Optimizing the Measurement of Information on the Context of Alcohol Consumption Within the Drink Less App Among People Drinking at Increasing and Higher Risk Levels: Mixed-Methods Usability Study.

Abstract

There is a growing public health evidence base focused on understanding the links between drinking contexts and alcohol consumption. However, the potential value of developing context-based interventions to help people drinking at increasing and higher risk levels to cut down remains underexplored. Digital interventions, such as apps, offer significant potential for delivering context-based interventions as they can collect contextual information and flexibly deliver personalized interventions while addressing barriers associated with face-to-face interventions, such as time constraints. This early phase study aimed to identify the best method for collecting information on the contexts of alcohol consumption among users of an alcohol reduction app by comparing 2 alternative drinking diaries in terms of user engagement, data quality, usability, and acceptability. Participants were recruited using the online platform Prolific and were randomly assigned to use 1 of the 2 adapted versions of the Drink Less app for 14 days. Tags (n=31) included tags for location, motivation, and company that participants added to drink records. Occasion type (n=31) included a list of occasion types that participants selected from when adding drink records. We assessed engagement and data quality with app data, usability with a validated questionnaire, and acceptability with semistructured interviews. Quantitative findings on engagement, data quality, and app usability were good overall, with participants using the app on most days (tags: mean 12.23, SD 2.46 days; occasion type: mean 12.39, SD 2.12 days). However, around 40% of drinking records in tags did not include company and motivation tags. Mean usability scores were similar across app versions (tags: mean 72.39, SD 8.10; occasion type: mean 74.23, SD 6.76). Qualitative analysis found that both versions were acceptable to users and were relevant to their drinking occasions, and participants reported increased awareness of their drinking contexts. Several participants reported that the diary helped them to reduce alcohol consumption in some contexts (eg, home or lone drinking) more than others (eg, social drinking) and suggested that they felt less negative affect recording social drinking contexts out of their home. Participants also suggested the inclusion of "work drinks" in both versions and "habit" as a motivation in the tags version. There was no clearly better method for collecting data on alcohol consumption as both methods had good user engagement, usability, acceptability, and data quality. Participants recorded sufficient data on their drinking contexts to suggest that an adapted version of Drink Less could be used as the basis for context-specific interventions. The occasion type version may be preferable owing to lower participant burden. A more general consideration is to ensure that context-specific interventions are designed to minimize the risk of unintended positive reinforcement of drinking occasions that are seen as sociable by users.