PDF(Pubmed)
Abstract：
BACKGROUND: Alcohol misuse is the fourth leading cause of death in the United States and a significant problem in the US military. Brief alcohol interventions can reduce negative alcohol outcomes in civilian and military populations, but additional scalable interventions are needed to reduce binge and heavy drinking. SMS text messaging interventions could address this need, but to date, no programs exist for military populations.
OBJECTIVE: We aimed to develop an SMS text messaging intervention to address binge and heavy drinking among Airmen in Technical Training in the US Air Force.
METHODS: We implemented a 2-phase, mixed methods study to develop the SMS text messaging intervention. In phase 1, a total of 149 respondents provided feedback about the persuasiveness of 49 expert-developed messages, preferences regarding message frequency, timing and days to receive messages, and suggested messages, which were qualitatively coded. In phase 2, a total of 283 respondents provided feedback about the persuasiveness of 77 new messages, including those developed through the refinement of messages from phase 1, which were coded and assessed based on the Behavior Change Technique Taxonomy (BCTT). For both phases, mean persuasiveness scores (range 1-5) were calculated and compared according to age (aged <21 or ≥21 years) and gender. Top-ranking messages from phase 2 were considered for inclusion in the final message library.
RESULTS: In phase 1, top-rated message themes were about warnings about adverse outcomes (eg, impaired judgment and financial costs), recommendations to reduce drinking, and invoking values and goals. Through qualitative coding of suggested messages, we identified themes related to warnings about adverse outcomes, recommendations, prioritizing long-term goals, team and belonging, and invoking values and goals. Respondents preferred to receive 1 to 3 messages per week (124/137, 90.5%) and to be sent messages on Friday, Saturday, and Sunday (65/142, 45.8%). In phase 2, mean scores for messages in the final message library ranged from 3.31 (SD 1.29) to 4.21 (SD 0.90). Of the top 5 highest-rated messages, 4 were categorized into 2 behavior change techniques (BCTs): valued self-identity and information about health consequences. The final message library includes 28 BCTT-informed messages across 13 BCTs, with messages having similar scores across genders. More than one-fourth (8/28, 29%) of the final messages were informed by the suggested messages from phase 1. As Airmen aged <21 years face harsher disciplinary action for alcohol consumption, the program is tailored based on the US legal drinking age.
CONCLUSIONS: This study involved members from the target population throughout 2 formative stages of intervention development to design a BCTT-informed SMS text messaging intervention to reduce binge and heavy drinking, which is now being tested in an efficacy trial. The results will determine the impact of the intervention on binge drinking and alcohol consumption in the US Air Force.
OBJECTIVE: We aimed to develop an SMS text messaging intervention to address binge and heavy drinking among Airmen in Technical Training in the US Air Force.
METHODS: We implemented a 2-phase, mixed methods study to develop the SMS text messaging intervention. In phase 1, a total of 149 respondents provided feedback about the persuasiveness of 49 expert-developed messages, preferences regarding message frequency, timing and days to receive messages, and suggested messages, which were qualitatively coded. In phase 2, a total of 283 respondents provided feedback about the persuasiveness of 77 new messages, including those developed through the refinement of messages from phase 1, which were coded and assessed based on the Behavior Change Technique Taxonomy (BCTT). For both phases, mean persuasiveness scores (range 1-5) were calculated and compared according to age (aged <21 or ≥21 years) and gender. Top-ranking messages from phase 2 were considered for inclusion in the final message library.
RESULTS: In phase 1, top-rated message themes were about warnings about adverse outcomes (eg, impaired judgment and financial costs), recommendations to reduce drinking, and invoking values and goals. Through qualitative coding of suggested messages, we identified themes related to warnings about adverse outcomes, recommendations, prioritizing long-term goals, team and belonging, and invoking values and goals. Respondents preferred to receive 1 to 3 messages per week (124/137, 90.5%) and to be sent messages on Friday, Saturday, and Sunday (65/142, 45.8%). In phase 2, mean scores for messages in the final message library ranged from 3.31 (SD 1.29) to 4.21 (SD 0.90). Of the top 5 highest-rated messages, 4 were categorized into 2 behavior change techniques (BCTs): valued self-identity and information about health consequences. The final message library includes 28 BCTT-informed messages across 13 BCTs, with messages having similar scores across genders. More than one-fourth (8/28, 29%) of the final messages were informed by the suggested messages from phase 1. As Airmen aged <21 years face harsher disciplinary action for alcohol consumption, the program is tailored based on the US legal drinking age.
CONCLUSIONS: This study involved members from the target population throughout 2 formative stages of intervention development to design a BCTT-informed SMS text messaging intervention to reduce binge and heavy drinking, which is now being tested in an efficacy trial. The results will determine the impact of the intervention on binge drinking and alcohol consumption in the US Air Force.
摘要：
背景：酒精滥用是美国第四大死亡原因，也是美国军方的重大问题。简短的酒精干预措施可以减少平民和军事人口的负面酒精结果，但是需要额外的可扩展干预措施来减少暴饮暴食和大量饮酒。短信干预可以满足这一需求，但迄今为止,没有针对军事人口的计划。
目的：我们旨在开发一种短信干预措施，以解决美国空军技术培训中飞行员的暴饮暴食和酗酒问题。
方法：我们实施了2个阶段，研究开发短信干预的混合方法。在第一阶段，共有149名受访者就49条专家制定的信息的说服力提供了反馈，有关消息频率的首选项，接收消息的时间和天数，和建议的信息，定性编码。在第二阶段，共有283名受访者就77条新讯息的说服力提供了反馈，包括通过对第1阶段的消息进行细化而开发的消息，这些消息是根据行为变化技术分类（BCTT）进行编码和评估的。对于这两个阶段，根据年龄(<21岁或≥21岁)和性别计算并比较平均说服力评分(范围1-5).考虑将来自第2阶段的排名最高的消息包含在最终消息库中。
结果：在第1阶段中，评分最高的消息主题是关于不良结果的警告（例如，受损的判断和财务成本)，建议减少饮酒，引用价值观和目标。通过对建议的消息进行定性编码，我们确定了与不良结果警告相关的主题，recommendations,优先考虑长期目标，团队和归属感，引用价值观和目标。受访者希望每周收到1至3条消息（124/137，90.5%），并在周五发送消息，星期六,和周日（65/142，45.8%）。在第2阶段，最终消息库中消息的平均得分范围为3.31（SD1.29）至4.21（SD0.90）。在排名最高的5条信息中，4分为2种行为改变技术（BCT）：有价值的自我认同和有关健康后果的信息。最终消息库包括13个BCT中的28个BCTT通知消息，不同性别的信息得分相似。超过四分之一(8/28,29%)的最终消息由来自阶段1的建议消息通知。由于年龄<21岁的飞行员因饮酒而面临更严厉的纪律处分，该计划是根据美国法定饮酒年龄量身定制的。
结论：这项研究涉及目标人群的成员在干预开发的2个形成阶段，以设计BCTT知情的SMS短信干预措施，以减少暴饮暴食和大量饮酒，目前正在疗效试验中进行测试。结果将确定干预措施对美国空军暴饮暴食和饮酒的影响。
目的：我们旨在开发一种短信干预措施，以解决美国空军技术培训中飞行员的暴饮暴食和酗酒问题。
方法：我们实施了2个阶段，研究开发短信干预的混合方法。在第一阶段，共有149名受访者就49条专家制定的信息的说服力提供了反馈，有关消息频率的首选项，接收消息的时间和天数，和建议的信息，定性编码。在第二阶段，共有283名受访者就77条新讯息的说服力提供了反馈，包括通过对第1阶段的消息进行细化而开发的消息，这些消息是根据行为变化技术分类（BCTT）进行编码和评估的。对于这两个阶段，根据年龄(<21岁或≥21岁)和性别计算并比较平均说服力评分(范围1-5).考虑将来自第2阶段的排名最高的消息包含在最终消息库中。
结果：在第1阶段中，评分最高的消息主题是关于不良结果的警告（例如，受损的判断和财务成本)，建议减少饮酒，引用价值观和目标。通过对建议的消息进行定性编码，我们确定了与不良结果警告相关的主题，recommendations,优先考虑长期目标，团队和归属感，引用价值观和目标。受访者希望每周收到1至3条消息（124/137，90.5%），并在周五发送消息，星期六,和周日（65/142，45.8%）。在第2阶段，最终消息库中消息的平均得分范围为3.31（SD1.29）至4.21（SD0.90）。在排名最高的5条信息中，4分为2种行为改变技术（BCT）：有价值的自我认同和有关健康后果的信息。最终消息库包括13个BCT中的28个BCTT通知消息，不同性别的信息得分相似。超过四分之一(8/28,29%)的最终消息由来自阶段1的建议消息通知。由于年龄<21岁的飞行员因饮酒而面临更严厉的纪律处分，该计划是根据美国法定饮酒年龄量身定制的。
结论：这项研究涉及目标人群的成员在干预开发的2个形成阶段，以设计BCTT知情的SMS短信干预措施，以减少暴饮暴食和大量饮酒，目前正在疗效试验中进行测试。结果将确定干预措施对美国空军暴饮暴食和饮酒的影响。
