Goal commitment and goal confidence mediate the path between desire to get drunk and binge drinking among young adults receiving text message goal‐related feedback

Abstract

Background Counteracting desires to drink are cognitive processes that exert self‐control to mitigate impulses or strengthen other, perhaps more distal, goals to limit consumption. Young adults are particularly challenged by mismatches between self‐regulation and desires to drink that make them susceptible to hazardous alcohol use. Methods We assessed whether drinking limit goal commitment and goal confidence mediate the association between desire to get drunk and binge drinking (4+ drinks for females and 5+ drinks for males on a given occasion) among young adults exposed to text message goal‐related feedback. We randomized 297 young adults to one of two text message interventions that incorporated drinking limit goal‐related assessments and feedback over 12 weeks of intervention exposure. On the 2 days per week that they typically drank alcohol, participants were asked to report plans to drink (yes/no). If a drinking plan was endorsed, participants reported their desire to get drunk (0 [not at all] to 8 [completely]), willingness to commit to a drinking limit goal (yes/no), and (contingent on goal commitment) goal confidence (0 [not at all] to 8 [completely]). The next day, participants reported their drinking quantity, coded as a binge drinking day (yes/no). Mediation was tested using path models of simultaneous between‐ and within‐person effects using maximum likelihood. Results At both within‐ and between‐person levels, we found significant indirect path effects of goal commitment and goal confidence between desire to get drunk and binge drinking. Greater than usual desire to get drunk was associated with lower drinking limit goal commitment and confidence, whereas greater than usual goal commitment and confidence were associated with lower likelihood of same‐day binge drinking. Discussion Findings support a mechanistic model where contextual variations in same‐day drinking limit goal commitment and confidence mitigate the path between desire to get drunk and binge drinking among young adults. Employing just‐in‐time strategies to reinforce drinking limit goal commitment and goal confidence could reduce hazardous drinking and related harms.

Prediction Rules Identify Which Young Adults Have Higher Rates of Heavy Episodic Drinking After Exposure to 12-Week Text Message Interventions

“…In contrast to the importance of pattern of alcohol consumption in predicting the three month HED outcome, baseline stage of change was not a key predictor, suggesting that motivational processes during the intervention, relative to baseline motivation and readiness to change, may be more important to the three month HED outcome. 13,14 Higher frequency of HED at follow-up was associated with rules that involved baseline AUDIT-C frequency of HED and frequency of drinking, number of friends who get drunk at least weekly, and negative urgency score. These baseline characteristics suggest the importance of peer behavior among young adults, along with the need to better address the interpersonal and social context of HED.…”

“…In contrast to the importance of pattern of alcohol consumption in predicting the three month HED outcome, baseline stage of change was not a key predictor, suggesting that motivational processes during the intervention, relative to baseline motivation and readiness to change, may be more important to the three month HED outcome. 13,14…”