JMIR Publications

ABSTRACT

Background:

Alcohol accounts for 5.1% of the global burden of disease and injury and approximately one in ten people worldwide develop an alcohol use disorder. “Approach Bias Modification” (ABM), a computerised cognitive training intervention where patients are trained to “avoid” alcohol-related images and “approach” neutral or positive images, has been shown to reduce alcohol relapse rates when delivered in residential settings (e.g., withdrawal management or rehabilitation). However, there are many people who drink at hazardous or harmful levels that do not require residential treatment or chose not to access it (e.g., due to its cost, duration, inconvenience, concerns about privacy). Smartphone app-delivered ABM could offer a free, convenient, intervention to reduce craving and consumption that is accessible regardless of time and place, and during periods when support is most needed. Importantly, an ABM app could also easily be personalised (e.g., allowing participants to select personally-relevant images as training stimuli) and gamified (e.g., by rewarding participants for speed and accuracy of responses) to encourage engagement and training completion.

Objective:

We aim to test the feasibility and acceptability of “SWIPE”, a gamified, personalised alcohol ABM smartphone app, assess it preliminary effectiveness, and explore which populations show strongest indicators of effectiveness.

Methods:

We aim to recruit 500 people who drink alcohol at hazardous or harmful levels (Alcohol Use Disorders Identification Test score of 8+) through social media and websites, who wish to reduce their drinking. Their intended alcohol use goal (reduction or abstinence) and motivation and confidence to change their consumption will be measured prior to training. Participants will be instructed to download the SWIPE app and complete at least 2 ABM sessions per week for 4 weeks. Recruitment and completion rates will be used to assess feasibility. Four weeks after downloading SWIPE, participants will be asked to rate SWIPE’s functionality, aesthetics, and quality, to assess acceptability. Alcohol consumption, craving, and dependence will be measured prior to commencing the first session of ABM and 4 weeks later to assess whether these variables change significantly over the course of ABM.

Results:

We expect to commence recruitment in August 2020 and complete data collection in March 2021.

Conclusions:

This will be the first study to test the feasibility, acceptability, and preliminary effectiveness of a personalised, gamified smartphone ABM intervention for hazardous or harmful drinkers. Results will inform further improvements to the app, as well as the design of a statistically-powered randomised controlled trial to test its efficacy relative to a control condition. Ultimately, we hope that SWIPE will extend the benefits of ABM to the millions of individuals who consume alcohol at hazardous levels and wish to reduce their use, but cannot or chose not to access treatment. Clinical Trial: This trial has been registered on the Australian New Zealand Clinical Trials Registry (registration number ACTRN12620000638932p; https://www.anzctr.org.au/ACTRN12620000638932p.aspx)