JMIR Publications

ABSTRACT

Background:

The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy.

Objective:

Here, we evaluate the acceptability of i) the smartphone app, Drink Less (intervention), and ii) the NHS alcohol advice webpage (usual digital care and comparator), among adult drinkers in the UK participating in a randomised control trial evaluating the effectiveness of the Drink Less app.

Methods:

A sub-sample of 26 increasing-and-higher-risk drinkers (AUDIT≥ 8), assigned to the intervention group (Drink Less, n=14) or usual digital care (NHS alcohol advice webpage, n=12) group took part in semi-structured interviews. The interview questions were mapped on to the seven facets of acceptability according to the Theoretical Framework of Acceptability (TFA); affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Alongside these constructs we also included a question on perceived personal relevance, which previous research has linked to acceptability and engagement. Framework and thematic analysis of data was undertaken.

Results:

The Drink Less app was perceived as being ethical, easy, user-friendly and effective for the period the app was used. Participants reported particularly liking the tracking and feedback sections of the app which they reported increased personal relevance and which resulted in positive affect when achieving their goals. They reported no opportunity cost. Factors such as negative affect when not meeting goals and boredom led to disengagement in the longer term for some participants. The NHS alcohol advice webpage was rated as being easy and user-friendly with no opportunity costs. However, the information presented was not perceived as bring personally relevant, or effective in changing drinking behaviour. Most reported neutral or negative affect and whilst most thought the alcohol advice webpage was accessible, some reported ethical concerns around availability of suggested resources. Some participants reported that it had acted as a starting point or a signpost to other resources. Participants in both groups discussed motivation to change and contextual factors such as COVID-19 lockdowns which influenced their perceived self-efficacy regardless of their assigned intervention.

Conclusions:

Drink Less appears to be an acceptable digital intervention among the recruited sample. The NHS alcohol advice webpage was generally considered to be unacceptable as a standalone intervention amongst the recruited sample, although it may signpost and help people access other resources and interventions. Clinical Trial: ISRCTN64052601