Abstract
BackgroundBrief interventions via the internet have been shown to reduce university students’ alcohol intake. This study tested two smartphone applications (apps) targeting drinking choices on party occasions, with the goal of reducing problematic alcohol intake among Swedish university students.MethodsStudents were recruited via e-mails sent to student union members at two universities. Those who gave informed consent, had a smartphone, and showed risky alcohol consumption according to the Alcohol Use Disorders Identification Test (AUDIT) were randomized into three groups. Group 1 had access to the Swedish government alcohol monopoly’s app, Promillekoll, offering real-time estimated blood alcohol concentration (eBAC) calculation; Group 2 had access to a web-based app, PartyPlanner, developed by the research group, offering real-time eBAC calculation with planning and follow-up functions; and Group 3 participants were controls. Follow-up was conducted at 7 weeks.ResultsAmong 28574 students offered participation, 4823 agreed to join; 415 were excluded due to incomplete data, and 1932 fulfilled eligibility criteria for randomization. Attrition was 22.7–39.3 percent, higher among heavier drinkers and highest in Group 2. Self-reported app use was higher in Group 1 (74%) compared to Group 2 (41%). Per-protocol analyses revealed only one significant time-by-group interaction, where Group 1 participants increased the frequency of their drinking occasions compared to controls (p = 0.001). Secondary analyses by gender showed a significant difference among men in Group 1 for frequency of drinking occasions per week (p = 0.001), but not among women. Among all participants, 29 percent showed high-risk drinking, over the recommended weekly drinking levels of 9 (women) and 14 (men) standard glasses.ConclusionsSmartphone apps can make brief interventions available to large numbers of university students. The apps studied using eBAC calculation did not, however, seem to affect alcohol consumption among university students and one app may have led to a negative effect among men. Future research should: 1) explore ways to increase user retention, 2) include apps facilitating technical manipulation for evaluation of added components, 3) explore the effects of adapting app content to possible gender differences, and 4) offer additional interventions to high-risk users.Trial registrationclinicaltrials.gov: NCT01958398.
Highlights
37–50 percent of college and university students consume alcohol at risky levels [1,2]
This study investigates the effects of two Swedish-language smartphone apps with real-time estimated blood alcohol concentration (eBAC) calculation and feedback among university students with established levels of risky drinking
The Promillekoll app seemed to be associated with a negative effect in the form of an increased number of drinking occasions over one week
Summary
37–50 percent of college and university students consume alcohol at risky levels [1,2]. One central focus of these methods concerns an individual’s intentions to drink and his or her behavioral control over alcohol consumption. A second central focus of effective methods is the use of protective cognitive and behavioral strategies that aim to limit alcohol consumption and collateral consequences [10]. Interventions that include skill training for protective behavioral strategies have shown an association with less alcohol use and alcohol-related consequences [11,12,13]. Many alcohol-related prevention programs tailored to college students include a skills training component aimed at reducing intoxication when drinking [4,14,15]. Brief interventions via the internet have been shown to reduce university students’ alcohol intake. This study tested two smartphone applications (apps) targeting drinking choices on party occasions, with the goal of reducing problematic alcohol intake among Swedish university students
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