Using a mobile health application to reduce alcohol consumption: a mixed-methods evaluation of the drinkaware track & calculate units application

Abstract

BackgroundSmartphone applications (“apps”) offer promise as tools to help people monitor and reduce their alcohol consumption. To date, few evaluations of alcohol reduction apps exist, with even fewer considering apps already available to the public. The aim of this study was to evaluate an existing publically available app, designed by Drinkaware, a UK-based alcohol awareness charity.MethodsWe adopted a mixed-methods design, analysing routinely collected app usage data to explore user characteristics and patterns of usage. Following this, in-depth interviews were conducted with a sub-sample of app users to examine perceptions of acceptability, usability and perceived effectiveness, as well as to provide recommendations on how to improve the app.ResultsOne hundred nineteen thousand seven hundred thirteen people downloaded and entered data into the app over a 13-month period. High attrition was observed after 1 week. Users who engaged with the app tended to be “high risk” drinkers and to report being motivated “to reduce drinking” at the point of first download. In those who consistently engaged with the app over time, self-reported alcohol consumption levels reduced, with most change occurring in the first week of usage. Our qualitative findings indicate satisfaction with the usability of the app, but mixed feedback was given regarding individual features. Users expressed conflicting views concerning the type of feedback and notifications that the app currently provides. A common preference was expressed for more personalised content.ConclusionsThe Drinkaware app is a useful tool to support behaviour change in individuals who are already motivated and committed to reducing their alcohol consumption. The Drinkaware app would benefit from greater personalisation and tailoring to promote longer term use. This evaluation provides insight into the usability and acceptability of various app features and contains a number of recommendations for improving user satisfaction and the potential effectiveness of apps designed to encourage reductions in alcohol consumption.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4358-9) contains supplementary material, which is available to authorized users.

A Smartphone App and Personalized Text Messaging Framework (InDEx) to Monitor and Reduce Alcohol Use in Ex-Serving Personnel: Development and Feasibility Study

“…It has been reported that many apps lack an evidence base and make no reference to the scientific literature [ 14 , 15 ]. Recent research has found the use of mobile apps as brief alcohol interventions to be effective compared with traditional delivery methods (eg , face-to-face) [ 16 , 17 ]; however, the content of most existing alcohol smartphone interventions is based on public health guidelines regarding safe alcohol limits [ 14 , 18 ]. These alcohol limits may not be perceived as credible because they are viewed as state sponsored and are often at odds with individual beliefs, prevailing social context, and perceptions of consumption [ 18 - 21 ].…”

A randomised trial of the effect of appearance versus health-framed messages on engagement with an online brief screening and alcohol reduction intervention

“…This supposition is supported by an analysis of usage statistics from a smart phone application designed to support reductions in alcohol consumption, also developed by the Drinkaware Trust, which found that the second most common motivation for downloading and using the application to moderate drinking was related to physical appearance (e.g. to lose weight, cited by 30,924 (25.8%) of 119,713 users) (Attwood, Parke, Larsen, & Morton, 2017), and that levels of this motivation varied by gender (e.g. 19,415 female users versus 11,000 male users).…”

“…As recent research conducted by the Drinkaware Trust demonstrates, those with higher scores on the AUDIT-C (e.g. those who drink more) tend to also have greater pre-existing awareness of the impact of alcohol on their health (Gunstone, Piggot, Butler, Appleton, & Larsen, 2018) and are more likely than those with lower scores to actively want to reduce drinking for health reasons rather than to support an appearance-related goal such as losing weight (Attwood et al, 2017).…”

A Smartphone App and Personalized Text Messaging Framework (InDEx) to Monitor and Reduce Alcohol Use in Ex-Serving Personnel: Development and Feasibility Study (Preprint)

“…Participants could 'log' an alcohol beverage or an 'alcohol free day' via the 'Add Drinks' tab, Table 2 illustrates the types of alcoholic drink a participant could log. Self-reported alcohol consumption is a standard method for assessing the efficacy of low-intensity interventions [13], [14], [39]. Participants could optionally provide the quantity consumed, strength, price, calories, who they were drinking with and where they were drinking.…”