Photography-based mobile assessment of alcohol use in young adults: Feasibility and comparison to standard assessment methodology (Preprint)

Abstract

Background: Heavy alcohol use is prevalent among young adults and may contribute to obesity.However, measurement tools for assessing caloric intake from alcohol are limited and rely on self-report, which is prone to biases.Objective: The purpose of the pilot study was to conduct feasibility testing of SmartIntake®, a photo-based smartphone app, to assess alcohol use among young adults. Aims consisted of 1) quantifying the ability of SmartIntake® to capture drinking behavior; 2) assessing app usability with the Computer System Usability Questionnaire (CSUQ); 3) conducting a qualitative interview; and 4) comparing preference, compliance, and alcohol use estimates (calories, grams per drinking episode) between SmartIntake® and online diet recalls that participants completed for a parent study.Methods: College students (N=15) who endorsed a pattern of heavy drinking were recruited from a larger study examining the impact of drinking on weight. Participants used SmartIntake® to send photographs of all alcohol and food intake over a three-day period, and then completed a follow up interview and the CSUQ. CSUQ items range from 1-7, with lower scores indicating greater usability. Total number of drinking occasions was determined by adding the number of drinking occasions captured by SmartIntake® plus the number of drinking occasions participants reported that they missed capturing. Compliance was defined by the number of days participants provided food/beverage photo data through the app, or the number of diet recalls completed.Results: The SmartIntake® app captured 13 of 15 (87%) drinking occasions. Participants rated the app as highly usable in the CSUQ (M= 2.28). Most participants (93%) preferred using SmartIntake® vs. recalls and compliance was significantly higher with SmartIntake® than recalls (93% vs 78%; P= .04). Alcohol grams and calories per drinking occasion were not significantly different between the two methods (P values range .25-.99); however triple the number of participants submitted alcohol reports with SmartIntake® compared to the diet recalls (SmartIntake® 9/15 vs recalls 3/15; P=.06).Conclusions: SmartIntake® was well accepted by college students who drink heavily and captured most drinking occasions. Participants had higher compliance with SmartIntake® compared to diet recalls and triple the number of participants reported alcohol use with SmartIntake®, suggesting this method may be well suited to assessing alcohol use in young adults.