An evidence-based alcohol-reduction smartphone app: development and evaluation

Abstract

Background: Excessive alcohol consumption is a prevalent social and health problem, with most drinkers not receiving help. Smartphone apps offer potential support that is accessible 24/7 and not dependent on face-to-face contact; however, there is little evidence of their effectiveness. This presentation reports the development and evaluation of an evidence-based alcohol reduction smartphone app Drink Less. Methods: Drink Less was developed using theory and evidence from published studies, expert consensus and an analysis of current apps. Beta-versions were tested with users using think-aloud and interview methods. Five modules were selected: normative feedback, feedback and self-monitoring, identity change, action planning and cognitive bias re-training. The app was evaluated in an intention-to-treat factorial design with 32 conditions and 672 participants. Outcome was measured by change at 1 month in mean past week consumption of alcohol, AUDIT scores, ratings of usability and usage. Findings: Participants were heavy drinkers, with mean past week alcohol consumption 39.9 units and AUDIT score 19.1. The 27% responding at one month reduced drinking by 3.8 units per week and 0.74 AUDIT points (p<0.001). There were two-way interactions between self-monitoring and action planning on AUDIT score (F=5.8, p=0.016) and between normative feedback and cognitive bias re-training on past week alcohol consumption (F=4.7, p=0.031). Discussion: An app with normative feedback, cognitive bias re-training, self-monitoring and action planning components may reduce drinking and merits further development with A/B testing of the modules and evaluation in a full-scale RCT with long-term outcomes.