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

Iain K Crombie, Linda Irvine, Brian Williams, Falko F Sniehotta, Dennis Petrie, Claire Jones, John Norrie, Josie MM Evans, Carol Emslie, Peter M Rice, Peter W Slane, Gerry Humphris, Ian W Ricketts, Ambrose J Melson, Peter T Donnan, Simona Hapca, Andrew McKenzie, Marcus Achison

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7 Citations (Scopus)


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 randomized controlled trial. Setting: Community-based study conducted in four regions of Scotland. Participants: A total of 825 men aged 25–44 years recruited from socially disadvantaged areas who had two or more episodes of binge drinking (> 8 UK units on a single occasion) in the preceding 28 days: 411 men were randomized to the intervention and 414 to the control. Intervention and comparator: A series of 112 interactive text messages was delivered by mobile phone during 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 three or more occasions (in the previous 28 days) at 12 months post-intervention. Findings: The proportion of men consuming > 8 units on three or more 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 (OR) = 0.79, 95% confidence interval (CI) = 0.57–1.08; 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.

Original languageEnglish
Pages (from-to)1609-1618
Number of pages10
Issue number9
Publication statusPublished - 1 Sep 2018


  • Binge drinking
  • community based
  • deprivation
  • men
  • narrative
  • text message intervention

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