SafERteens M-Coach

The specific aims are to: 1) Compare the efficacy of adaptive interventions (AIs) that begin
with BI+TM (brief intervention + text messaging) vs. BI+HC (brief intervention + remote
health coach) on reducing alcohol misuse and violent behaviors among youth while in the
Emergency Department (ED); and, 2) Identify the most efficacious second-stage strategy
post-ED visit for those who initially respond and for those who do not. Specifically, 700
youth (ages 14-20) in the ED screening positive for alcohol use and violent behaviors will be
randomly assigned to: BI+TM or BI+HC. After receiving the SafERteens BI in the ED, youth will
complete weekly assessments over an 8 week period to tailor intervention content and measure
mechanisms of change, with one month determination of participant response (e.g., binge
drinking, violence). Responders in each arm will be re-randomized to continued condition
(e.g., stay the course or maintenance), or reduced condition (e.g., stepped down).
Non-responders will be re-randomized to continued condition (e.g., stay the course or
maintenance), or intensified condition (e.g., stepped up). Follow-up assessments will take
place at 4 and 8 months post-baseline.

Inclusion Criteria:

- patients age 14-20 years presenting to the HMC ED for any reason(except exclusions as
noted below)

- past 4 month binge alcohol use and violent behaviors (i.e., physical aggression)

- have a cell phone with texting capabilities and a cell phone plan for texting

Exclusion Criteria:

- patients who do not understand English

- patients deemed unable to provide informed consent due to mental incompetence,
incarceration, or medically unstable (abnormal vital signs requiring urgent
resuscitation) or

- present for acute suicidal ideation or acute suicide attempt, child abuse, or sexual
assault