Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 20, 2020
Date Accepted: Mar 10, 2021
The Usability and Acceptability of a Mobile Application for Self-management of Unhealthy Alcohol Use Among Veterans: Results from a Pilot Study of the Step Away App
ABSTRACT
Background:
Unhealthy alcohol use is common among Operation Enduring Freedom and Operation Iraqi Freedom Veterans, yet barriers limit treatment participation for many. Mobile applications that deliver alcohol interventions may overcome these barriers.
Objective:
This study assessed usability dimensions (efficiency, effectiveness, satisfaction, learnability and attractiveness) of Step Away, a mobile application designed to reduce alcohol-related risks, and explored pre-post changes on alcohol use, psychological distress and quality of life.
Methods:
This single-arm pilot study recruited Operations Enduring and Iraqi Freedom Veterans aged 18-55 who exceeded NIAAA drinking guidelines and owned an iPhone. Enrolled Veterans (N=55) completed baseline and 1-, 3-, and 6-month assessments. Learnability was assessed by Step Away use during week one. System Usability Scale (1-100; >70 acceptable usability) assessed effectiveness, efficiency and satisfaction, while 1 item (1-9) measured attractiveness of 10 screenshots. Additional outcomes included pre-post change on heavy drinking days (men: ≥5 drinks/day; women: ≥4 drinks/day), and Short Inventory of Problems-Revised, Kessler-10, and brief WHO Quality of Life Questionnaire scores.
Results:
Step Away use averaged 55.1 minutes (SD=57.6) in week 1 and <15 minutes/week in weeks 2-24. Mean System Usability Scale scores were 69.3 (SD=19.7) and 71.9 (SD=15.8) at 1 and 3 months, respectively. Median attractiveness scores ranged from 5-8, with lower ratings for text-laden screens. Heavy drinking days decreased from 29.4% (95% confidence interval: 23.4 – 35.4) at baseline to 16.2% (9.9 – 22.4) at 6 months (P<.001). Likewise, over 6 months Short Inventory of Problems-Revised scores decreased from 6.3 (5.1 – 7.5) to 3.6 (2.4 – 4.9) (P<.001) and Kessler-10 scores decreased from 18.8 (17.4 – 20.1) to 17.3 (15.8 – 18.7) (P=.046). Changes were not detected on quality of life scores.
Conclusions:
Operations Enduring and Iraqi Freedom Veterans engaged with Step Away and significantly decreased heavy drinking days. A larger, randomized trial is warranted to confirm our findings.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
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.