Real Time Monitoring of Engagement with a Text Message Intervention to Reduce Binge Drinking Among Men Living in Socially Disadvantaged Areas of Scotland

Purpose: This study identified the extent and nature of engagement with a theoretically-based behavior change text message intervention intended to reduce binge drinking. The data were from a randomised controlled trial tackling binge drinking among socially disadvantaged men.

Methods: An intervention, comprising 112 text messages, and based on the principles of the Health Action Process Approach was delivered to 411 socially disadvantaged men. Participants sent almost 7,500 responses to the text messages. Engagement was assessed by whether text message replies showed the intended response to key components of the behavior change strategy.

Results: The median number of responses to the text messages was 17 per man (range 0-81). Men often gave detailed sensitive personal information about their drinking and the harms it caused them. They also described their attempts at drinking less, the setbacks encountered and the benefits they enjoy when they are successful at cutting down. Specific examples of engagement with the targeted messages include: of the 248 men who responded to the prompt on outcome expectancies, most (230) identified potential benefits of cutting down; for intention to reduce drinking 260 men responded of whom 44% said they had thought about changing; of the 172 men who responded to the question on goal setting, 158 reported personal goals.

Conclusions: The responses showed that most men engaged as intended with the key components of the intervention. Text message interventions should include questions addressing key components of the behavior change strategy to determine whether there is effective engagement with intervention components.