A smartphone app helped heavy drinkers cut their alcohol intake by four units per week—roughly two pints of beer or two glasses of wine. Excessive alcohol use kills 3.3 million people globally each year, and over 10 million UK adults regularly drink above government guidelines. Web-based programmes can help, but evidence for apps is thin, and no one knew which specific features actually drive change. This project tested a theory-driven app on nearly 700 drinkers, comparing intensive versus minimal versions of five behaviour-change techniques. The app let users set a personal drinking goal, then offered features such as normative feedback, cognitive bias re-training, self-monitoring, and action planning. On average, participants logged in 12 times over a month and drank four fewer units by the end. Combinations of normative feedback with cognitive bias re-training, and self-monitoring with action planning, produced the best results. More intensive versions of individual techniques did not outperform minimal ones. If refined and scaled, this app could become a low-cost, widely accessible tool for reducing alcohol harm in the UK, easing pressure on NHS services and helping millions drink within safer limits.
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Alcohol consumption is responsible for approximately 3.3 million deaths worldwide each year. Over 10 million people in the UK regularly drink in excess of Government guidelines. Tackling excessive alcohol consumption is a public health priority. Web interventions to help people reduce their consumption appear to be effective, but there is little evidence about apps and a lack of understanding about what techniques an app should contain to make it effective. SPHR researchers examined the literature for behaviour change theory and techniques that may inform interventions to help people to reduce their alcohol consumption. Alcohol and behaviour change experts were consulted for their views about which techniques an app should contain. This led to a scientifically-informed app which was professionally designed and subsequently improved in response to user feedback. The main feature of the app was that it allowed each user to set their own goal to which they would like to reduce their alcohol consumption. There were five additional features that were based on behaviour change techniques to help participants reduce their drinking. These features were called normative feedback, cognitive bias re-training, identity change, selfmonitoring, and action planning. Almost 700 drinkers took part in a study to evaluate the effectiveness of the app. Groups of users were randomly given ‘intensive’ or ‘minimal’ versions of different techniques and the effectiveness of each was measured by comparing levels of drinking before and after using the app. On average, people logged-in 12 times during a one-month period and drank four fewer units of alcohol at the end of using the app compared with the start. People who received a more intensive version of a technique did not reduce their alcohol consumption significantly more than people who got a less intensive version of the same technique. The combinations of normative feedback and cognitive bias re-training, and of self-monitoring and action-planning led to improved alcohol outcomes. These findings suggest that these techniques may assist with reducing drinking and are worth keeping in the next version of the app for further development and evaluation.
NIHR School for Public Health Research - Public Health
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