title: User Preferences for Content, Features, and Style for an App to Reduce Harmful Drinking in Young Adults: Analysis of User Feedback in App Stores and Focus Group Interviews.
abstract: BACKGROUND
  Electronic screening and brief intervention (eSBI) is effective in reducing weekly alcohol consumption when delivered by a computer. Mobile phone apps demonstrate promise in delivering eSBI; however, few have been designed with an evidence-based and user-informed approach.
  
  
  OBJECTIVE
  This study aims to explore from a user perspective, preferences for content, appearance, and operational features to inform the design of a mobile phone app for reducing quantity and frequency of drinking in young adults engaged in harmful drinking (18-30 year olds).
  
  
  METHODS
  Phase 1 included a review of user reviews of available mobile phone apps that support a reduction in alcohol consumption. Apps were identified on iTunes and Google Play and were categorized into alcohol reduction support, entertainment, blood alcohol content measurement (BAC), or other. eSBI apps with ≥18 user reviews were subject to a content analysis, which coded praise, criticism, and recommendations for app content, functionality, and esthetics. Phase 2 included four focus groups with young adults drinking at harmful levels and residing in South London to explore their views on existing eSBI apps and preferences for future content, functionality, and appearance. Detailed thematic analysis of the data was undertaken.
  
  
  RESULTS
  In Phase 1, of the 1584 apps extracted, 201 were categorized as alcohol reduction, 154 as BAC calculators, 509 as entertainment, and 720 as other. We classified 32 apps as eSBI apps. Four apps had ≥18 user reviews: Change for Life Drinks Tracker, Drinksmeter, Drinkaware, and Alcohol Units Calculator. The highest proportion of content praises were for information and feedback provided in the apps (12/27, 44%), followed by praise for the monitoring features (5/27, 19%). Many (8/12, 67%) criticisms were for the drinking diary; all of these were related to difficulty entering drinks. Over half (18/32, 56%) of functionality criticisms were descriptions of software bugs, and over half of those (10/18, 56%) were for app crashing or freezing. Drinksmeter and Alcohol Units Calculator were the most highly praised apps overall (23/57 and 22/57; 39% of praise overall). In Phase 2, two main themes were identified. The meaningfulness theme reflected how young adults thought apps needed to be tailored to the interests and values of their age group, particularly emphasizing content and feedback around broader health and well-being factors such as exercise, diet, and image. The community theme suggested that young adults want to be able to engage with other app users, both in groups of friends and with online users for motivation and support.
  
  
  CONCLUSIONS
  Targeted and relevant information and feedback, in addition to easy-to-use monitoring tools, were found to be important features of a mobile phone app to support a reduction in drinking. Future app development should consider tailoring all app aspects to the needs of young adults, considering broader well-being monitoring tools and online community functions.
authors.affiliation: Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. joanna.milward@kcl.ac.uk.
authors.forename: Joanna
authors.identifier: http://orcid.org/0000-0001-6756-6410
authors.initials: J
authors.lastname: Milward
authors.forename: Zarnie
authors.identifier: http://orcid.org/0000-0002-2958-9555
authors.initials: Z
authors.lastname: Khadjesari
authors.forename: Stephanie
authors.identifier: http://orcid.org/0000-0003-1685-8733
authors.initials: S
authors.lastname: Fincham-Campbell
authors.forename: Paolo
authors.identifier: http://orcid.org/0000-0002-9511-7230
authors.initials: P
authors.lastname: Deluca
authors.forename: Rod
authors.identifier: http://orcid.org/0000-0001-6302-944X
authors.initials: R
authors.lastname: Watson
authors.forename: Colin
authors.identifier: http://orcid.org/0000-0002-9053-3649
authors.initials: C
authors.lastname: Drummond
keywords: alcohol; apps; brief intervention; digital; drinking; focus group; mhealth; smartphone; young adults