A Randomized Pilot Trial of a Mobile Delivered Brief Motivational Interviewing and Behavioral Economic Alcohol Intervention for Emerging Adults

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. Public Health Significance Statement Live text-messaging with a counselor is a feasible and well-received way to deliver a brief alcohol intervention to reduce harmful alcohol use in emerging adults. This study found that live text-messaging with a counselor can reduce the frequency of binge drinking, a significant risk factor for experiencing alcohol-related problems. Live text-messaging may provide the benefits of interpersonal contact while retaining a sense of privacy and minimizing some burden associated with in-person sessions (e.g., travel costs, discomfort).