Abstract
Excessive alcohol consumption poses a serious problem for public health. Digital behavior change interventions have the potential to help users reduce their drinking. In accordance with Open Science principles, this paper describes the development of a smartphone app to help individuals who drink excessively to reduce their alcohol consumption. Following the UK Medical Research Council's guidance and the Multiphase Optimization Strategy, development consisted of two phases: (i) selection of intervention components and (ii) design and development work to implement the chosen components into modules to be evaluated further for inclusion in the app. Phase 1 involved a scoping literature review, expert consensus study and content analysis of existing alcohol apps. Findings were integrated within a broad model of behavior change (Capability, Opportunity, Motivation-Behavior). Phase 2 involved a highly iterative process and used the "Person-Based" approach to promote engagement. From Phase 1, five intervention components were selected: (i) Normative Feedback, (ii) Cognitive Bias Re-training, (iii) Self-monitoring and Feedback, (iv) Action Planning, and (v) Identity Change. Phase 2 indicated that each of these components presented different challenges for implementation as app modules; all required multiple iterations and design changes to arrive at versions that would be suitable for inclusion in a subsequent evaluation study. The development of the Drink Less app involved a thorough process of component identification with a scoping literature review, expert consensus, and review of other apps. Translation of the components into app modules required a highly iterative process involving user testing and design modification.
Highlights
Excessive alcohol consumption poses a serious problem for public health [1, 2]
Excessive alcohol consumption is estimated to cost high- and middle-income economies 2.5 per cent of gross domestic product due to costs associated with health and Implications Practice: The development process for the Drink Less app could provide a practical model for developing evidence- and theory-based digital interventions for health-related behavior change following the principles of Open Science
The initial development resulted in a smartphone app centered around alcohol reduction goal setting with five independent intervention modules: (i) Normative Feedback, (ii) Cognitive Bias Retraining, (iii) Self-monitoring and Feedback, (iv) Action Planning, and (v) Identity Change
Summary
Excessive alcohol consumption poses a serious problem for public health [1, 2]. About 3.3 million deaths are attributable to alcohol consumption worldwide each year [1] and alcohol consumption is the third leading cause of morbidity and premature death in high-income countries [3]. Over 5 per cent of the global burden of disease and injury is estimated to be attributable to alcohol [4]. Excessive alcohol consumption (widely indicated by a score of 8 or above on the Alcohol Use Disorders Identification Test [AUDIT] [5]) is estimated to cost high- and middle-income economies 2.5 per cent of gross domestic product due to costs associated with health and Implications Practice: The development process for the Drink Less app could provide a practical model for developing evidence- and theory-based digital interventions for health-related behavior change following the principles of Open Science. Research: The reporting in full of the approach used to develop digital healthcare interventions such as Drink Less provides a firm foundation for interpreting the results of evaluation studies that follow
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