Web and Smartphone Apps Providing Personalized Feedback Can Help Hazardous Drinkers Substantially Reduce Their Alcohol Consumption Over Eight Weeks

Brief electronic intervention providing personalized feedback can help hazardous drinkers substantially reduce their drinking, according to a new study in Alcohol: Clinical & Experimental Research. After an eight-week intervention, young adults whose drinking was previously deemed “hazardous” had similar drinking patterns to those considered “non-harmful.” Brief intervention—several minutes of advice or counseling about the negative consequences of drinking—is demonstrably effective. Electronic delivery potentially helps reach the large proportion of people with dangerous drinking who do not seek in-person treatment (possibly 60+%). Although web-based interventions perform well, smartphone programs have the potential for tracking consumption in real-time, facilitating more attuned feedback. Interventions incorporating smartphone apps have not been well evaluated, however. Most do not provide feedback aimed at reducing alcohol consumption nor offer guidance relating to impulsivity, an aspect of executive function closely connected to the development of substance use disorders. Consequently, researchers in Melbourne examined the impact of a brief electronic intervention with both web- and app-based components. It was designed to provide personalized feedback—on social norms and health consequences—along with impulsivity measures and explanations that could plausibly motivate changes in drinking behavior.

Investigators worked with data from 313 undergraduate students (mean age 21, 74% women). The participants filled out surveys on demographics, alcohol use, anxiety, and depression and completed impulsivity-related cognitive tasks; a subset of 178 downloaded a smartphone app designed to track their drinking in real time over two weeks. Participants were categorized as hazardous or non-harmful drinkers and organized into three groups with similar levels of alcohol intake. Those in the Control group received no feedback. Those in the Alcohol Intake Feedback (Alc) group received personalized information about their consumption (quantity, frequency, and risk). Those in the Alcohol Intake Plus Cognitive Feedback (AlcCog) group received similar personalized information in addition to an impulsivity score and its implications for their risk of developing alcohol-related problems. Following an eight-week trial, 246 participants again completed surveys about their drinking, anxiety, and depression and undertook the impulsivity-related cognitive task; a subset of 145 used a smartphone app to track their alcohol use over two weeks. The researchers used statistical analysis to explore evolutions in drinking behavior associated with the interventions.

Hazardous drinkers in the Alc and AlcCog groups reduced their drinking more than those in the Control group. The Alc hazardous drinkers cut their alcohol consumption by one-third (almost four drinks per week, or 1 ½ drinks per day); the AlcCog group by slightly more (two drinks per day). The non-harmful drinkers did not change their drinking behaviors. After eight weeks, hazardous drinkers had similar alcohol use profiles to the non-harmful drinkers, as measured by their total alcohol intake, amount consumed per drinking day, and the frequency of binge drinking occasions. The reductions in alcohol use were not related, however, to whether the intervention was web-only or combined web- and app-based components. There appeared to be no additional benefit in providing hazardous drinkers with guidance around impulsivity and alcohol use. There was no change in the drinking frequency or level of impulsivity for any group.

The study provides further evidence that smartphone app interventions could have a meaningful impact on lessening the health, social, and economic burdens of problem drinking. Additional research is needed on which electronic features best support drinking reduction, the impact of such interventions on those at even greater risk of AUD, and whether reductions in drinking are sustained long-term.

Impact of personalized alcohol intake and cognitive feedback on alcohol use behavior in hazardous drinkers: A quasi-randomised trial. A. Poulton, G. Dali, C. McGinness, S. Tomoyo Clarke, T. Turner, J. Liu, J. Giggins, R. Marcuson, R. Hester. (pp xxx)

ACER-23-5593.R1