Feasibility and acceptability of text messaging to assess daily substance use and sexual behaviors among urban emerging adults

Abstract

Background: Daily process research can help distinguish causal relationships between substance use and sexual risk behaviors in high-risk groups, such as urban emerging adults. We employed text messaging to assess 18–25 year-olds’ daily substance use and sexual risk behaviors over 28 days. We describe the implementation of this method, attitudes regarding the daily surveys, and correlates of survey completion.

Method: We recruited 111 emerging adults from an urban Emergency Department in a resource-limited area who reported recent drug use and unprotected sex (M_age=22.0; 53.2% female; 45.1% African American; 43.2% receiving public assistance).

Results: Respondents completed M = 18.0 (SD = 8.7) of 28 daily surveys (27 items each). Participants completing a 1-month follow-up found the surveys not at all/only a little annoying (90.3%) and were comfortable with questions about drugs/alcohol (97.9%) and sex (94.6%). Completion was higher on weekdays versus weekends, and earlier in the study. Daily survey completion was unrelated to same-day substance use measured by the Timeline Follow Back at follow-up; polysubstance use and drinks consumed were associated with lower odds of next-day completion. School enrollment, public assistance, unlimited texting plan, lower baseline alcohol use, and depression symptoms at follow-up were associated with higher completion. Technology difficulties were commonly mentioned barriers to completion.

Conclusions: Participants in this urban, resource-constrained sample found the daily text message methodology acceptable for reporting sensitive information. With rapid advancements in technologies and increased accessibility, text messaging remains a promising methodology for the study of daily processes in substance use and HIV risk behaviors.

Keywords:

• Text messaging
• assessment
• emerging adults
• substance use
• risky sex
• mobile technology

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse under career development award K23 DA036008.