title: Smartphone application for unhealthy alcohol use: A pilot study.
abstract: Technology-delivered interventions are useful tools for addressing unhealthy alcohol use. Smartphones in particular offer opportunities to deliver interventions at the user's convenience. A smartphone application with 5 modules (personal feedback, self-monitoring of drinking, designated driver tool, blood alcohol content [BAC] calculator, information) was developed. Its acceptability and associations between use and drinking outcomes were assessed.
  
  
  
  One hundred thirty adults with unhealthy alcohol use (>14 [men]/>7 [women] drinks/week or ≥1 episode/month with 6 or more drinks) recruited in Switzerland (n = 70) and Canada (n = 60) were offered to use the application. Follow-up occurred after 3 months. Appreciation, usefulness, and self-reported frequency of use of the modules, and drinking outcomes (drinks/week, binge drinking) were assessed. Associations between application use and drinking at 3 months were evaluated with negative binomial and logistic regression models, adjusted for baseline values and gender.
  
  
  
  Of the participants, 48% were women, mean (SD) age: 32.8 (10.0). Follow-up rate: 86.2%. There were changes from baseline (BL) to follow-up (FU) in number of drinks/week, BL: 15.0 (16.5); FU: 10.9 (10.5), P = .01, and binge drinking, BL: 95.4%; FU: 64.3%, P < .0001. All modules had median ratings between 6 and 8 (scale of 1-10). Among the participants, 77% used the application, 76% used the personal feedback module, 41% the self-monitoring of drinking, 22% the designated driver tool, 53% the BAC calculator, and 31% the information module. Participants using the application more than once reported significantly fewer drinks/week at follow-up: Incidence Rate Ratio (IRR), number of drinks per week = 0.70 (0.51; 0.96).
  
  
  
  A smartphone application for unhealthy alcohol use appears acceptable and useful (although there is room for improvement). Without prompting, its use is infrequent. Those who used the application more than once reported less weekly drinking than those who did not. Efficacy of the application should be tested in a randomized trial with strategies to increase frequency of its use.
authors.affiliation: a Alcohol Treatment Center, Department of Community Medicine and Health , Lausanne University Hospital , Lausanne , Vaud , Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bertholet
authors.affiliation: a Alcohol Treatment Center, Department of Community Medicine and Health , Lausanne University Hospital , Lausanne , Vaud , Switzerland.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Daeppen
authors.affiliation: b Department of Population Health , New York University School of Medicine , New York , New York , USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McNeely
authors.affiliation: c Institute of Mental Health Policy Research, Centre for Addiction and Mental Health , Toronto , Ontario , Canada.|d Departments of Psychology and of Psychiatry , University of Toronto , Toronto , Ontario , Canada.
authors.forename: Vlad
authors.initials: V
authors.lastname: Kushnir
authors.affiliation: c Institute of Mental Health Policy Research, Centre for Addiction and Mental Health , Toronto , Ontario , Canada.|d Departments of Psychology and of Psychiatry , University of Toronto , Toronto , Ontario , Canada.|e Research School of Population Health, Australian National University , Canberra , Australian Capital Territory , Australia.
authors.forename: John A
authors.initials: JA
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D063425:Binge Drinking / Q000517:prevention & control*; D003258:Consumer Behavior / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D063731:Mobile Applications / Q000706:statistics & numerical data*; D010865:Pilot Projects; D000068997:Smartphone; D055815:Young Adult
keywords: Alcohol; brief intervention; electronic intervention; smartphone