Text-Based Messaging Strategies for Preventing Subsequent Problematic Alcohol Use

Episodic heavy or binge drinking and the associated health and social consequences are substantial public health concerns, with a high prevalence among young adults. This is particularly true among US military personnel. While alcohol consumption in the US military is very high and normative, there is zero tolerance for getting in legal trouble while drinking, and Airmen who do get in alcohol-related legal trouble (e.g., DUI, sexual assault) typically receive what is called an Alcohol Related Incident (ARI).

In other populations, Brief Alcohol Interventions (BAIs) for alcohol misuse have been validated as efficacious with robust evidence for mostly college young adults who report episodic heavy drinking. Many BAI studies have targeted young adults who drink hazardously; these individuals are generally not interested in abstaining from alcohol but are often willing to decrease the amount they drink or change the manner in which they drink in order to reduce harmful consequences. The investigators have previously published the results of a BAI group-based intervention that has been shown to reduce ARIs universally (not in just high-risk drinkers) in over 150,000 on average by 16%. Since this intervention began in 2010, the BAI has been disseminated to most Airmen in Technical (Advanced) Training in the US Air Force. However, it is clear that additional research is needed to enhance the efficacy of the BAI intervention and to reduce the risk associated with problem drinking behavior. One such strategy that could improve health promotion outcomes is well timed and tailored automated text messages. Building on the preliminary study where text messages reduced driving after drinking as well as total drinks consumed before driving, text messaging may be highly effective as the precise time that Airmen gain access to alcohol (when they are allowed off base for the first time) is known and is the same time point for all Airmen.

One of the challenges to conducting alcohol research in the military is the lack of privileged communication. As a result, it is difficult to obtain valid self-reports due to a tendency to deny or minimize use. Fortunately, the research team has recently validated a method for collecting anonymous data over time.

This study will randomize approximately 7000 Airmen to either the currently administered group BAI versus the BAI + Interactive Counselor Facilitated Text messages timed to occur before, during, and after Airmen have access to alcohol; and (2) To evaluate the efficacy of the intervention at an end of training and 6-month follow-up using repeated anonymous surveys with unique identifiers allowing investigators to match up surveys while simultaneously maintaining anonymity.

Inclusion criteria

• Must be a United States Air Force Technical Training student in one of the following training groups or wings: 37th Training Wing, 81st Training Wing, 82nd Training Wing, or 59th Training Group.
• Must be 18 years of Age
• Must be able to understand English
• Must be able to receive text messages

Exclusion criteria

• Under 18 years of age
• Not in the specified Technical Training groups or wings