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The goal of this study is to evaluate effectiveness of scalable, tailored text- messaging programs for alcohol use among older adults. This study focuses on gain and loss framing of behavior change goals (i.e., the positives of change and the negatives of remaining with the status quo), critical components of behavioral science and health behavioral interventions. Loss-framing is used to motivate individuals to avoid future problems by focusing on the consequences of no change in behavior, and gain-framing is used to facilitate progress by focusing on the benefits of change. The investigators will design and evaluate three text-messaging programs using a randomized controlled trial: (A) Loss-framed messaging (B) Gain-framed messaging; and (C) Combined (loss and gain) messaging among a sample of 150 older adults with hazardous drinking. Participants will be randomized to one of the three conditions, each of which will include 8 weeks of text-messaging. During the study participants will completed assessments online and via text messages to track drinking.
There is an urgent call for efficient and effective assessment, prevention, and intervention among older adults (age 50 and older) to reduce health risk of hazardous drinking, encourage healthy aging, and reduce burden on healthcare systems. Brief, low-burden, low-cost, digital interventions among older adults can answer this call. Text-messaging health interventions are considered an effective, scalable way to deliver behavioral health interventions, and they have been used as evidence-based solutions in primary care settings among older adults for behaviors other than alcohol use to supplement traditional care. Contrary to stereotypes, older adults use mobile technology, seek online and mobile interventions, and often engage longer compared to younger populations. The primary objective of the proposed study is to evaluate effectiveness of scalable, tailored text- messaging programs for alcohol use among older adults. This study focuses on gain and loss framing of behavior change goals (i.e., the positives of change and the negatives of remaining with the status quo), critical components of behavioral science and health behavioral interventions. Loss-framing is used to motivate individuals to avoid future problems by focusing on the consequences of no change in behavior, and gain-framing is used to facilitate progress by focusing on the benefits of change. The investigators will design and evaluate three text-messaging programs using a randomized controlled trial: (A) Loss-framed messaging (B) Gain-framed messaging; and (C) Combined (loss and gain) messaging among a sample of 150 older adults with hazardous drinking. Participants will be randomized to one of the three conditions, each of which will last 8 weeks. Participants will undergo cross- sectional online assessments (baseline, week 4, week 8 and week 16), and they will also complete a mobile assessment (via text message) once per week to track drinking. The effects of condition on drinking behavior will be compared at weeks 4, 8 and 16. In addition, attrition from the study will be closely tracked. Finally, the investigators will explore how the effects condition are impacted by gender and age (via moderation analysis).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Loss-framed Messaging | Active Comparator | Daily text messages on the consequences of hazardous drinking (e.g., "Think of all you have lost as a result of drinking too much. Make today a day that sets the stage for change.") |
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| Gain-framed Messaging | Active Comparator | Daily text messages on the benefits of reducing drinking to safe guidelines (e.g., "Think of all you can achieve if you can control your drinking. Make today a day that sets the stage for change.") |
|
| Gain-framed and Loss-framed Messaging | Active Comparator | Daily text messages that alternate between loss-framed (e.g., "Think of all you have lost as a result of drinking too much. Make today a day that sets the stage for change.") and gain-framed messaging (e.g., "Think of all you can achieve if you can control your drinking. Make today a day that sets the stage for change.") |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Brief Normative Feedback | Behavioral | Once a participant has completed the assessment of their drinking during the baseline battery, the participant will receive brief normative feedback about how their drinking compares to their peers. |
| Measure | Description | Time Frame |
|---|---|---|
| Weekly sum of standard drinks | Measure 1 of drinking, average of weekly sum of standard drinks | baseline, week 4, week 8, and week 16 |
| Weekly sum of heavy drinking days | Measure 2 of drinking, average of weekly heavy drinking days | baseline, week 4, week 8, and week 16 |
| Measure | Description | Time Frame |
|---|---|---|
| Percent adherence to daily drinking assessment via text messages | Responses to text messages (via text message) are considered "adherence" to the daily drinking assessment. This measure is akin to compliance. | once daily, starting at baseline, lasting for 8 weeks |
| Percent adherence to weekly drinking assessment via web |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alexis Kuerbis, LCSW, PhD | Silberman School of Social Work at Hunter College City, University of New York | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hunter College of CUNY | New York | New York | 10035 | United States |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Jun 2, 2025 | |
| Reset | Jun 16, 2025 | |
| Release | Sep 15, 2025 | |
| Reset | Oct 3, 2025 | |
| Release | Jan 14, 2026 | |
| Reset | Jan 29, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jun 2, 2025 | Jun 16, 2025 | |||
| Sep 15, 2025 |
| ID | Term |
|---|---|
| D000428 | Alcohol Drinking |
| ID | Term |
|---|---|
| D004327 | Drinking Behavior |
| D001519 | Behavior |
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Participants will be urn randomized according to gender, age and intensity of drinking to the three conditions collected at screening. They will be assigned to one of 3 text-messaging programs.
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Participants will be blind to condition.
| Loss-framed Text-messaging | Behavioral | Daily text-messages on the consequence of hazardous drinking. |
|
| Gain-framed Text-messaging | Behavioral | Daily text messages on the benefits of reducing drinking to safe guidelines. |
|
Responses to text messages (via text message) are considered "adherence" to the weekly drinking assessment. This measure is akin to compliance. |
| once weekly, starting at baseline, lasting 8 weeks |
| Percent willingness to continue the program for another 8 weeks | Participants are asked, "would you like to continue to receive text messages for the next 8 weeks?" If participants report yes, that is willingness to continue in the program. If no, then participants are not willing to continue in the program. | At week 8 assessment |
| Oct 3, 2025 |
| Jan 14, 2026 | Jan 29, 2026 |