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Supportive text messages to reduce mood symptoms and problem drinking in patients with primary depression or alcohol use disorder: protocol for an implementation research study.

ABSTRACT: BACKGROUND:Depression and Alcohol Use Disorders (AUDs) are two leading causes of disability worldwide and are associated with significant treatment challenges requiring new, innovative, cost-effective and technologically-based therapies including the use of supportive text messages. OBJECTIVE:To determine the feasibility and effectiveness of supportive text messages in long-term follow-up to reduce mood symptoms and problem drinking in patients with Depression or AUD respectively and to explore the usefulness of self-reports of health services utilization as an outcomes measure. METHODS:This will be a longitudinal, prospective, parallel-design, two-arm, placebo-controlled single-rater-blinded randomized clinical trial with a recruitment period of 6 months and an observation period of 12 months for each participant, with two strata based on primary diagnosis of Major Depressive Disorder or AUD. The sample size will be 120, with about 60 patients randomized from each primary diagnostic grouping. Patients in all intervention groups will receive twice-daily supportive SMS text messages for 3 months and then daily supportive text messages for the next three months. Patients will also receive a phone call every two weeks from the research assistant assigning treatment allocation to confirm that they are still receiving the text messages and to thank them for taking part in the study. Patients in the control group will receive no text messages but will also receive a phone call from the same research assistant every two weeks to thank them for taking part in the study. RESULTS:The study starts in April 2015 and ends in September 2016. It is envisaged that both qualitative and quantitative primary and secondary outcomes, including patient perceptions of the intervention, will shed light on the feasibility of using automated supportive text message interventions in long term for patients with Depression and AUD. This will inform a full-scale clinical trial. CONCLUSIONS:The paradigm for behavior change using text messages as a patient-direct intervention is consistent with a cognitive behavior therapy approach and addictions counselling principles. Given the automaticity of the messages, we anticipate that if the intervention proves successful, it will represent a low cost strategy that will be readily available and can bring relief to patients in hard-to-reach areas with limited access to psychological therapies. TRIAL REGISTRATION:ClinicalTrials.gov: NCT02327858; https://clinicaltrials.gov/ct2/show/NCT02327858 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02327858).

SUBMITTER: Agyapong VI

PROVIDER: S-EPMC4814207 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature

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Supportive text messages to reduce mood symptoms and problem drinking in patients with primary depression or alcohol use disorder: protocol for an implementation research study.

Agyapong Vincent Israel Opoku VI Mrklas Kelly K Suen Victoria Yung Mei VY Rose Marianne Sarah MS Jahn Megan M Gladue Irene I Kozak Jody J Leslie Maureen M Dursun Serdar S Ohinmaa Arto A Greenshaw Andrew A

JMIR research protocols 20150515 2

<h4>Background</h4>Depression and Alcohol Use Disorders (AUDs) are two leading causes of disability worldwide and are associated with significant treatment challenges requiring new, innovative, cost-effective and technologically-based therapies including the use of supportive text messages.<h4>Objective</h4>To determine the feasibility and effectiveness of supportive text messages in long-term follow-up to reduce mood symptoms and problem drinking in patients with Depression or AUD respectively ...[more]

PMID: 25979786

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Project description:Face-to-face communication has several sources of contextual information that enables language comprehension. This information is used, for instance, to perceive mood of interlocutors, clarifying ambiguous messages. However, these contextual cues are absent in text-based communication. Emoticons have been proposed as cues used to stress the emotional intentions on this channel of communication. Most studies have suggested that their role is to contribute to a more accurate perception of emotions. Nevertheless, it is not clear if their influence on disambiguation is independent of their emotional valence and its interaction with text message valence. In the present study, we designed an emotional congruence paradigm, where participants read a set of messages composed by a positive or negative emotional situation sentence followed by a positive or negative emoticon. Participants were instructed to indicate if the sender was in a good or bad mood. With the aim of analyzing the disambiguation process and observing if the role of the emoticons in disambiguation is different according their valence, we measure the rate of responses of perceived mood and the reaction times (RTs) for each condition. Our results showed that the perceived mood in ambiguous messages tends to be more negative regardless of emotion valence. Nonetheless, we observed that this tendency was not the same for positive and negative emoticons. Specifically, negative mood perception was higher for incongruent positive emoticons. On the other hand, RTs for positive emoticons were faster than for the negative ones. Responses for incongruent messages were slower than for the congruent ones. However, the incongruent condition showed different RTs depending on the emoticons' valence. In the incongruent condition, responses for negative emoticons was the slowest. Results are discussed taking into account previous observations about the potential role of emoticons in mood perception and cognitive processing. We concluded that the role of emoticons in disambiguation and mood perception is due to the interaction of emoticon valence with the entire message.

Project description:BackgroundSocially disadvantaged men are at high risk of suffering from alcohol-related harm. Disadvantaged groups are less likely to engage with health promotion. There is a need for interventions that reach large numbers at low cost and which promote high levels of engagement with the behaviour change process. The aim of this study was to design a theoretically and empirically based text message intervention to reduce binge drinking by socially disadvantaged men.ResultsFollowing MRC guidance, the intervention was developed in four stages. Stage 1 developed a detailed behaviour change strategy based on existing literature and theory from several areas. These included the psychological theory that would underpin the intervention, alcohol brief interventions, text message interventions, effective behaviour change techniques, narratives in behaviour change interventions and communication theory. In addition, formative research was carried out. A logic model was developed to depict the pathways between intervention inputs, processes and outcomes for behaviour change. Stage 2 created a narrative which illustrated and modelled key steps in the strategy. Stage 3 rendered the intervention into a series of text messages and ensured that appropriate behavioural change techniques were incorporated. Stage 4 revised the messages to ensure comprehensive coverage of the behaviour change strategy and coherence of the narrative. It also piloted the intervention and made final revisions to it.ConclusionsThe structured, systematic approach to design created a narrative intervention which had a strong theoretical and empirical basis. The use of a narrative helped make the intervention realistic and allowed key behaviour change techniques to be modelled by characters. The narrative was intended to promote engagement with the intervention. The intervention was rendered into a series of short text messages, and subsequent piloting showed they were acceptable in the target group. Delivery of an intervention by text message offers a low-cost, low-demand method that can reach large numbers of people. This approach provides a framework for the design of behaviour change interventions which could be used for interventions to tackle other health behaviours.

Project description:UnlabelledBackgroundProblem alcohol use is common among illicit drug users and is associated with adverse health outcomes. It is also an important factor in poor prognosis among drug users with hepatitis C virus (HCV) as it impacts progression to hepatic cirrhosis or opiate overdose in opioid users. The aim of this systematic review was to assess the effects of psychosocial interventions for problem alcohol use in adult illicit drug users with concurrent problem alcohol use (principally, problem drug users of opiates and stimulants).MethodsWe searched the following databases (November 2011): Cochrane Library, PUBMED, EMBASE, CINAHL, PsycINFO and reference list of articles. We also searched conference proceedings and online registers of clinical trials. Two reviewers independently assessed risk of bias and extracted data from included randomized controlled trials.ResultsFour studies (594 participants) were included in this review. Half of the trials were rated as having a high or unclear risk of bias. The four studies considered six different psychosocial interventions grouped into four comparisons: 1) cognitive-behavioral coping skills training versus 12-step facilitation (N = 41), 2) brief intervention versus treatment as usual (N = 110), 3) hepatitis health promotion versus motivational interviewing (N = 256), and 4) brief motivational intervention versus assessment-only group (N = 187). Differences between studies precluded any pooling of data. Findings are described for each trial individually. Most findings were not statistically significant except for comparison 2: decreased alcohol use at three months (risk ratio (RR) 0.32; 95% confidence interval (CI) 0.19 to 0.54) and nine months (RR 0.16; 95% CI 0.08 to 0.33) in the treatment-as-usual group and comparison 4: reduced alcohol use in the brief motivational intervention (RR 1.67; 95% CI 1.08 to 2.60).ConclusionsNo conclusion can be made because of the paucity of the data and the low quality of the retrieved studies.

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Supportive text messages to reduce mood symptoms and problem drinking in patients with primary depression or alcohol use disorder: protocol for an implementation research study.

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Supportive text messages to reduce mood symptoms and problem drinking in patients with primary depression or alcohol use disorder: protocol for an implementation research study.

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