A smartphone app to reduce excessive alcohol consumption: Identifying the effectiveness of intervention components in a factorial randomised control trial

Abstract

Our aim was to evaluate intervention components of an alcohol reduction app: Drink Less. Excessive drinkers (AUDIT> =8) were recruited to test enhanced versus minimal (reduced functionality) versions of five app modules in a 25 factorial trial. Modules were: Self-monitoring and Feedback, Action Planning, Identity Change, Normative Feedback, and Cognitive Bias Re-training. Outcome measures were: change in weekly alcohol consumption (primary); full AUDIT score, app usage, app usability (secondary). Main effects and two-way interactions were assessed by ANOVA using intention-to-treat. A total of 672 study participants were included. There were no significant main effects of the intervention modules on change in weekly alcohol consumption or AUDIT score. There were two-way interactions between enhanced Normative Feedback and Cognitive Bias Re-training on weekly alcohol consumption (F = 4.68, p = 0.03) and between enhanced Self-monitoring and Feedback and Action Planning on AUDIT score (F = 5.82, p = 0.02). Enhanced Self-monitoring and Feedback was used significantly more often and rated significantly more positively for helpfulness, satisfaction and recommendation to others than the minimal version. To conclude, in an evaluation of the Drink Less smartphone application, the combination of enhanced Normative Feedback and Cognitive Bias Re-training and enhanced Self-monitoring and Feedback and Action Planning yielded improvements in alcohol-related outcomes after 4-weeks.

A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine

“…The outcomes of these trials show that mobile cognitive-task based interventions are feasible but not efficacious as in a stand-alone context (58,61). However, the combination of cognitive bias modification (approach bias re-training) and normative feedback significantly reduces weekly alcohol consumption in excessive drinkers (59).…”

“…Similarly, influencing the immediate dynamic relationship between cognition and drug use has also been used for intervention purposes. Web and smartphone platforms have been used to administer cognitive-task based interventions, such as cognitive bias modification (CBM) training (59)(60)(61), where cognitive performance is routinely measured as a central element of interventions that span several weeks. The outcomes of these trials show that mobile cognitive-task based interventions are feasible but not efficacious as in a stand-alone context (58,61).…”

Updating the evidence on the effectiveness of the alcohol reduction app, Drink Less: using Bayes factors to analyse trial datasets supplemented with extended recruitment

“…A detailed description of the content, development and factorial trial evaluation of the app is reported in two separate papers 1,22 .…”

“…Abstract: "reminded insensitive but tended" are you able to provide any BF for this statement? ; The relevant BFs for this conclusion are included in the results section of the abstract and we have added the BF range for the two-way interactive effects: "Data were mainly insensitive but tended to support there being no large main effects of the enhanced version of individual components on consumption (0.22 [1]. Bayesian analyses, more generally, are often used in clinical trials for dose finding, efficacy monitoring, toxicity monitoring, and for diagnosis/decision making [2].…”

Reducing Risky Alcohol Use via Smartphone App Skills Training Among Adult Internet Help-Seekers: A Randomized Pilot Trial

“…One, targeting internet help-seekers with harmful levels of alcohol use (15 or more drinks/week), did not find any effects over 6 months, although some benefit appeared to occur among those who actually downloaded the app (23). A fourth smartphone app, Drink Less, evaluated among adult help-seekers with at least hazardous alcohol use who all downloaded the app, showed declines in alcohol use over time among all participants, where self-monitoring and feedback combined led to use of more app sessions (24); secondary analysis using Bayes factors showed weak evidence for an interactive combined effect of four components (normative feedback, cognitive bias retraining, self-monitoring and feedback, and action planning) yielding lower alcohol consumption (25).…”