Texting to Reduce Alcohol Misuse (TRAM): main findings from a randomised controlled trial of a text message intervention to reduce binge drinking among disadvantaged men

Aims: To test the effectiveness of a theoretically-based text message intervention to reduce binge drinking among socially disadvantaged men.Design:A multi-centre parallel group, pragmatic, individually randomised controlled trial.Setting:Community based study conducted in four regions of Scotland.Participants825 men aged 25-44 years recruited from socially disadvantaged areas who had =2 episodes of binge drinking (>8 UK units on a single occasion) in the preceding 28 days: 411 men were randomised to the intervention and 414 to the control.Intervention and comparator:A series of 112 interactive text messages was delivered by mobile phone over a 12 week period. The intervention was structured around the Health Action Process Approach, a comprehensive model which allows integration of a range of evidence based behaviour change techniques. The control group received 89 texts on general health, with no mention of alcohol or use of behaviour change techniques.Measurements:The primary outcome measure was the proportion of men consuming >8 units on =3 occasions (in the previous 28 days) at 12 months post-intervention.Findings:The proportion of men consuming >8 units on =3 occasions (in the previous 28 days) was 41.5% in the intervention group and 47.8% in the control group. Formal analysis showed that there was no evidence that the intervention was effective (odds ratio 0.79, 95% CI 0.57 to 1.08; absolute reduction 5.7%, 95% CI -13.3 to 1.9). The Bayes factor for this outcome was 1.3, confirming that the results were inconclusive. The retention was high and similar in intervention (84.9%) and control (86.5%) groups. Most men in the intervention group engaged with the text messages: almost all (92%) replied to text messages and 67% replied more than 10 times.Conclusions:A theoretically based text messaging intervention aimed at reducing binge drinking in disadvantaged men was not found to reduce prevalence of binge drinking at 12 month follow-up.