Wright Cassandra, Dietze Paul M, Agius Paul A, Kuntsche Emmanuel, Livingston Michael, Black Oliver C, Room Robin, Hellard Margaret, Lim Megan Sc
Burnet Institute, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
JMIR Mhealth Uhealth. 2018 Jul 20;6(7):e149. doi: 10.2196/mhealth.9324.
BACKGROUND: Real-time ecological momentary interventions have shown promising effects in domains other than alcohol use; however, only few studies regarding ecological momentary interventions for alcohol use have been conducted thus far. The increasing popularity of smartphones offers new avenues for intervention and innovation in data collection. OBJECTIVE: We aimed to test the efficacy of an ecological momentary intervention, comprising mobile Web-based ecological momentary assessments (EMAs) and text messaging (short message service, SMS) brief interventions, delivered during drinking events using participants' mobile phones. METHODS: We conducted a three-armed randomized controlled trial to assess the effect of a mobile Web-based ecological momentary assessment with texting feedback on self-reported alcohol consumption and alcohol-related harms in young adults. Participants were enrolled from an existing observational cohort study of young adults screened for risky drinking behavior. The intervention group (ecological momentary intervention group) completed repeated ecological momentary assessments during 6 drinking events and received immediate texting-based feedback in response to each ecological momentary assessment. The second group (ecological momentary assessment group) completed ecological momentary assessments without the brief intervention, and the third did not receive any contact during the trial period. Recent peak risky single-occasion drinking was assessed at the baseline and follow-up using telephone interviews. We used a random effects mixed modeling approach using maximum likelihood estimation to provide estimates of differences in mean drinking levels between groups between baseline and 12-week follow-up. RESULTS: A total of 269 participants were randomized into the 3 groups. The ecological momentary intervention group exhibited a small and nonsignificant increase between baseline and follow-up in (geometric) the mean number of standard drinks consumed at the most recent heavy drinking occasion (mean 12.5 vs 12.7). Both ecological momentary assessment and control groups exhibited a nonsignificant decrease (ecological momentary assessment: mean 13.8 vs 11.8; control: mean 12.3 vs 11.6); these changes did not differ significantly between groups (Wald χ 1.6; P=.437) and the magnitude of the effects of the intervention were markedly small. No other significant differences between groups on measures of alcohol consumption or related harms were observed. The intervention acceptability was high despite the technical problems in delivery. CONCLUSIONS: With a small number of participants, this study showed few effects of an SMS-based brief intervention on peak risky single-occasion drinking. Nevertheless, the study highlights areas for further investigation into the effects of EMI on young adults with heavy alcohol consumption. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12616001323415; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369534 (Archived by WebCite at http://www.webcitation.org/7074mqwcs).
背景:实时生态瞬时干预在酒精使用以外的领域已显示出有前景的效果;然而,迄今为止,关于酒精使用的生态瞬时干预的研究仅有少数几项。智能手机日益普及为数据收集方面的干预和创新提供了新途径。 目的:我们旨在测试一种生态瞬时干预的效果,该干预包括基于移动网络的生态瞬时评估(EMA)和短信(短消息服务,SMS)简短干预,通过参与者的手机在饮酒事件期间进行。 方法:我们进行了一项三臂随机对照试验,以评估基于移动网络的生态瞬时评估及短信反馈对年轻人自我报告的酒精消费量和与酒精相关危害的影响。参与者来自一项现有的针对有危险饮酒行为的年轻人的观察性队列研究。干预组(生态瞬时干预组)在6次饮酒事件期间完成重复的生态瞬时评估,并针对每次生态瞬时评估收到即时的基于短信的反馈。第二组(生态瞬时评估组)完成生态瞬时评估但无简短干预,第三组在试验期间未接受任何联系。在基线和随访时通过电话访谈评估近期单次高峰危险饮酒情况。我们使用随机效应混合建模方法并采用最大似然估计来提供基线和12周随访之间各组平均饮酒水平差异的估计值。 结果:总共269名参与者被随机分为3组。生态瞬时干预组在基线和随访之间,在最近一次重度饮酒场合饮用的(几何)标准饮品平均数量上有小幅且不显著的增加(平均12.5对12.7)。生态瞬时评估组和对照组均有不显著的下降(生态瞬时评估组:平均13.8对11.8;对照组:平均12.3对11.6);这些变化在组间无显著差异(Wald χ 1.6;P = 0.437),且干预效果的幅度明显较小。在酒精消费或相关危害的测量指标上,未观察到组间其他显著差异。尽管在实施过程中存在技术问题,但干预的可接受性较高。 结论:本研究参与者数量较少,显示基于短信的简短干预对单次高峰危险饮酒影响甚微。尽管如此,该研究突出了需进一步调查生态瞬时干预对重度饮酒年轻人影响的领域。 试验注册:澳大利亚新西兰临床试验注册中心ACTRN12616001323415;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369534(由WebCite存档于http://www.webcitation.org/7074mqwcs)
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