Using Text Message Reminders to Help Adolescents and Young Adults Remain Mindful of Their Commitment to Substance Use Behavior Change

Abstract

Substance use disorder is a major health and safety concern, and initiation of use typically occurs during adolescence or young adulthood. Early initiation of substance increases the likelihood that individuals will experience a variety of negative consequences due to substance use. Interventions have been developed to support adolescent and young adult substance use behavior change. Text messaging or short message service (SMS) are an inexpensive, reliable, and relatively simple way of reaching adolescents and young adults to support their substance use behavior change goals. This randomized controlled trial evaluated the feasibility, acceptability, and efficacy of four-weeks of SMS reminders designed to support adolescent substance use behavior change goals. Participants were randomly assigned to a self-selected message content intervention condition (self-selected), an other-selected message content intervention condition (yoked-intervention), and a general health message content condition (control). Fifty-nine adolescents and young adults participated in the study. Overall, the SMS intervention was feasible and acceptable, although recruitment of eligible participants into the study was lower than expected. Participants’ achieved their substance use goals at a relatively high rate, reported decreased alcohol and cannabis use, reported decreased negative substance use consequences, and reported increased self-efficacy. The pooled intervention condition demonstrated statistically significantly lesser levels of change relative to the control group, suggesting that messages focusing on co-occurring issues may be more relevant to adolescents and young adults with lower levels of motivation to change or less severe substance use problems.