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

Text-delivered prevention programs provide unique opportunities to deliver substance use prevention interventions to at-risk populations. 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. 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 ( = -.63) and anxiety symptoms = -.57). Relative to controls, adolescents in the intervention group maintained a higher quality of parental relationship ( = .41) and parenting skills ( = .51), suggesting a prophylactic effect. Marginal decrease in the odds of positive drug tests were found for youth in intervention group (77.1% decrease, =0.07) but not with controls (54.3% decrease, =0.42,). Results provide preliminary evidence in the feasibility, acceptability, and efficacy of targeting risk and protective factors that are implicated in substance use text-delivered interventions for high-risk populations.