None listed
Conditions
Brief summary
Background: Over 35% of Australians who drink in excess of NHMRC guideline levels (AIHW, 2008). Individuals who drink at harmful levels can experience a range of negative physical, psychological and social consequences (NHMRC, 2009; LaBrie et al. 2009) but are generally unlikely to seek professional help to reduce their alcohol consumption (Reavley et al, 2010). Smartphone health-related apps may mitigate many identified barriers to help-seeking, such as concerns about privacy and stigma, treatment cost and time commitment and a preference for self-reliance (Ballon et al., 2004; Saunders et al., 2006). Additionally, other advantages include their low cost, convenience and accessibility. However, while numerous apps purport to reduce alcohol consumption, most show poor evidence-based content quality (Penzenstadler et al. 2016). Only nine apps have been subject to assessment and only four of these have demonstrated promising outcomes, albeit most with major methodological limitations (Gajecki et al., 2017; Gonzalez & Dulin, 2015; Gustafson et al., 2014; You et al., 2017). This intervention: To address this intervention gap, a team of clinicians and researchers at the Centre of Drug, Alcohol and Addiction Research (CEDAAR) at Deakin University developed a unique evidence-based smartphone app. Through an iterative process involving clinical expert input, consumer feedback, user-testing and piloting, we have developed an app that uses an effective behaviour change technique–Implementation Intentions (Gollwitzer & Sheeran, 2006)–in addition to goals, monitoring, feedback. Implementation Intentions have the ability to bridge the intention-behaviour gap, and are associated with strong and consistent behaviour change outcomes, including for risky drinking (e.g. Armitage, 2009). Implementation Intentions work by pairing a key obstacle (‘If my friends pressure me to drink’) with a concrete alternative behaviour (‘Then I will say I have a big day tomorrow and decline’). Through memory cues and scripted responses, Implementation Intentions replace automatic unhelpful habits with helpful alternative responses that become increasingly automatic. General procedure: This Randomised Controlled Trial (RCT) aims to investigate whether personalised Implementation Intentions delivered through an app are efficacious for reducing alcohol consumption and related harms among risky drinkers. It will also examine a number of potential mediators and moderators. Participants will be randomised to one of two groups: Intervention or Waitlist. Outcomes: The RCT will assess whether alcohol consumption and related harm are reduced post intervention in the Intervention group compared with the Waitlist group and whether these reductions are maintained at 4-weeks follow-up. In addition, the study will assess whether a range of secondary outcomes are impacted by the intervention and whether certain baseline and change variables predict outcome.
Interventions
The intervention is a smartphone app (iOS and Android compatible) that delivers a structured 4-week intervention program with the aim of reducing alcohol consumption among individuals who engage in harmful drinking. The app has an embedded follow-up 4 weeks later. The app delivers four evidence-based intervention components: consumption monitoring, consumption feedback, goal-setting, and Implementation Intentions (“If-Then Plans”).
Monitoring occurs via a daily alert that asks participants to
The intervention is a smartphone app (iOS and Android compatible) that delivers a structured 4-week intervention program with the aim of reducing alcohol consumption among individuals who engage in harmful drinking. The app has an embedded follow-up 4 weeks later. The app delivers four evidence-based intervention components: consumption monitoring, consumption feedback, goal-setting, and Implementation Intentions (“If-Then Plans”). Monitoring occurs via a daily alert that asks participants to report what type of drink they consumed on the previous day, and how much. The feedback component, delivered within the same daily alert (and is also always available), shows a daily consumption bar graph spanning the entire intervention (indicating whether each day’s entry was above or below Australian safe drinking guidelines) and a cumulative average line graph (indicating whether the consumption average is above or below Australian safe drinking guidelines). The goal-setting component is comprised of four goals that serve to both limit drinking times and drinking speed. Finally, the Implementation Intention component is comprised of a guided setup that involves selecting and personalising If-Then Plans associated with each of the above goals. Adherence to the intervention is monitored via compliance to self-reported daily drinking reports and the collection of app usage analytics in relation to practicing the implementation intentions. The time-course of the program is as follows: Week 1 (‘Drinking as Usual’) involves consumption monitoring only (a single daily alert, as in monitoring component above); Weeks 2, 3, and 4 (‘Learning How to Cut Down’) are comprised of the full intervention (with the four key components, as outlined above); Weeks 5, 6, 7, and 8 (‘Practicing Independently’) constitute the post-intervention phase, whereby the app is mostly disabled. During this phase, participants receive a single weekly alert to remind them to engage in practicing their If-Then Plans, and during week 8 they receive a daily consumption monitoring alert. Following completion of the follow-up survey, the fully functional app is reinstated, along with some addition settings for ongoing use.
Sponsors
Deakin University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
Problematic alcohol use – 5 to 10 inclusive as measured by AUDIT-C Permanent access to iOS or Android smartphone Express an intention to reduce or quit drinking alcohol Between the ages of 18 - 60
Exclusion criteria
None
Outcome results
None listed