JMIR Publications

ABSTRACT

Background:

The high prevalence and adverse consequences of excessive drinking among lower educated adolescents and young adults is a public concern in the Netherlands. Evidence-based alcohol prevention programs targeting adolescents and young adults with a low educational background are sparse.

Objective:

The present study describes the planned process for theory and evidence-based development, implementation and evaluation of a dynamically tailored mobile alcohol intervention entitled ‘What Do You Drink’ (WDYD).

Methods:

We used Intervention Mapping (IM) as the framework for the systematic development of WDYD. It consists of 6 steps, a needs assessment (step 1), formulating intervention objectives (step 2), translating theoretical methods into practical applications (step 3), integrating this into a coherent program (step 4), anticipating future implementation and adoption (step 5), and developing an evaluation plan (step 6).

Results:

Reducing excessive drinking among Dutch lower educated students aged 16 to 24 years was defined as the desired behavioral outcome and subdivided into five program objectives: 1) make the decision to reduce drinking; 2) set realistic drinking goals; 3) use effective strategies to achieve drinking goals; 4) monitor own drinking behavior, and 5) evaluate own drinking behavior and adjust goals. Risk awareness, motivation, social norms, and self-efficacy were identified as most important and changeable individual determinants related to excessive drinking and, therefore, incorporated in WDYD. Dynamic tailoring was selected as the basic intervention method to change these determinants. A user-centered design strategy was used to enhance fit of the intervention with the needs of students. The intervention was developed in 4 iterations, and prototypes were subsequently tested with students and refined. This resulted in a fully automated, stand-alone native app in which students received dynamically tailored feedback about their alcohol use and goal achievement via multiple sessions within 17 weeks based on diary data assessing their alcohol consumption, motivation, confidence and mood. A randomized controlled trial with Ecological Momentary Assessments will be used to examine the effects, use and acceptability of the intervention.

Conclusions:

The use of IM led to the development of an innovative, evidence-based intervention to reduce excessive alcohol drinking among Dutch lower educated adolescents and young adults. Developing an intervention on the basis of theory and empirical evidence enables researchers and program planners to identify and retain the effective intervention elements and to translate the intervention to new populations and/or settings. This is important as ‘black boxes’ or poorly described interventions have long been a criticism of the eHealth field and effective intervention elements across mHealth alcohol interventions are still largely unknown. Clinical Trial: Trialregister.nl NTR6619