Feasibility and Acceptability of Text Messaging to Assess Daily Substance Use and Sexual Behaviors among Urban Emerging Adults.

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 (=22.0; 53.2% female; 45.1% African American; 43.2% receiving public assistance).

Results: Respondents completed =18.0 ( = 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.