Pilot Study of an Integrated Smartphone and Breathalyzer Contingency Management Intervention for Alcohol Use

Abstract

Introduction: Monitoring devices provide a platform for assessing alcohol use and implementing alcohol interventions. This pilot study focused on assessing the early-stage feasibility and usability of a smartphone-based application and breathalyzer used in a contingency management intervention for alcohol use. Methods: Six non-treatment seeking participants completed a 9-week ABA within-subjects designed intervention targeting alcohol use. Participants submitted 2-8 alcohol breathalyzer samples per day and completed self-report drinking measures and usability assessments. During the A phases (weeks 1-3 and 8-9) participants received reinforces for submitting breathalyzer samples, regardless of their results. During the contingency management, B phase (weeks 4-7), and received reinforcers only when negative breathalyzer samples were submitted. Usability assessment of the application was also conducted during weeks 2 and 9. Results: Participants in the contingent B phase (49%) were more likely to submit alcoholnegative breathalyzer samples compared to the non-contingent A phases (27%; p<0.001). Usability assessment of the application varied, and participants noted several technical concerns. Conclusion: The use of smartphones and breathalyzers may be a practical solution to extend the reach of contingency management during and after treatment.

mMotiv8: A smartphone‐based contingency management intervention to promote smoking cessation

“…In addition, the study reported large differences in the percentage of negative samples in CM (85%) versus control (35%) participants ( n = 40). These results are consistent with several other studies that have employed technology‐based CM procedures to promote abstinence from alcohol (Alessi & Petry, 2013; Oluwoye et al, 2019). A recent feasibility study also extended technology‐based CM to promote abstinence from cannabis (Beckham et al, 2018).…”

Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

“…Technology might optimise the application of reinforcement principles, monitoring and reinforcing the target behaviour more frequently than is otherwise possible [22,24]. A meta-analysis of mobile telephone-delivered CM [25] and more recent evaluation studies [19,[26][27][28][29][30] suggest these interventions are effective in generating positive behaviour change. However, the platforms upon which these interventions can be implemented might vary in their appropriateness or acceptability to the patient population.…”

Development of Automated Reinforcement Management System (ARMS): Protocol for a Phase I Feasibility and Usability Study

“…Once the modifications are made in response to the second wave of clinician feedback, ARMS will be evaluated primarily for efficacy but also for feasibility and patient usability through an A-B-A (or, "return-to-baseline") completely within-subject experimental design. Following similar single subject-design studies conducted by our group [20,24], the two A phases will each last 2 weeks and the B phase will last 4 weeks, for a total study duration of 8 weeks. During all phases, participants will be asked to use the ARMS app to submit breathalyzer samples at 10 AM, 2 PM, and 8 PM each day.…”

“…Fortunately, recent technological advances have enabled the combined use of mobile apps and low-cost consumer electronic breathalyzer devices to remotely monitor alcohol use [17,18]. Studies wherein smartphone apps and remote breathalyzers were used to provide contingency management for AUD have found them to be effective in promoting alcohol abstinence [17,19,20]. Although other technologies, such as prescription digital therapeutics (eg, reSET and reSET-O by Pear Therapeutics), have been approved by the US Food and Drug Administration (FDA) for substance use disorders, they have not directly targeted substance abstinence.…”