Mobile Health Interventions for Self-Control of Unhealthy Alcohol Use: Systematic Review

Abstract

Background Unhealthy alcohol use (UAU) is one of the major causes of preventable morbidity, mortality, and associated behavioral risks worldwide. Although mobile health (mHealth) interventions can provide consumers with an effective means for self-control of UAU in a timely, ubiquitous, and cost-effective manner, to date, there is a lack of understanding about different health outcomes brought by such interventions. The core components of these interventions are also unclear. Objective This study aimed to systematically review and synthesize the research evidence about the efficacy of mHealth interventions on various health outcomes for consumer self-control of UAU and to identify the core components to achieve these outcomes. Methods We systematically searched 7 electronic interdisciplinary databases: Scopus, PubMed, PubMed Central, CINAHL Plus with full text, MEDLINE with full text, PsycINFO, and PsycARTICLES. Search terms and Medical Subject Headings “mHealth,” “text message,” “SMS,” “App,” “IVR,” “self-control,” “self-regulation,” “alcohol*,” and “intervention” were used individually or in combination to identify peer-reviewed publications in English from 2008 to 2017. We screened titles and abstracts and assessed full-text papers as per inclusion and exclusion criteria. Data were extracted from the included papers according to the Consolidated Standards of Reporting Trials-EHEALTH checklist (V 1.6.1) by 2 authors independently. Data quality was assessed by the Mixed Methods Appraisal Tool. Data synthesis and analyses were conducted following the procedures for qualitative content analysis. Statistical testing was also conducted to test differences among groups of studies. Results In total, 19 studies were included in the review. Of these 19 studies, 12 (63%) mHealth interventions brought significant positive outcomes in improving participants’ health as measured by behavioral (n=11), physiological (n=1), and cognitive indicators (n=1). No significant health outcome was reported in 6 studies (6/19, 32%). Surprisingly, a significant negative outcome was reported for the male participants in the intervention arm in 1 study (1/19, 5%), but no change was found for the female participants. In total, 5 core components reported in the mHealth interventions for consumer self-control of UAU were context, theoretical base, delivery mode, content, and implementation procedure. However, sound evidence is yet to be generated about the role of each component for mHealth success. The health outcomes were similar regardless of types of UAU, deployment setting, with or without nonmobile cointervention, and with or without theory. Conclusions Most studies reported mHealth interventions for self-control of UAU appeared to be improving behavior, especially the ones delivered by short message service and interactive voice response systems. Further studies are needed to gather sound evidence about th...

Ethische Aspekte internet- und mobilgestützter Interventionen (IMIs) bei Suchtstörungen

“…So konnten Sander et al in ihrer Meta-Analyse hohe Effektstärken für den präventiven Einsatz von IMIs nachweisen [9]. Auch konnte die Wirksamkeit von internetbasierten Anwendungen [18] und Anwendungen für mobile Endgeräte nachgewiesen werden [19]. Die ethischen Aspekte von IMIs bei Suchtstörungen sind jedoch bislang kaum erforscht [15].…”

“…Die Wirksamkeit von IMIs hinsichtlich des Therapieerfolges bei Suchtstörungen ist relativ gut erforscht. Dabei zeigen sich positive Effekte in unterschiedlichen Behandlungsstufen [6,9,14,18,19,[25][26][27]. Gerade in der Suchtprävention wird ein großes Potential gesehen [9].…”

“…Studien [38] sowie Meta-Reviews [26] haben gezeigt, dass besonders hinsichtlich der Prävention eine erhebliche Kostenreduktion bei gleichzeitig maximiertem Nutzen möglich ist. Auch bei Interventionen in der Therapiephase, etwa zum Selbstmanagement [19] oder zum Contingency Management [39], haben sich IMIs als kosteneffiziente Alternative erwiesen. Allerdings gibt es Einschränkungen.…”

Preliminary Efficacy of a Cognitive Behavioral Therapy Text Messaging Intervention Targeting Alcohol Use and Antiretroviral Therapy Adherence: A Randomized Clinical Trial

“…Text messaging has shown promise as an approach to improving health outcomes among both populations with HIV [13][14][15][16][17] and those with problematic alcohol use [18]. In a study of young adult alcohol users, an interactive text messaging intervention targeting binge drinking was associated with reductions in alcohol consumption and alcohol related injury prevalence at 6 month follow-up, relative to controls [19].…”

“…In a study of young adult alcohol users, an interactive text messaging intervention targeting binge drinking was associated with reductions in alcohol consumption and alcohol related injury prevalence at 6 month follow-up, relative to controls [19]. Likewise, a systematic review that examined outcomes of mobile health interventions targeting unhealthy alcohol use reported that 11 out of 18 studies demonstrated benefits of these approaches on drinking outcomes including alcohol use frequency, heavy drinking days, and binge drinking [20]. Text messaging interventions for people living with HIV have been the focus of various systematic reviews and meta-analyses, confirming that these approaches improve various parameters of HIV care, particularly ART adherence [21][22][23][24][25].…”