Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 3, 2018
Open Peer Review Period: Aug 9, 2018 - Oct 4, 2018
Date Accepted: Dec 12, 2018
(closed for review but you can still tweet)
A validated assessment and critical analysis of commercial smartphone applications targeting alcohol and illicit substance use
ABSTRACT
Background:
Smartphone applications promise to enhance the reach of evidence-based interventions (cognitive behavior therapy, contingency management, therapeutic education system) for populations with SUDs with minimal disruption to health systems. However, further studies are needed to systematically evaluate smartphone applications targeting alcohol and illicit substances.
Objective:
To evaluate the functionality, aesthetics, and quality of information of apps claiming to target alcohol, benzodiazepine, cocaine, crack/cocaine, crystal methamphetamine, and heroin use using the validated Mobile App Rating Scale and critical content analysis.
Methods:
A systematic search was conducted in March 2018 of apps facilitating recovery in iTunes and Google Play app stores and yielded 904 apps using keywords described in prior studies (e.g. recovery, sobriety, sober, alcohol, heroin). An interdisciplinary team of clinicians, behavioral informatics, and public health reviewers trained in substance use disorders conducted descriptive analysis of 74 apps categorized as reducing use. In addition to the MARS scale, descriptive analysis of relevant apps was conducted by the study team to assess for quality indicators emphasized by expert guidelines and review articles.
Results:
Most apps (n=74) claimed to reduce use or promote abstinence and yielded an overall low median MARS score of 2.82 (+0.55) and a wide range of scores (1.64, 4.20). Ratings were also low for engagement (2.75±0.72), functionality (3.64±0.78), aesthetics (3.03±0.87), information (2.82±0.62), and satisfaction (1.76±0.67) sub-domains. Innovative design and content features elicited in the review included initial assessments of substance use following app download, tracking substance use and related consequences (e.g., cost, calorie intake), remote and proximate peer support per geospatial positioning, and allowing users and family members of individuals with SUDs to locate 12 step group meetings, treatment programs, and mental health services. Few apps integrated evidence-based psychotherapeutic (e.g., cognitive behavioral therapy, motivational interviewing) and pharmacologic interventions (e.g., naloxone, buprenorphine).
Conclusions:
Few commercially available apps yielded in our search integrated evidence-based interventions (e.g., extended-release naltrexone, buprenorphine, naloxone, SMART Recovery, cognitive behavioral therapy) and a concerning number of apps promoted harmful drinking and illicit substance use. Clinical Trial: None
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.