Reducing Risk for Adolescent Substance Misuse with Text-Delivered Counseling to Adolescents and Parents

Abstract

Background: Text-delivered prevention programs provide unique opportunities to deliver substance use prevention interventions to at-risk populations. Methods: A pilot randomized controlled trial was conducted to test the feasibility, acceptability, and preliminary efficacy of a 4-week, automated personalized text-messaging prevention program, designed to reduce risk factors and increase protective factors associated with adolescent substance use and misuse. Sixty-nine adolescents were recruited from a Federally Qualified Health Care clinic and randomized to a text-delivered intervention, or a wait-list control condition. Simultaneously, fifty-two parents of adolescent participants were enrolled into a parenting skills text-delivered intervention. Participants completed a baseline assessment and three follow-up surveys over three-months. Adolescent saliva specimens for drug testing were collected. Results: All intervention-allocated adolescents implemented at least one of the text-based counseling recommendations and 79% indicated that they found the texts helpful. Significant intervention effects were found on risk and protective factors for substance misuse. Adolescents in the intervention group reported reduced depression symptoms (d = −.63) and anxiety symptoms (d = −.57). Relative to controls, adolescents in the intervention group maintained a higher quality of parental relationship (d = .41) and parenting skills (d = .51), suggesting a prophylactic effect. Marginal decrease in the odds of positive drug tests were found for youth in intervention group (77.1% decrease, p = 0.07) but not with controls (54.3% decrease, p = 0.42,). Conclusions: Results provide preliminary evidence in the feasibility, acceptability, and efficacy of targeting risk and protective factors that are implicated in substance use via text-delivered interventions for high-risk populations.

Keywords:

• Adolescent
• parent
• substance use
• text-delivered substance misuse intervention

Declaration of interest

All authors report no conflicts of interest.

All research procedures followed human participants ethical protection guidelines.

All research procedures were approved by the University of Tennessee IRB Number: 18-04518-FB

All authors certify that the study was performed in accordance with the ethical standardsas laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Additional information

Funding

This work was supported by University of Tennessee, Center for Behavioral Health Research, College of Social Work.