JMIR Publications

ABSTRACT

Background:

Excessive alcohol use is associated with significant harms, with wide-ranging social and economic impacts. Efforts to prevent and reduce the harmful use of alcohol are a public health priority. Smartphone apps have potential to provide accessible and cost-effective support to those seeking to reduce alcohol consumption, however the evidence base regarding which components are effective is lacking. Self-monitoring is considered as one of the most effective components for behaviour change across multiple health domains, yet the mixed evidence for its role in the alcohol use space. Improved understanding of use, acceptability and outcomes of smartphone apps and their inherent components is required in order to determine their potential role in alcohol behaviour change.

Objective:

We investigated the feasibility and acceptability of the Drink Tracker (DT), a novel feature of the commercially available Daybreak app.

Methods:

The Daybreak app is accessible worldwide via major app stores and offered free of charge to Australian residents. Individuals (aged over 18) registering for Daybreak were invited to access the DT to monitor their alcohol consumption as part of an uncontrolled observational prospective study. Feasibility was assessed via uptake and frequency of use of the DT. Acceptability was measured via participant feedback to determine overall satisfaction, perceived helpfulness, and likelihood of recommending the DT to others. Self-reported changes in alcohol consumption (Alcohol Use Disorders Identification Test score) and psychological distress (Kessler Psychological Distress Scale score) at 3-month follow-up were also measured. Preliminary data collected for the first 4 months (October 2023 to February 2024) of the study were reported, including 3-month follow-up outcomes.

Results:

Feasibility was demonstrated, with almost 70% (2847/4119, 69.1%) of those registering for Daybreak going on to access the DT. Of those accessing the DT, 71.1% (2024/2847) consented to research, comprising the final participant sample. Frequency of use was high, with over half of participants (1112/2024, 54.9%) using the DT more than once, and more than one third (757/2024, 37.4%) using the DT more than five times. Of the 30 participants completing 3-month follow-up, acceptability was high, with 73.3% (22/30) reporting high satisfaction levels with the DT overall, 86.7% (26/30) indicating it was easy to use and rating a mean score of 7.7 (SD 2.8) out of 10 in terms of likelihood of recommending to others. Significant reductions in alcohol consumption (P<.001) and psychological distress scores (P<.001) were observed at 3-month follow-up.

Conclusions:

Our results suggest that the Daybreak DT is highly feasible and acceptable in supporting individuals accessing commercially available smartphone apps to change their relationship with alcohol. While positive clinical outcomes were observed, the absence of a control group disallows any conclusions with regards to the efficacy of the DT. Further testing via an RCT is required. Clinical Trial: N/A