Young adults who drink heavily reported that a specific intervention that provides personalized feedback on daily drinking would be beneficial for people who want to reduce their drinking and would encourage self-reflection among those who are not yet ready to change their drinking habits. The young adults were participants in a pilot study of a first-of-its-kind technology aimed at reducing heavy drinking in young adults through self-selected goal setting and daily personalized feedback based on self-reported behaviors related to drinking. The study is described in Alcohol: Clinical and Experimental Research.
This second open trial pilot study of the intervention, called ‘A-FRAME’ (Alcohol Feedback, Reflection, and Morning Evaluation), tested the feasibility and acceptability of new components and elicited more feedback on the tool. ‘A-FRAME’ study participants received a text each morning with a link to a web-based survey, where they answered questions about their drinking and related behaviors, such as whether they took shots, played drinking games, or used cannabis. They were also asked to rate any negative consequences they experienced due to their drinking, such as injury, embarrassment, hangover, aggression, or nausea. Participants could choose to receive daily and biweekly feedback about their blood-alcohol content, how their behavior compares to national norms, the calories they consumed while drinking, how much money they spent on alcohol, their high-risk behaviors and consequences, as well as strategies for reducing drinking and related consequences. Calories and spending were newly added topics requested by participants in the first pilot study.
All 18 participants completed the study, including a post-test survey and interview. The response rate to the 28 daily surveys was 94 percent. Almost all participants said A-FRAME increased their awareness of current or future drinking, with one participant calling it ‘eye-opening.’ Participants rated the intervention ‘acceptable’ or better for engagement, aesthetics, information quality, and general perception. Sixteen of the eighteen participants stated they would use A-FRAME in the next year if available, and half reported sharing something they learned from the program with others.
Of the 100 daily feedback reports, half of the participants viewed blood alcohol content feedback, a quarter viewed calories consumed, and a fifth viewed their spending. About half of the participants viewed their 2-week and four-week feedback reports. Blood-alcohol content, comparison to norms, calories consumed, and spending were the most viewed topics in the reports. Consequences and strategies were the topics viewed least often. Participants reported they appreciated the ability to set goals, choose which feedback topics they reviewed, and see the trends over time.
The study involved a racially diverse but relatively small sample size of eighteen young adults who were in or who had graduated from a four-year college. Participants were required to be at least somewhat willing to make a change to their drinking, but readiness to change was not measured. The researchers will use the study’s findings to refine the A-FRAME intervention and have planned a more extensive, randomized control trial to test its effectiveness in reducing heavy drinking.
Alcohol Feedback, Reflection, and Morning Evaluation (A-FRAME): Refining and testing feasibility and acceptability of a smartphone-delivered alcohol intervention for heavy-drinking young adults. J. Merrill, N. Gebru, R. Peterson, G. Lopez, C. Lau-Barraco, N. Barnett, K. Carey.
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