Abstract
BackgroundScreening for alcohol misuse and brief interventions (BIs) for harm in trauma care settings are known to reduce alcohol intake and injury recidivism, but are rarely implemented. We created the content for a mobile phone text message BI service to reduce harmful drinking among patients admitted to hospital following an injury who screen positive for hazardous alcohol use. The aim of this study was to pre-test and refine the text message content using a robust contextualisation process ahead of its formal evaluation in a randomised controlled trial.MethodsPre-testing was conducted in two phases. First, in-depth interviews were conducted with 14 trauma inpatients (16–60 years) at Auckland City Hospital and five key informants. Participants were interviewed face-to-face using a semi-structured interview guide. Topics explored included: opinions on text message ideas and wording, which messages did or did not work well and why, interactivity of the intervention, cultural relevance of messages, and tone of the content. In a second phase, consultation was undertaken with Māori (New Zealand’s indigenous population) and Pacific groups to explore the relevance and appropriateness of the text message content for Māori and Pacific audiences.ResultsFactors identified as important for ensuring the text message content was engaging, relevant, and useful for recipients were: reducing the complexity of message content and structure; increasing the interactive functionality of the text message programme; ensuring an empowering tone to text messages; and optimising the appropriateness and relevance of text messages for Māori and Pacific people. The final version of the intervention (named ‘YourCall™’) had three pathways for people to choose between: 1) text messages in English with Te Reo (Māori language) words of welcome and encouragement, 2) text messages in Te Reo Māori, and 3) text messages in English (with an option to receive a greeting in Samoan, Tongan, Cook Island Māori, Niuean, Tokelauan, Tuvaluan, or Fijian).ConclusionsWe have developed a text message intervention underpinned by established BI evidence and behaviour change theory and refined based on feedback and consultation. The next step is evaluation of the intervention in a randomised-controlled trial.
Highlights
Screening for alcohol misuse and brief interventions (BIs) for harm in trauma care settings are known to reduce alcohol intake and injury recidivism, but are rarely implemented
Final version of text message intervention The final version of the text message intervention had three main language-based text message pathways for people to choose between: 1) text messages in English with Te Reo Māori words of welcome and encouragement, 2) text messages in Te Reo Māori, and 3) text messages in English
This paper describes the development of appropriate content for a text message BI service aimed at reducing hazardous drinking and alcohol-related harm among trauma inpatients
Summary
Screening for alcohol misuse and brief interventions (BIs) for harm in trauma care settings are known to reduce alcohol intake and injury recidivism, but are rarely implemented. We created the content for a mobile phone text message BI service to reduce harmful drinking among patients admitted to hospital following an injury who screen positive for hazardous alcohol use. Injury is the largest contributor to New Zealand’s alcohol-related burden of disease, [1,2,3] and alcohol is considered the leading risk factor for injury [4,5,6,7]. Factors associated with a higher risk of Screening and BI is an important component of a comprehensive public health strategy to reduce hazardous alcohol use and prevent alcohol-related harm. For injured patients attended to in trauma care settings, BI can reduce subsequent alcohol intake and alcohol-related harms [14].
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