The effectiveness of text-based messaging strategies for preventing subsequent problematic alcohol use among technical trainees in the U.S. Air force

间歇性重度或暴饮及其相关的健康和社会后果是重大的公共卫生问题，在年轻人中流行率很高。在美国军事人员中尤其如此。虽然美国军队的酒精消费量非常高，而且很规范，但对饮酒时陷入法律的麻烦是零容忍的，而那些陷入与酒精有关的法律的麻烦的飞行员（例如，DUI，性侵犯）通常会收到所谓的酒精相关事件（ARI）。在其他人群中，针对酒精滥用的简短酒精干预（BAI）已被验证为有效，对于大多数报告间歇性大量饮酒的大学年轻人来说，有强有力的证据。许多BAI研究针对的是饮用危险饮料的年轻人;这些人通常对戒酒不感兴趣，但通常愿意减少饮酒量或改变饮酒方式以减少有害后果。我们之前已经证实了1一项基于BAI小组的干预措施的结果，该干预措施已被证明可普遍降低阿里斯的发病率（不仅仅是高风险饮酒者），超过15万人平均降低16%。自2010年开始以来，BAI已经传播到美国空军的大多数技术（高级）训练飞行员。然而，很明显，需要更多的研究来提高我们的BAI干预的有效性，并降低与问题饮酒行为相关的风险。其中一个可以改善健康促进结果的策略是适时和量身定制的自动短信。在我们的初步研究中，短信减少了酒后驾驶以及驾驶前的总饮酒量（见以前的工作），短信可能是非常有效的，因为飞行员获得酒精的精确时间（当他们第一次被允许离开基地时）是已知的，并且对所有飞行员来说都是相同的时间。在军队中进行酒精研究的挑战之一是缺乏特权沟通。因此，由于倾向于否认或尽量减少使用，很难获得有效的自我报告。幸运的是，我们最近验证了我们的研究团队开发的一种方法，用于随着时间的推移收集匿名数据。我们建议在军队中进行第一次研究，以及第一次大规模，充分的试验，干预效果将被跟踪到一年的随访。我们的发现将对在平民和军人群体中进行研究产生强烈的影响。因此，我们提出了以下具体目标：（1）我们将大约3000名飞行员随机分为两组，一组是目前管理的BAI组，另一组是BAI +互动咨询师促进短信组，这些短信在飞行员饮酒之前、期间和之后定时发生;和（2）在3个月、6个月、9个月和12个月的随访中，使用重复的匿名调查评估干预的有效性，这些调查具有独特的标识符，允许我们在保持匿名的同时匹配调查。

Episodic heavy or binge drinking and the associated health and social consequences are substantial public health concerns, with a high prevalence among young adults. This is particularly true among US military personnel. While alcohol consumption in the US military is very high and normative, there is zero tolerance for getting in legal trouble while drinking, and Airmen who do get in alcohol-related legal trouble (e.g., DUI, sexual assault) typically receive what is called an Alcohol Related Incident (ARI). In other populations, Brief Alcohol Interventions (BAIs) for alcohol misuse have been validated as efficacious with robust evidence for mostly college young adults who report episodic heavy drinking. Many BAI studies have targeted young adults who drink hazardously; these individuals are generally not interested in abstaining from alcohol, but are often willing to decrease the amount they drink or change the manner in which they drink in order to reduce harmful consequences. We have previously published1 the results of a BAI group- based intervention that has been shown to reduce ARIs universally (not in just high risk drinkers) in over 150,000 on average by 16%. Since we began in 2010, the BAI has been disseminated to most Airmen in Technical (Advanced) Training in the USAF. However, it is clear that additional research is needed to enhance the efficacy of our BAI intervention and to reduce the risk associated with problem drinking behavior. One such strategy that could improve health promotion outcomes is well timed and tailored automated text messages. Building on our preliminary study where text messages reduced driving after drinking as well as total drinks consumed before driving (See Previous Work), text messaging may be highly effective as the precise time that Airmen gain access to alcohol (when they are allowed off base for the first time) is known and is the same time for all Airmen. One of the challenges to conducting alcohol research in the military is the lack of privileged communication. As a result, it is difficult to obtain valid self-reports due to a tendency to deny or minimize use. Fortunately, we have recently validated a method developed by our research team for collecting anonymous data over time. We propose to conduct what is the first study in the military, as well as the first large scale, adequately powered trial, where intervention effects will be tracked out to a one year follow-up. Our findings would have strong implications for conducting research in both civilian and military populations. Thus, we propose the following Specific Aims: (1) We will randomize approximately 3000 Airmen to either the currently administered group BAI versus the BAI + Interactive Counselor Facilitated Text messages timed to occur before, during, and after Airmen have access to alcohol; and (2) To evaluate the efficacy of the intervention at a 3-, 6-, 9- and 12-month follow-up using repeated anonymous surveys with unique identifiers allowing us to match up surveys while simultaneously maintaining anonymity.