JMIR Publications

ABSTRACT

Background:

Alcohol Use Disorder (AUD) carries a huge health and economic cost to society. Effective interventions exist but numerous challenges limit their adoption, especially in a pandemic context. AUD recovery apps (AUDRA) have emerged as a potential complement to in-person interventions. They are easy to access and show promising results in terms of efficacy. However, they rely on individual adoption decision and remain underused.

Objective:

The aim of this survey study is to explore the beliefs that determine the intention to use AUDRA.

Methods:

We conducted a cross-sectional survey study of people suffering from AUD. We used the Unified Theory of Acceptance and Use of Technology, which predicts use and behavioral intention to use based on performance expectancy, effort expectancy, social influence and facilitating conditions. Participants were recruited directly from two sources: first, respondents at addiction treatment facilities in Ontario, Canada were contacted in person and filled a paper form; second, members from AUD recovery support groups on social media were contacted and invited to fill an online sruvey. The survey was conducted between October 2019 and June 2020.

Results:

The final sample was comprised of 159 participants (124 online and 35 paper based) self-identifying somewhat or very much with AUD. Most participants (85.5%) were aware of AUDRA and those participants scored higher on performance expectancy, effort expectancy and social influence. Overall, the model explains 35.4% of the variance in behavioral intention to use AUDRA and 11.1% of the variance in use. Social influence (p-value 0.314), especially for women (p-value 0.227) and effort expectancy (p value 0.247) were key antecedents of behavioral intention. Facilitating conditions was not significant overall but was moderated by age (p value 0.231) suggesting that it matters for older participants. Performance expectancy did not predict behavioral intention, which is unlike many other technologies but confirms other findings with mhealth. Open-ended questions suggest that privacy concerns may play a significant role for AUDRA.

Conclusions:

This study suggests that unlike many other technologies, the adoption of AUDRA is not mainly determined by utilitarian factors such as performance expectancy. Rather, effort expectancy and social influence play a key role in determining the intention to use AUDRA.