JMIR Publications

ABSTRACT

Background:

Mobile instant messaging (IM) apps (e.g., WhatsApp and WeChat) were widely used by the general population and are more interactive than text-based programs (short message service, SMS) to modify unhealthy lifestyles. Little is known about IM apps use for health promotion, including alcohol reduction for university students.

Objective:

This study aims to explore university student drinkers' perceptions of using IM apps for alcohol reduction as they had high alcohol exposure (e.g., drinking invitations from peers and alcohol promotion on campus) and the proportion of IM apps use in Hong Kong.

Methods:

A qualitative study was conducted on 20 Hong Kong Chinese university students (current drinkers) with Alcohol Use Disorder Identification test (AUDIT) scores ≥8 recruited using purposive sampling. Semi-structure individual interviews were conducted from September to October 2019. Interview questions focused on drinking behaviors, quitting history, opinions towards IM apps use as an intervention tool, perceived usefulness of IM apps for alcohol reduction, and opinions on the content and design of IM apps for alcohol reduction. Each interview lasted around an hour. All interviews were audiotaped and transcribed verbatim. Two researchers independently analyzed the transcripts using thematic analysis with an additional investigator to verify the consistency of the coding.

Results:

Participants considered IM apps a feasible and acceptable platform for alcohol reduction intervention. They preferred to receive instant messages based on personalized problem-solving and drinking consequences with credible sources. Other perceived important components of instant messages included providing psycho-social support in time and setting goals with participants to reduce drinking. They further provided suggestions on the designs of IM interventions, in which they preferred simple and concise messages, chat styles based on participants' preferences (e.g., adding personalized emoji and stickers in the chat), and peers as counselors.

Conclusions:

Qualitative interviews with Chinese university student drinkers showed high acceptability, engagement, and perceived utility of IM apps for alcohol reduction intervention. IM intervention can be an alternative for alcohol reduction intervention apart from traditional text-based programs. The study has implications for developing the IM intervention for other unhealthy behaviors and highlights important topics that warrant future research, including substance use and physical inactivity.