Feasibility of using text messaging for unhealthy behaviors screening in a clinical setting: a case study on adolescent hazardous alcohol use.
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ABSTRACT:
SUBMITTER: Rios-Bedoya CF
PROVIDER: S-EPMC3638169 | biostudies-literature | 2013 Mar-Apr
REPOSITORIES: biostudies-literature
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Feasibility of using text messaging for unhealthy behaviors screening in a clinical setting: a case study on adolescent hazardous alcohol use.
Ríos-Bedoya Carlos Francisco CF Hay Casey C
Journal of the American Medical Informatics Association : JAMIA 20120703 2
Underage alcohol use is the leading cause of preventable mortality among adolescents in the USA. Moreover, the average age of onset of underage drinking is 13 years. This study examined the feasibility of using a text messaging survey (TMS) to assess adolescent alcohol use. A sample of 29 adolescents, aged 13-17 years, was recruited from two primary care clinics. They completed a 16 question TMS while in the waiting room and a two-question exit TMS. The participation rate was 87%. Two out of 25 ...[more]
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Project description:Introduction:Few smokers receive evidence-based cessation services during primary care visits. We aimed to assess the feasibility of a proactive text messaging program for primary care patients who smoke. Methods:We used electronic health records (EHRs) to identify smokers from two Massachusetts community health centers who had a mobile phone number listed. In March 2014-June 2015 patients were screened by their primary care physician then sent a proactive text message inviting them to enroll by texting back. Patients who opted-in were asked about their readiness to quit. The text message program included messages from the QuitNowTXT library and novel content for smokers who were not ready to quit. Results:Among 949 eligible smokers, 88 (9%) enrolled after receiving a single proactive text message. Compared with those who did not enroll, enrollees were more often female (61% vs. 48%, p=0.02) but otherwise did not differ in age, race, insurance status, or comorbidities. Twenty-eight percent of enrollees were not ready to quit in the next 30 days. The median time in the program was 9 days (interquartile range 2-32). Twenty-five percent of current smokers sent one or more keyword requests to the server. These did not differ by readiness to quit. Conclusions:A proactively delivered text messaging program targeting primary care patients who smoke was feasible and engaged both smokers ready to quit and those not ready to quit. This method shows promise as part of a population health model for addressing tobacco use outside of the primary care office.
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Project description:IntroductionNeighborhood features such as the density of tobacco outlets relative to one's home and evaluations of safety of one's activity space (routine locations), are known to influence health behaviors. Understanding the time-varying nature of these aspects of the urban ecology provides unique insights into the dynamic interactions of individuals and their environments.MethodsThe present study tested the time-varying effects of tobacco outlets and perceived safety within a randomized controlled trial of an adolescent text-messaging smoking intervention. We used ecological momentary assessment data (EMA) from an automated text-messaging smoking cessation randomized trial with 197 primarily African American urban adolescents. We employed a time-varying effect model to estimate the effects of density of tobacco outlets within one-half mile of participants' home locations (time-invariant covariate) and evaluations of safety of their activity space (time-varying covariate) on momentary smoking over 6 months by treatment condition. The time-varying effect model approach models behavioral change and associations of coefficients expressed dynamically and graphically represented as smooth functions of time.ResultsDifferences in trajectories of smoking between treatment conditions were apparent over the course of the study. During months 2 and 6, the association between tobacco outlet density and smoking was significantly stronger in the control condition, suggesting treatment dampens this association during these time periods. The intervention also significantly reduced the association of perceived safety and smoking among the treatment condition during months 3 through 6.ConclusionsResults support testing the time-varying effects of urban ecological features and perceptions of safety among adolescents in text-based smoking cessation interventions.ImplicationsThis study makes a unique contribution towards understanding the time-varying effects of urban neighborhoods on adolescent tobacco use within the context of a text-delivered intervention. Helping to adjust the long-held conceptualization of intervention effects as a static outcome, to that of a dynamic, time-varying process, is an important contribution of this study. The ability to specify when behavioral change occurs within the context of a randomized control trial provides understanding into the time-varying treatment effects of text-based smoking intervention. For example, researchers can modify the intervention to have strategically timed booster sessions that align with when the odds of smoking begin to increase in order to provide more precise treatment. The current study results show that increasing support to participants during months 2 and 4 may help suppress smoking over the course of a 6-month intervention.
| S-EPMC6596452 | biostudies-literature
Project description:Background and aimsThe global growth of mobile phone use has led to new opportunities for health interventions, including through text messaging. We aimed to estimate the effects of text messaging interventions on alcohol consumption among risky drinkers.MethodsSystematic review and meta-analysis of reports on randomized controlled trials (RCTs) published in English. Searches were conducted on 23 May 2019 in PubMed; PubMed Central; CENTRAL; CDSR; DARE; NHS-EED; Scopus; PsycINFO; PsycARTICLES; CINAHL; and Web of Science. Measurements included number of episodes of heavy drinking (HED) per month and weekly alcohol consumption (WAC) in grams. Trials among risky drinkers who were not receiving co-interventions were included in the review (n = 3481, mean age 29 years, 41% female). Data were extracted from reports and authors were contacted for additional data.ResultsTen trials were included and all analyses were based on random-effects models. Primary analyses, including seven trials (n = 2528) for HED and five trials (n = 2236) for WAC, found that the interventions may reduce self-reported HED [-0.33 episodes per month; 95% confidence interval (CI) = -0.79, 0.12] and WAC (-18.62 g per week; 95% CI = -39.61, 2.38), although both estimates included the null. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality of evidence was judged to be low for both HED and WAC, primarily due to risk of attrition and performance bias, heterogeneity and influence of pilot trials on estimates.ConclusionsText messaging alcohol interventions may reduce alcohol consumption compared with no or basic health information; however, there are doubts about the overall quality of the evidence.
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