title: The Role of Mobile Applications in Improving Alcohol Health Literacy in Young Adults With Type 1 Diabetes: Help or Hindrance?
abstract: BACKGROUND
  Mobile health (mHealth) is an expanding field which includes the use of social media and mobile applications (apps). Apps are used in diabetes self-management but it is unclear whether these are being used to support safe drinking of alcohol by people with type 1 diabetes (T1DM). Alcohol health literacy is poor among young adults with T1DM despite specific associated risks.
  
  
  METHODS
  Systematic literature review followed by critical appraisal of commercially available apps. An eSurvey investigating access to mHealth technology, attitudes toward apps for diabetes management and their use to improve alcohol health literacy was completed by participants.
  
  
  RESULTS
  Of 315 articles identified in the literature search, 7 met the inclusion criteria. Ten diabetes apps were available, most of which lacked the educational features recommended by clinical guidelines. In all, 27 women and 8 men with T1DM, aged 19-31 years were surveyed. Of them, 32 had access to a smartphone/tablet; 29 used apps; 20 used/had used diabetes apps; 3 had used apps related to alcohol and diabetes; 11 had discussed apps with their health care team; 22 felt more communication with their health care team would increase awareness of alcohol-associated risks.
  
  
  CONCLUSIONS
  Use of mobile apps is commonplace but the use of apps to support safe drinking in this population was rare. Most participants expressed a preference for direct communication with their health care teams about this subject. Further research is needed to determine the preferences of health care professionals and how they can best support young adults in safe drinking.
authors.affiliation: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Tamony
authors.affiliation: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Holt
authors.affiliation: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK k.barnard@soton.ac.uk.
authors.forename: Katharine
authors.initials: K
authors.lastname: Barnard
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000097:blood / Q000517:prevention & control / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D063731:Mobile Applications; D010353:Patient Education as Topic / Q000379:methods*; D057240:Patient Preference; D018570:Risk Assessment; D012307:Risk Factors; D012648:Self Care; D000068997:Smartphone; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000295:instrumentation*; D055815:Young Adult
keywords: alcohol; diabetes; mHealth; mobile apps; smartphone