Home > Publications
2024
Abigail K Stevely, Claire Garnett, John Holmes, Andrew Jones, Larisa Dinu; Melissa Oldham
In: JMIR Formative Research, 2024.
Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps
@article{Stevely2024b,
title = {Optimizing the Measurement of Information on the Context of Alcohol Consumption Within the Drink Less App Among People Drinking at Increasing and Higher Risk Levels: Mixed-Methods Usability Study},
author = {Abigail K Stevely, Claire Garnett, John Holmes, Andrew Jones, Larisa Dinu and Melissa Oldham},
url = {https://formative.jmir.org/2024/1/e50131},
doi = {doi:10.2196/50131},
year = {2024},
date = {2024-10-24},
urldate = {2024-10-24},
journal = {JMIR Formative Research},
keywords = {Alcohol, alcohol consumption, Apps},
pubstate = {published},
tppubtype = {article}
}
2018
Claire Garnett, David Crane, Robert West, Jamie Brown; Susan Michie.
The development of Drink Less: an alcohol reduction smartphone app for excessive drinkers Journal Article
In: Translational Behavioral Medicine, 2018.
Abstract | Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps, behaviour, Digital Interventions
@article{,
title = {The development of Drink Less: an alcohol reduction smartphone app for excessive drinkers},
author = {Claire Garnett, David Crane, Robert West, Jamie Brown and Susan Michie. },
doi = {10.1093/tbm/iby043},
year = {2018},
date = {2018-05-04},
journal = {Translational Behavioral Medicine},
abstract = {Excessive alcohol consumption poses a serious problem for public health. Digital behavior change interventions have the potential to help users reduce their drinking. In accordance with Open Science principles, this paper describes the development of a smartphone app to help individuals who drink excessively to reduce their alcohol consumption. Following the UK Medical Research Council’s guidance and the Multiphase Optimization Strategy, development consisted of two phases: (i) selection of intervention components and (ii) design and development work to implement the chosen components into modules to be evaluated further for inclusion in the app. Phase 1 involved a scoping literature review, expert consensus study and content analysis of existing alcohol apps. Findings were integrated within a broad model of behavior change (Capability, Opportunity, Motivation-Behavior). Phase 2 involved a highly iterative process and used the “Person-Based” approach to promote engagement. From Phase 1, five intervention components were selected: (i) Normative Feedback, (ii) Cognitive Bias Re-training, (iii) Self-monitoring and Feedback, (iv) Action Planning, and (v) Identity Change. Phase 2 indicated that each of these components presented different challenges for implementation as app modules; all required multiple iterations and design changes to arrive at versions that would be suitable for inclusion in a subsequent evaluation study. The development of the Drink Less app involved a thorough process of component identification with a scoping literature review, expert consensus, and review of other apps. Translation of the components into app modules required a highly iterative process involving user testing and design modification.},
keywords = {Alcohol, alcohol consumption, Apps, behaviour, Digital Interventions},
pubstate = {published},
tppubtype = {article}
}
Excessive alcohol consumption poses a serious problem for public health. Digital behavior change interventions have the potential to help users reduce their drinking. In accordance with Open Science principles, this paper describes the development of a smartphone app to help individuals who drink excessively to reduce their alcohol consumption. Following the UK Medical Research Council’s guidance and the Multiphase Optimization Strategy, development consisted of two phases: (i) selection of intervention components and (ii) design and development work to implement the chosen components into modules to be evaluated further for inclusion in the app. Phase 1 involved a scoping literature review, expert consensus study and content analysis of existing alcohol apps. Findings were integrated within a broad model of behavior change (Capability, Opportunity, Motivation-Behavior). Phase 2 involved a highly iterative process and used the “Person-Based” approach to promote engagement. From Phase 1, five intervention components were selected: (i) Normative Feedback, (ii) Cognitive Bias Re-training, (iii) Self-monitoring and Feedback, (iv) Action Planning, and (v) Identity Change. Phase 2 indicated that each of these components presented different challenges for implementation as app modules; all required multiple iterations and design changes to arrive at versions that would be suitable for inclusion in a subsequent evaluation study. The development of the Drink Less app involved a thorough process of component identification with a scoping literature review, expert consensus, and review of other apps. Translation of the components into app modules required a highly iterative process involving user testing and design modification.
David Crane, Claire Garnett, Susan Michie, Robert West; Jamie Brown.
In: Scientific Reports, 2018.
Abstract | Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps, Digital Interventions
@article{,
title = {A smartphone app to reduce excessive alcohol consumption: Identifying the effectiveness of intervention components in a factorial randomised control trial},
author = {David Crane, Claire Garnett, Susan Michie, Robert West and Jamie Brown. },
url = {https://www.nature.com/articles/s41598-018-22420-8},
doi = {10.1038/s41598-018-22420-8},
year = {2018},
date = {2018-03-12},
journal = {Scientific Reports},
abstract = {Our aim was to evaluate intervention components of an alcohol reduction app: Drink Less. Excessive drinkers (AUDIT> =8) were recruited to test enhanced versus minimal (reduced functionality) versions of five app modules in a 25 factorial trial. Modules were: Self-monitoring and Feedback, Action Planning, Identity Change, Normative Feedback, and Cognitive Bias Re-training. Outcome measures were: change in weekly alcohol consumption (primary); full AUDIT score, app usage, app usability (secondary). Main effects and two-way interactions were assessed by ANOVA using intention-to-treat. A total of 672 study participants were included. There were no significant main effects of the intervention modules on change in weekly alcohol consumption or AUDIT score. There were two-way interactions between enhanced Normative Feedback and Cognitive Bias Re-training on weekly alcohol consumption (F = 4.68, p = 0.03) and between enhanced Self-monitoring and Feedback and Action Planning on AUDIT score (F = 5.82, p = 0.02). Enhanced Self-monitoring and Feedback was used significantly more often and rated significantly more positively for helpfulness, satisfaction and recommendation to others than the minimal version. To conclude, in an evaluation of the Drink Less smartphone application, the combination of enhanced Normative Feedback and Cognitive Bias Re-training and enhanced Self-monitoring and Feedback and Action Planning yielded improvements in alcohol-related outcomes after 4-weeks.},
keywords = {Alcohol, alcohol consumption, Apps, Digital Interventions},
pubstate = {published},
tppubtype = {article}
}
Our aim was to evaluate intervention components of an alcohol reduction app: Drink Less. Excessive drinkers (AUDIT> =8) were recruited to test enhanced versus minimal (reduced functionality) versions of five app modules in a 25 factorial trial. Modules were: Self-monitoring and Feedback, Action Planning, Identity Change, Normative Feedback, and Cognitive Bias Re-training. Outcome measures were: change in weekly alcohol consumption (primary); full AUDIT score, app usage, app usability (secondary). Main effects and two-way interactions were assessed by ANOVA using intention-to-treat. A total of 672 study participants were included. There were no significant main effects of the intervention modules on change in weekly alcohol consumption or AUDIT score. There were two-way interactions between enhanced Normative Feedback and Cognitive Bias Re-training on weekly alcohol consumption (F = 4.68, p = 0.03) and between enhanced Self-monitoring and Feedback and Action Planning on AUDIT score (F = 5.82, p = 0.02). Enhanced Self-monitoring and Feedback was used significantly more often and rated significantly more positively for helpfulness, satisfaction and recommendation to others than the minimal version. To conclude, in an evaluation of the Drink Less smartphone application, the combination of enhanced Normative Feedback and Cognitive Bias Re-training and enhanced Self-monitoring and Feedback and Action Planning yielded improvements in alcohol-related outcomes after 4-weeks.
Claire Garnett, David Crane, Jamie Brown, Eileen Kaner, Fiona Beyer, Colin Muirhead, Matthew Hickman, James Redmore, Frank de Vocht, Emma Beard; Susan Michie.
Reported Theory Use by Digital Interventions for Hazardous and Harmful Alcohol Consumption, and Association With Effectiveness: Meta-Regression Journal Article
In: Journal of Medical Internet Research, vol. 20, no. 2, 2018.
Abstract | Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps, Digital Interventions
@article{,
title = {Reported Theory Use by Digital Interventions for Hazardous and Harmful Alcohol Consumption, and Association With Effectiveness: Meta-Regression},
author = {Claire Garnett, David Crane, Jamie Brown, Eileen Kaner, Fiona Beyer, Colin Muirhead, Matthew Hickman, James Redmore, Frank de Vocht, Emma Beard and Susan Michie. },
doi = {10.2196/jmir.8807},
year = {2018},
date = {2018-02-28},
journal = {Journal of Medical Internet Research},
volume = {20},
number = {2},
abstract = {Background
Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this.
Objective
The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness.
Methods
Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models.
Results
Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I2=77.6%, P<.001). No significant associations were detected between reporting of theory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations.
Conclusions
Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories.},
keywords = {Alcohol, alcohol consumption, Apps, Digital Interventions},
pubstate = {published},
tppubtype = {article}
}
Background
Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this.
Objective
The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness.
Methods
Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models.
Results
Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I2=77.6%, P<.001). No significant associations were detected between reporting of theory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations.
Conclusions
Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories.
Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this.
Objective
The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness.
Methods
Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models.
Results
Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I2=77.6%, P<.001). No significant associations were detected between reporting of theory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations.
Conclusions
Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories.
Claire V Garnett, David Crane, Jamie Brown, Eileen F S Kaner, Fiona R Beyer, Colin R Muirhead, Matthew Hickman, Emma Beard, James Redmore, Frank de Vocht; Susan Michie.
Behavior Change Techniques Used in Digital Behavior Change Interventions to Reduce Excessive Alcohol Consumption: A Meta-regression Journal Article
In: Annals of Behaviour Medicine, vol. 52, no. 6, 2018.
Abstract | Links | Altmetric | Tags: alcohol consumption, Apps, behaviour, Digital Interventions
@article{,
title = {Behavior Change Techniques Used in Digital Behavior Change Interventions to Reduce Excessive Alcohol Consumption: A Meta-regression},
author = {Claire V Garnett, David Crane, Jamie Brown, Eileen F S Kaner, Fiona R Beyer, Colin R Muirhead, Matthew Hickman, Emma Beard, James Redmore, Frank de Vocht and Susan Michie.},
doi = {10.1093/abm/kax029},
year = {2018},
date = {2018-01-27},
journal = {Annals of Behaviour Medicine},
volume = {52},
number = {6},
abstract = {Background
Digital behavior change interventions (DBCIs) appear to reduce alcohol consumption, but greater understanding is needed of their mechanisms of action.
Purpose
To describe the behavior change techniques (BCTs) used in DBCIs and examine whether individual BCTs, the inclusion of more BCTs or more Control Theory congruent BCTs is associated with increased effectiveness.
Methods
Forty-one randomized control trials were extracted from a Cochrane review of alcohol reduction DBCIs and coded for up to 93 BCTs using an established and reliable method. Random effects unadjusted and adjusted meta-regression models were performed to assess associations between BCTs and intervention effectiveness.
Results
Interventions used a mean of 9.1 BCTs (range 1–22), 23 different BCTs were used in four or more trials. Trials that used “Behavior substitution” (−95.112 grams per week [gpw], 95% CI: −162.90, −27.34), “Problem solving” (−45.92 gpw, 95% CI: −90.97, −0.87) and “Credible source” (−32.09 gpw, 95% CI: −60.64, −3.55) were significantly associated with greater alcohol reduction than trials without these BCTs. The “Behavior substitution” result should be treated as preliminary because it was reported in only four trials, three of which were conducted by the same research group. “Feedback” was used in 98% of trials (n = 41); other Control Theory congruent BCTs were used less frequently: for example, “Goal setting” 43% (n = 18) and “Self-monitoring” 29%, (n = 12).
Conclusions
“Behavior substitution,” “Problem solving,” and “Credible source” were associated with greater alcohol reduction. Many BCTs were used infrequently in DBCIs, including BCTs with evidence of effectiveness in other domains, such as “Self-monitoring” and “Goal setting.”},
keywords = {alcohol consumption, Apps, behaviour, Digital Interventions},
pubstate = {published},
tppubtype = {article}
}
Background
Digital behavior change interventions (DBCIs) appear to reduce alcohol consumption, but greater understanding is needed of their mechanisms of action.
Purpose
To describe the behavior change techniques (BCTs) used in DBCIs and examine whether individual BCTs, the inclusion of more BCTs or more Control Theory congruent BCTs is associated with increased effectiveness.
Methods
Forty-one randomized control trials were extracted from a Cochrane review of alcohol reduction DBCIs and coded for up to 93 BCTs using an established and reliable method. Random effects unadjusted and adjusted meta-regression models were performed to assess associations between BCTs and intervention effectiveness.
Results
Interventions used a mean of 9.1 BCTs (range 1–22), 23 different BCTs were used in four or more trials. Trials that used “Behavior substitution” (−95.112 grams per week [gpw], 95% CI: −162.90, −27.34), “Problem solving” (−45.92 gpw, 95% CI: −90.97, −0.87) and “Credible source” (−32.09 gpw, 95% CI: −60.64, −3.55) were significantly associated with greater alcohol reduction than trials without these BCTs. The “Behavior substitution” result should be treated as preliminary because it was reported in only four trials, three of which were conducted by the same research group. “Feedback” was used in 98% of trials (n = 41); other Control Theory congruent BCTs were used less frequently: for example, “Goal setting” 43% (n = 18) and “Self-monitoring” 29%, (n = 12).
Conclusions
“Behavior substitution,” “Problem solving,” and “Credible source” were associated with greater alcohol reduction. Many BCTs were used infrequently in DBCIs, including BCTs with evidence of effectiveness in other domains, such as “Self-monitoring” and “Goal setting.”
Digital behavior change interventions (DBCIs) appear to reduce alcohol consumption, but greater understanding is needed of their mechanisms of action.
Purpose
To describe the behavior change techniques (BCTs) used in DBCIs and examine whether individual BCTs, the inclusion of more BCTs or more Control Theory congruent BCTs is associated with increased effectiveness.
Methods
Forty-one randomized control trials were extracted from a Cochrane review of alcohol reduction DBCIs and coded for up to 93 BCTs using an established and reliable method. Random effects unadjusted and adjusted meta-regression models were performed to assess associations between BCTs and intervention effectiveness.
Results
Interventions used a mean of 9.1 BCTs (range 1–22), 23 different BCTs were used in four or more trials. Trials that used “Behavior substitution” (−95.112 grams per week [gpw], 95% CI: −162.90, −27.34), “Problem solving” (−45.92 gpw, 95% CI: −90.97, −0.87) and “Credible source” (−32.09 gpw, 95% CI: −60.64, −3.55) were significantly associated with greater alcohol reduction than trials without these BCTs. The “Behavior substitution” result should be treated as preliminary because it was reported in only four trials, three of which were conducted by the same research group. “Feedback” was used in 98% of trials (n = 41); other Control Theory congruent BCTs were used less frequently: for example, “Goal setting” 43% (n = 18) and “Self-monitoring” 29%, (n = 12).
Conclusions
“Behavior substitution,” “Problem solving,” and “Credible source” were associated with greater alcohol reduction. Many BCTs were used infrequently in DBCIs, including BCTs with evidence of effectiveness in other domains, such as “Self-monitoring” and “Goal setting.”
2017
David Crane, Claire Garnett, Jamie Brown, Robert West; Susan Michie.
Factors Influencing Usability of a Smartphone App to Reduce Excessive Alcohol Consumption: Think Aloud and Interview Studies Journal Article
In: Frontiers in Public Health Digital Health , 2017.
Abstract | Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps, Digital Interventions
@article{,
title = {Factors Influencing Usability of a Smartphone App to Reduce Excessive Alcohol Consumption: Think Aloud and Interview Studies},
author = {David Crane, Claire Garnett, Jamie Brown, Robert West and Susan Michie.},
doi = {10.3389/fpubh.2017.00039},
year = {2017},
date = {2017-04-03},
journal = {Frontiers in Public Health Digital Health },
abstract = {Background
Interventions delivered by smartphone apps have the potential to help drinkers reduce their consumption of alcohol. To optimize engagement and reduce the high rates of attrition associated with the use of digital interventions, it is necessary to ensure that an app’s design and functionality is appropriate for its intended purposes and target population.
Aims
To understand the usability of an app to help people reduce their alcohol consumption.
Method
The app, Drink Less, contains a core module focusing on goal setting, supplemented by five additional modules: self-monitoring and feedback, identity change, cognitive bias re-training, action planning, and social comparison. Two studies were conducted, a “think aloud” study performed with people using the app for the first time and a semistructured interview study performed after users had had access to the app for at least 2 weeks. A thematic analysis of the “think aloud” and interview transcripts was conducted by one coder and verified by a second.
Results
Twenty-four participants, half of whom were women and half from disadvantaged groups, took part in the two studies. Three main themes identified in the data were “Feeling lost and unsure of what to do next,” “Make the app easy to use,” and “Make the app beneficial and rewarding to use.” These themes reflected participants’ need for (i) guidance, particularly when first using the app or when entering data; (ii) the data entry process to be simple and the navigation intuitive; (iii) neither the amount of text nor range of options to be overwhelming; (iv) the app to reward them for effort and progress; and (v) it to be clear how the app could help alcohol reduction goals be reached.
Conclusion
First-time and experienced users want an alcohol reduction app to be easy, rewarding, and beneficial to use. An easy-to-use app would reduce user burden, offer ongoing help, and be esthetically pleasing. A rewarding and beneficial app would provide positive reinforcement, give feedback about progress, and demonstrate credibility. Users need help when first using the app, and they need a compelling reason to continue using it.},
keywords = {Alcohol, alcohol consumption, Apps, Digital Interventions},
pubstate = {published},
tppubtype = {article}
}
Background
Interventions delivered by smartphone apps have the potential to help drinkers reduce their consumption of alcohol. To optimize engagement and reduce the high rates of attrition associated with the use of digital interventions, it is necessary to ensure that an app’s design and functionality is appropriate for its intended purposes and target population.
Aims
To understand the usability of an app to help people reduce their alcohol consumption.
Method
The app, Drink Less, contains a core module focusing on goal setting, supplemented by five additional modules: self-monitoring and feedback, identity change, cognitive bias re-training, action planning, and social comparison. Two studies were conducted, a “think aloud” study performed with people using the app for the first time and a semistructured interview study performed after users had had access to the app for at least 2 weeks. A thematic analysis of the “think aloud” and interview transcripts was conducted by one coder and verified by a second.
Results
Twenty-four participants, half of whom were women and half from disadvantaged groups, took part in the two studies. Three main themes identified in the data were “Feeling lost and unsure of what to do next,” “Make the app easy to use,” and “Make the app beneficial and rewarding to use.” These themes reflected participants’ need for (i) guidance, particularly when first using the app or when entering data; (ii) the data entry process to be simple and the navigation intuitive; (iii) neither the amount of text nor range of options to be overwhelming; (iv) the app to reward them for effort and progress; and (v) it to be clear how the app could help alcohol reduction goals be reached.
Conclusion
First-time and experienced users want an alcohol reduction app to be easy, rewarding, and beneficial to use. An easy-to-use app would reduce user burden, offer ongoing help, and be esthetically pleasing. A rewarding and beneficial app would provide positive reinforcement, give feedback about progress, and demonstrate credibility. Users need help when first using the app, and they need a compelling reason to continue using it.
Interventions delivered by smartphone apps have the potential to help drinkers reduce their consumption of alcohol. To optimize engagement and reduce the high rates of attrition associated with the use of digital interventions, it is necessary to ensure that an app’s design and functionality is appropriate for its intended purposes and target population.
Aims
To understand the usability of an app to help people reduce their alcohol consumption.
Method
The app, Drink Less, contains a core module focusing on goal setting, supplemented by five additional modules: self-monitoring and feedback, identity change, cognitive bias re-training, action planning, and social comparison. Two studies were conducted, a “think aloud” study performed with people using the app for the first time and a semistructured interview study performed after users had had access to the app for at least 2 weeks. A thematic analysis of the “think aloud” and interview transcripts was conducted by one coder and verified by a second.
Results
Twenty-four participants, half of whom were women and half from disadvantaged groups, took part in the two studies. Three main themes identified in the data were “Feeling lost and unsure of what to do next,” “Make the app easy to use,” and “Make the app beneficial and rewarding to use.” These themes reflected participants’ need for (i) guidance, particularly when first using the app or when entering data; (ii) the data entry process to be simple and the navigation intuitive; (iii) neither the amount of text nor range of options to be overwhelming; (iv) the app to reward them for effort and progress; and (v) it to be clear how the app could help alcohol reduction goals be reached.
Conclusion
First-time and experienced users want an alcohol reduction app to be easy, rewarding, and beneficial to use. An easy-to-use app would reduce user burden, offer ongoing help, and be esthetically pleasing. A rewarding and beneficial app would provide positive reinforcement, give feedback about progress, and demonstrate credibility. Users need help when first using the app, and they need a compelling reason to continue using it.
Claire Garnett, David Crane, Robert West, Susan Michie, Jamie Brown; Adam Winstock.
User characteristics of a smartphone app to reduce alcohol consumption Journal Article
In: Translational Behavioral Medicine, vol. 7, no. 4, pp. 845-853, 2017.
Abstract | Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps, behaviour, Digital Interventions
@article{,
title = {User characteristics of a smartphone app to reduce alcohol consumption},
author = {Claire Garnett, David Crane, Robert West, Susan Michie, Jamie Brown and Adam Winstock.},
doi = {10.1007/s13142-017-0477-1},
year = {2017},
date = {2017-03-17},
journal = {Translational Behavioral Medicine},
volume = {7},
number = {4},
pages = {845-853},
abstract = {Digital interventions are available to help people reduce their alcohol consumption, but it is not known who uses these interventions and how this treatment-seeking group compares with the general population of drinkers. The study objective was to compare the socio-demographic and drinking characteristics of users of the ‘Drinks Meter’ smartphone app with the general population of drinkers in England and website users of the same intervention. Data were used from the Drinks Meter app and website, and a nationally representative cross-sectional survey in England (Alcohol Toolkit Study). Participants were drinkers aged 16+ in England. Data were collected on participants’ age, gender, region, sexual orientation, social grade and AUDIT score. Regression analyses were conducted to assess differences in socio-demographic and drinking characteristics between samples. Drinks Meter app users, compared with drinkers of the general population, were younger, more likely to be from the South, not heterosexual, less likely to be of a lower social grade and had a higher mean AUDIT score. Drinks Meter app users were younger than website users and reported greater alcohol consumption and related harms. Drinkers using the Drinks Meter app are more likely to be younger and report greater alcohol consumption and related harms compared with the general population of drinkers in England and website users of the same intervention. Apps that provide feedback on drinking appear to be reaching those who report greater alcohol consumption and related harms.},
keywords = {Alcohol, alcohol consumption, Apps, behaviour, Digital Interventions},
pubstate = {published},
tppubtype = {article}
}
Digital interventions are available to help people reduce their alcohol consumption, but it is not known who uses these interventions and how this treatment-seeking group compares with the general population of drinkers. The study objective was to compare the socio-demographic and drinking characteristics of users of the ‘Drinks Meter’ smartphone app with the general population of drinkers in England and website users of the same intervention. Data were used from the Drinks Meter app and website, and a nationally representative cross-sectional survey in England (Alcohol Toolkit Study). Participants were drinkers aged 16+ in England. Data were collected on participants’ age, gender, region, sexual orientation, social grade and AUDIT score. Regression analyses were conducted to assess differences in socio-demographic and drinking characteristics between samples. Drinks Meter app users, compared with drinkers of the general population, were younger, more likely to be from the South, not heterosexual, less likely to be of a lower social grade and had a higher mean AUDIT score. Drinks Meter app users were younger than website users and reported greater alcohol consumption and related harms. Drinkers using the Drinks Meter app are more likely to be younger and report greater alcohol consumption and related harms compared with the general population of drinkers in England and website users of the same intervention. Apps that provide feedback on drinking appear to be reaching those who report greater alcohol consumption and related harms.
2016
Claire Garnett, David Crane, Susan Michie, Robert West; Jamie Brown.
Evaluating the effectiveness of a smartphone app to reduce excessive alcohol consumption: protocol for a factorial randomised control trial Journal Article
In: BMC Public Health , 2016.
Abstract | Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps, Digital Interventions
@article{,
title = {Evaluating the effectiveness of a smartphone app to reduce excessive alcohol consumption: protocol for a factorial randomised control trial},
author = {Claire Garnett, David Crane, Susan Michie, Robert West and Jamie Brown.},
doi = {10.1186/s12889-016-3140-8},
year = {2016},
date = {2016-07-08},
journal = {BMC Public Health },
abstract = {Background
Excessive alcohol consumption is a leading cause of death and morbidity worldwide and interventions to help people reduce their consumption are needed. Interventions delivered by smartphone apps have the potential to help harmful and hazardous drinkers reduce their consumption of alcohol. However, there has been little evaluation of the effectiveness of existing smartphone interventions.
A systematic review, amongst other methodologies, identified promising modular content that could be delivered by an app: self-monitoring and feedback; action planning; normative feedback; cognitive bias re-training; and identity change. This protocol reports a factorial randomised controlled trial to assess the comparative potential of these five intervention modules to reduce excessive alcohol consumption.
Methods
A between-subject factorial randomised controlled trial. Hazardous and harmful drinkers aged 18 or over who are making a serious attempt to reduce their drinking will be randomised to one of 32 (25) experimental conditions after downloading the ‘Drink Less’ app. Participants complete baseline measures on downloading the app and are contacted after 1-month with a follow-up questionnaire. The primary outcome measure is change in past week consumption of alcohol. Secondary outcome measures are change in AUDIT score, app usage data and usability ratings for the app. A factorial between-subjects ANOVA will be conducted to assess main and interactive effects of the five intervention modules for the primary and secondary outcome measures.
Discussion
This study will establish the extent to which the five intervention modules offered in this app can help reduce hazardous and harmful drinking. This is the first step in optimising and understanding what component parts of an app could help to reduce excessive alcohol consumption. The findings from this study will be used to inform the content of a future integrated treatment app and evaluated against a minimal control in a definitive randomised control trial with long-term outcomes.},
keywords = {Alcohol, alcohol consumption, Apps, Digital Interventions},
pubstate = {published},
tppubtype = {article}
}
Background
Excessive alcohol consumption is a leading cause of death and morbidity worldwide and interventions to help people reduce their consumption are needed. Interventions delivered by smartphone apps have the potential to help harmful and hazardous drinkers reduce their consumption of alcohol. However, there has been little evaluation of the effectiveness of existing smartphone interventions.
A systematic review, amongst other methodologies, identified promising modular content that could be delivered by an app: self-monitoring and feedback; action planning; normative feedback; cognitive bias re-training; and identity change. This protocol reports a factorial randomised controlled trial to assess the comparative potential of these five intervention modules to reduce excessive alcohol consumption.
Methods
A between-subject factorial randomised controlled trial. Hazardous and harmful drinkers aged 18 or over who are making a serious attempt to reduce their drinking will be randomised to one of 32 (25) experimental conditions after downloading the ‘Drink Less’ app. Participants complete baseline measures on downloading the app and are contacted after 1-month with a follow-up questionnaire. The primary outcome measure is change in past week consumption of alcohol. Secondary outcome measures are change in AUDIT score, app usage data and usability ratings for the app. A factorial between-subjects ANOVA will be conducted to assess main and interactive effects of the five intervention modules for the primary and secondary outcome measures.
Discussion
This study will establish the extent to which the five intervention modules offered in this app can help reduce hazardous and harmful drinking. This is the first step in optimising and understanding what component parts of an app could help to reduce excessive alcohol consumption. The findings from this study will be used to inform the content of a future integrated treatment app and evaluated against a minimal control in a definitive randomised control trial with long-term outcomes.
Excessive alcohol consumption is a leading cause of death and morbidity worldwide and interventions to help people reduce their consumption are needed. Interventions delivered by smartphone apps have the potential to help harmful and hazardous drinkers reduce their consumption of alcohol. However, there has been little evaluation of the effectiveness of existing smartphone interventions.
A systematic review, amongst other methodologies, identified promising modular content that could be delivered by an app: self-monitoring and feedback; action planning; normative feedback; cognitive bias re-training; and identity change. This protocol reports a factorial randomised controlled trial to assess the comparative potential of these five intervention modules to reduce excessive alcohol consumption.
Methods
A between-subject factorial randomised controlled trial. Hazardous and harmful drinkers aged 18 or over who are making a serious attempt to reduce their drinking will be randomised to one of 32 (25) experimental conditions after downloading the ‘Drink Less’ app. Participants complete baseline measures on downloading the app and are contacted after 1-month with a follow-up questionnaire. The primary outcome measure is change in past week consumption of alcohol. Secondary outcome measures are change in AUDIT score, app usage data and usability ratings for the app. A factorial between-subjects ANOVA will be conducted to assess main and interactive effects of the five intervention modules for the primary and secondary outcome measures.
Discussion
This study will establish the extent to which the five intervention modules offered in this app can help reduce hazardous and harmful drinking. This is the first step in optimising and understanding what component parts of an app could help to reduce excessive alcohol consumption. The findings from this study will be used to inform the content of a future integrated treatment app and evaluated against a minimal control in a definitive randomised control trial with long-term outcomes.
2015
Claire Garnett, David Crane, Robert West, Jamie Brown; Susan Michie.
In: JMIR mHealth and uHealth, vol. 3, no. 2, 2015.
Abstract | Links | Altmetric | Tags: Alcohol, alcohol consumption, Apps, Digital Interventions, Smartphone
@article{,
title = {Identification of Behavior Change Techniques and Engagement Strategies to Design a Smartphone App to Reduce Alcohol Consumption Using a Formal Consensus Method},
author = {Claire Garnett, David Crane, Robert West, Jamie Brown and Susan Michie. },
doi = {10.2196/mhealth.3895},
year = {2015},
date = {2015-06-29},
journal = {JMIR mHealth and uHealth},
volume = {3},
number = {2},
abstract = {Background
Digital interventions to reduce excessive alcohol consumption have the potential to have a broader reach and be more cost-effective than traditional brief interventions. However, there is not yet strong evidence for their ability to engage users or their effectiveness.
Objective
This study aimed to identify the behavior change techniques (BCTs) and engagement strategies most worthy of further study by inclusion in a smartphone app to reduce alcohol consumption, using formal expert consensus methods.
Methods
The first phase of the study consisted of a Delphi exercise with three rounds. It was conducted with 7 international experts in the field of alcohol and/or behavior change. In the first round, experts identified BCTs most likely to be effective at reducing alcohol consumption and strategies most likely to engage users with an app; these were rated in the second round; and those rated as effective by at least four out of seven participants were ranked in the third round. The rankings were analyzed using Kendall’s W coefficient of concordance, which indicates consensus between participants. The second phase consisted of a new, independent group of experts (n=43) ranking the BCTs that were identified in the first phase. The correlation between the rankings of the two groups was assessed using Spearman’s rank correlation coefficient.
Results
Twelve BCTs were identified as likely to be effective. There was moderate agreement among the experts over their ranking (W=.465, χ211=35.8, P<.001) and the BCTs receiving the highest mean rankings were self-monitoring, goal-setting, action planning, and feedback in relation to goals. There was a significant correlation between the ranking of the BCTs by the group of experts who identified them and a second independent group of experts (Spearman’s rho=.690, P=.01). Seventeen responses were generated for strategies likely to engage users. There was moderate agreement among experts on the ranking of these engagement strategies (W=.563, χ215=59.2, P<.001) and those with the highest mean rankings were ease of use, design – aesthetic, feedback, function, design – ability to change design to suit own preferences, tailored information, and unique smartphone features.
Conclusions
The BCTs with greatest potential to include in a smartphone app to reduce alcohol consumption were judged by experts to be self-monitoring, goal-setting, action planning, and feedback in relation to goals. The strategies most likely to engage users were ease of use, design, tailoring of design and information, and unique smartphone features.},
keywords = {Alcohol, alcohol consumption, Apps, Digital Interventions, Smartphone},
pubstate = {published},
tppubtype = {article}
}
Background
Digital interventions to reduce excessive alcohol consumption have the potential to have a broader reach and be more cost-effective than traditional brief interventions. However, there is not yet strong evidence for their ability to engage users or their effectiveness.
Objective
This study aimed to identify the behavior change techniques (BCTs) and engagement strategies most worthy of further study by inclusion in a smartphone app to reduce alcohol consumption, using formal expert consensus methods.
Methods
The first phase of the study consisted of a Delphi exercise with three rounds. It was conducted with 7 international experts in the field of alcohol and/or behavior change. In the first round, experts identified BCTs most likely to be effective at reducing alcohol consumption and strategies most likely to engage users with an app; these were rated in the second round; and those rated as effective by at least four out of seven participants were ranked in the third round. The rankings were analyzed using Kendall’s W coefficient of concordance, which indicates consensus between participants. The second phase consisted of a new, independent group of experts (n=43) ranking the BCTs that were identified in the first phase. The correlation between the rankings of the two groups was assessed using Spearman’s rank correlation coefficient.
Results
Twelve BCTs were identified as likely to be effective. There was moderate agreement among the experts over their ranking (W=.465, χ211=35.8, P<.001) and the BCTs receiving the highest mean rankings were self-monitoring, goal-setting, action planning, and feedback in relation to goals. There was a significant correlation between the ranking of the BCTs by the group of experts who identified them and a second independent group of experts (Spearman’s rho=.690, P=.01). Seventeen responses were generated for strategies likely to engage users. There was moderate agreement among experts on the ranking of these engagement strategies (W=.563, χ215=59.2, P<.001) and those with the highest mean rankings were ease of use, design – aesthetic, feedback, function, design – ability to change design to suit own preferences, tailored information, and unique smartphone features.
Conclusions
The BCTs with greatest potential to include in a smartphone app to reduce alcohol consumption were judged by experts to be self-monitoring, goal-setting, action planning, and feedback in relation to goals. The strategies most likely to engage users were ease of use, design, tailoring of design and information, and unique smartphone features.
Digital interventions to reduce excessive alcohol consumption have the potential to have a broader reach and be more cost-effective than traditional brief interventions. However, there is not yet strong evidence for their ability to engage users or their effectiveness.
Objective
This study aimed to identify the behavior change techniques (BCTs) and engagement strategies most worthy of further study by inclusion in a smartphone app to reduce alcohol consumption, using formal expert consensus methods.
Methods
The first phase of the study consisted of a Delphi exercise with three rounds. It was conducted with 7 international experts in the field of alcohol and/or behavior change. In the first round, experts identified BCTs most likely to be effective at reducing alcohol consumption and strategies most likely to engage users with an app; these were rated in the second round; and those rated as effective by at least four out of seven participants were ranked in the third round. The rankings were analyzed using Kendall’s W coefficient of concordance, which indicates consensus between participants. The second phase consisted of a new, independent group of experts (n=43) ranking the BCTs that were identified in the first phase. The correlation between the rankings of the two groups was assessed using Spearman’s rank correlation coefficient.
Results
Twelve BCTs were identified as likely to be effective. There was moderate agreement among the experts over their ranking (W=.465, χ211=35.8, P<.001) and the BCTs receiving the highest mean rankings were self-monitoring, goal-setting, action planning, and feedback in relation to goals. There was a significant correlation between the ranking of the BCTs by the group of experts who identified them and a second independent group of experts (Spearman’s rho=.690, P=.01). Seventeen responses were generated for strategies likely to engage users. There was moderate agreement among experts on the ranking of these engagement strategies (W=.563, χ215=59.2, P<.001) and those with the highest mean rankings were ease of use, design – aesthetic, feedback, function, design – ability to change design to suit own preferences, tailored information, and unique smartphone features.
Conclusions
The BCTs with greatest potential to include in a smartphone app to reduce alcohol consumption were judged by experts to be self-monitoring, goal-setting, action planning, and feedback in relation to goals. The strategies most likely to engage users were ease of use, design, tailoring of design and information, and unique smartphone features.