# Adaptive Text Messaging Intervention for Risky Drinking in Postpartum Women

> **NIH NIH R34** · PARTNERSHIP TO END ADDICTION · 2020 · $237,957

## Abstract

Abstract
The proposed R34 will develop a theory-driven, adaptive text messaging intervention (TMI) for risky drinking in
postpartum women. Risky drinking is prevalent among women of reproductive age, and more than half of
women who reduce their alcohol use during pregnancy return to pre-pregnancy levels by three months
postpartum. Postpartum risky drinking can impair a mother’s ability to care for her baby, and is associated with
increased risk for child abuse and neglect and involvement with the child welfare system, as well as poor long-
term child outcomes. Most adults who engage in risky drinking do not seek treatment, and postpartum women
may be especially unlikely to seek formal treatment due to stigma and fears of child protective services
involvement. Text messaging is a promising strategy for reaching non-treatment-seeking risky drinkers that
may be particularly suitable for postpartum women, as it is convenient and anonymous. This approach also
has wide scalability potential, as it is capable of reaching large numbers of people at relatively low cost. The
proposed study will apply the Multiphase Optimization Strategy (MOST) framework, an engineering-inspired
approach for developing efficient and scalable mobile health interventions, to develop the first adaptive TMI
specifically designed for risky drinking in postpartum women. The proposed study will refine a theoretical
model to inform the TMI that is based on the Relapse Prevention model and specifies the temporal relations of
stress, negative mood, and maternal self-efficacy with intention to drink and daily drinking behavior in
postpartum women, and their daily fluctuations in response to triggers that are unique to the postpartum period
(sleep quality and baby irritability). The proposed TMI will include behavior change interventions based on
motivational interviewing and cognitive behavioral therapy that target coping skills and motivation to avoid
drinking, and that are adaptively tailored to fluctuations in stress, negative mood, and self-efficacy. Specific
aims are to (1) test and refine the proposed theoretical model via Ecological Momentary Assessment with 30
women for 14 days to determine daily fluctuations in stress, negative mood, and self-efficacy in response to
triggers and their impact on drinking intentions; (2) develop the content and decision rules for the TMI via
iterative cycles of user feedback collected via focus groups with 30 postpartum women; and (3) conduct a pilot
micro-randomized trial (MRT) with 50 women to assess feasibility of design and methods and obtain
preliminary proof-of-concept data to prepare for a future fully-powered optimization trial. Study products will be
a set of preliminary TMI components for postpartum risky drinking, ready for optimization and evaluation in a
future larger scale R01, and a set of piloted EMA and MRT methods for the population of postpartum risky
drinkers.

## Key facts

- **NIH application ID:** 10131299
- **Project number:** 1R34AA028407-01A1
- **Recipient organization:** PARTNERSHIP TO END ADDICTION
- **Principal Investigator:** SARAH E. DAUBER
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $237,957
- **Award type:** 1
- **Project period:** 2020-09-20 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10131299

## Citation

> US National Institutes of Health, RePORTER application 10131299, Adaptive Text Messaging Intervention for Risky Drinking in Postpartum Women (1R34AA028407-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10131299. Licensed CC0.

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