at 3-month follow-up. Results: 90.9% completed both initial full-length sessions and at least two of the four mini sessions with 87.9% retention at 3-month follow-up. Participants found the interventions useful, interesting, relevant, and effective, with no between-group differences. There were no statistically significant group differences in drinks per week or alcohol-related problems at follow-up, but BMI + SFAS participants reported fewer past-month HDEs than those who received education. Conclusions: Live text-messaging to deliver the BMI + SFAS is feasible and well-received. The preliminary efficacy results should be interpreted cautiously due to the small sample size but support further investigation.

Do brief motivational interventions increase motivation for change in drinking among college students? A two‐step meta‐analysis of individual participant data

“…How to improve motivation when feedback is delivered through the Web or an app may require additional considerations for better engagement and outcome. Recent studies that provided synchronous teleconferencing (e.g., Zoom) or text‐based intervention have demonstrated the feasibility and preliminary effectiveness (e.g., Gex et al, 2022). With the COVID‐19 pandemic, no‐contact in‐person meetings have proliferated and have been generally accepted (Mark et al, 2022; Oliveira et al, 2021).…”

Imagining the future can shape the present: A systematic review of the impact of episodic future thinking on substance use outcomes.

“…As an example, by collecting information about the degree of problematic substance use, we might be able to discern whether in cases of less severe problematic substance use, EFT could operate as a stand-alone intervention, and in cases of more severity, it could complement evidence-based substance use treatments to heighten their effect. In fact, recent studies have shown the promise of EFT as an adjunct to more comprehensive treatments for individuals who met criteria for alcohol use disorder (Meshesha et al, 2020) and as an independent treatment for individuals who self-reported heavy drinking two times per month (Gex et al, 2022). Similarly, it is possible that EFT may be best utilized as a stand-alone treatment in cases in which the goal is harm reduction versus abstinence by allowing individuals to preexperience the future to avoid negative consequences arising from substance use.…”

“…Thus, not only is EFT consistent with the tenets of cognitive behavioral therapy, but it can also be seamlessly integrated into various evidence-based treatment approaches. In fact, two recent studies showed the ease and feasibility of integrating an EFT task into an evidence-based brief motivational interviewing protocol that included discussions of alternative, substance-free activities in a clinical sample with alcohol use disorder (Meshesha et al, 2020) and in a college sample that reported heavy drinking (Gex et al, 2022).…”

Automated, tailored adaptive mobile messaging to reduce alcohol consumption in help‐seeking adults: A randomized controlled trial

“…Overall, results highlight the opportunity to significantly reduce risky drinking with long‐term automated messaging interventions that are scalable and low‐effort on participants. Given the opportunity to improve automated interventions with clinician or coach‐supported messaging [68], the studies highlighting the efficacy of human‐supported messaging in alcohol reduction [69] and the rise of conversational artificial intelligence, hybrid models should be explored in future studies. Given both the debilitating personal consequences of excessive alcohol consumption and the economic burden and costs to society [10], reducing binge drinking episodes by 8.2 a month and weekly drinking by 12.9 drinks per week can have a measurable impact on public health through rapid scaling without significant implementation costs.…”