A Smartphone App and Personalized Text Messaging Framework (InDEx) to Monitor and Reduce Alcohol Use in Ex-Serving Personnel: Development and Feasibility Study (Preprint)

BACKGROUND Self-reported alcohol misuse remains high in armed forces personnel even after they have left service. More than 50% of ex-serving personnel meet the criteria for hazardous alcohol use; however, many fail to acknowledge that they have a problem. Previous research indicates that interventions delivered via smartphone apps are suitable in promoting self-monitoring of alcohol use, have a broad reach, and may be more cost-effective than other types of brief interventions. There is currently no such intervention specifically designed for the armed forces. OBJECTIVE This study sought to describe the development of a tailored smartphone app and personalized text messaging (short message service, SMS) framework and to test the usability and feasibility (measured and reported as user engagement) of this app in a hard-to-engage ex-serving population. METHODS App development used Agile methodology (an incremental, iterative approach used in software development) and was informed by behavior change theory, participant feedback, and focus groups. Participants were recruited between May 2017 and June 2017 from an existing United Kingdom longitudinal military health and well-being cohort study, prescreened for eligibility, and directed to download either Android or iOS versions of the ”Information about Drinking for Ex-serving personnel” (InDEx) app. Through the app, participants were asked to record alcohol consumption, complete a range of self-report measures, and set goals using implementation intentions (if-then plans). Alongside the app, participants received daily automated personalized text messages (SMS) corresponding to specific behavior change techniques with content informed by the health action process approach with the intended purpose of promoting the use of the drinks diary, suggesting alternative behaviors, and providing feedback on goals setting. RESULTS Invitations to take part in the study were sent to ex-serving personnel, 22.6% (31/137) of whom accepted and downloaded the app. Participants opened the InDEx app a median of 15.0 (interquartile range [IQR] 8.5-19.0) times during the 4 week period (28 days), received an average of 36.1 (SD 3.2) text messages (SMS), consumed alcohol on a median of 13.0 (IQR 11.0-15.0) days, and consumed a median of 5.6 (IQR 3.3-11.8) units per drinking day in the first week, which decreased to 4.7 (IQR 2.0-6.9) units by the last week and remained active for 4.0 (IQR 3.0-4.0) weeks. CONCLUSIONS Personnel engaged and used the app regularly as demonstrated by the number of initializations, interactions, and time spent using InDEx. Future research is needed to evaluate the engagement with and efficacy of InDEx for the reduction of alcohol consumption and binge drinking in an armed forces population.

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A Qualitative Evaluation of the Acceptability of a Tailored Smartphone Alcohol Intervention for a Military Population: Information About Drinking for Ex-Serving Personnel (InDEx) App (Preprint)

10.2196/preprints.12267 ◽

2018 ◽

Author(s):

Jo-Anne Puddephatt ◽

Daniel Leightley ◽

Laura Palmer ◽

Norman Jones ◽

Toktam Mahmoodi ◽

...

Keyword(s):

Alcohol Consumption ◽

Text Messaging ◽

Telephone Interview ◽

Armed Forces ◽

Text Messages ◽

Ease Of Use ◽

Smartphone App ◽

Self Monitoring ◽

The Individual ◽

Sms Text Messaging

BACKGROUND Alcohol consumption in the UK Armed Forces is higher than in the general population, and this pattern continues after leaving the service. Smartphone apps may be useful to increase ex-serving personnel’s awareness of their alcohol consumption, support self-monitoring, and prompt a change in behavior. OBJECTIVE The study aimed to explore the acceptability of Information about Drinking in Ex-serving personnel (InDEx), a tailored smartphone app, combined with personalized short message service (SMS) text messaging designed to target ex-serving personnel who meet the criteria for hazardous alcohol use. METHODS The InDEx intervention included 4 key modules: (1) assessment and normative feedback, (2) self-monitoring and feedback, (3) goal setting and review, and (4) personalized SMS text messaging. A semistructured telephone interview study was conducted with ex-serving personnel after using the app for a 28-day period. Interviews were used to explore the acceptability of app modules and its functionality and the perceived changes in participant’s drinking. Interview transcripts were analyzed using inductive thematic analysis. RESULTS Overall, 94% (29/31) participants who used InDEx agreed to take part in a telephone interview. Overall, 4 themes were identified: Credibility, Meeting their needs, Simplicity, and Helpful for ex-serving personnel. The importance of credibility, functionality, and meeting the individual needs of ex-serving personnel was emphasized. Acceptability and engagement with specific modules of the app and text messages were influenced by the following: (1) if they felt it provided credible information, (2) whether the content was appropriately personalized to them, (3) the ease of use, and (4) beliefs about their own drinking behaviors. Participants recommended that the app would be most suitable for personnel about to leave the Armed Forces. CONCLUSIONS InDEx was an acceptable smartphone app for ex-serving personnel for monitoring alcohol consumption and in providing meaningful feedback to the individual. Pages that met the participant’s interests and provided real time personalized, credible feedback on their drinking and text messages tailored to participant’s interactions with the app were particularly favored.

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Abstract 12385: Past Alcohol Consumption and Incident Atrial Fibrillation

Circulation ◽

10.1161/circ.132.suppl_3.12385 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Shalini Dixit ◽

Alvaro Alonso ◽

Elsayed Z Soliman ◽

Lin Y Chen ◽

Gregory M Marcus

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Alcohol Use ◽

Population Based ◽

Self Report ◽

Atherosclerosis Risk In Communities ◽

Increased Risk ◽

Before And After ◽

Dietary Intake Assessment ◽

Aric Study

Introduction: Although current alcohol consumption appears to be a risk factor for incident atrial fibrillation (AF), limitations related to self-reported alcohol use and confounding in observational studies limit the certainty of conclusions regarding causality. Whether cessation of alcohol consumption can protect against incident AF remains unknown. Methods: We examined all participants in the Atherosclerosis Risk in Communities (ARIC) study, a population-based cohort of 15,792 men and women aged 45-65, without prevalent AF. Past alcohol consumption was assessed via self-report during the baseline dietary intake assessment. Cases of incident AF were ascertained via study ECGs, hospital discharge ICD-9 codes, and death certificates. Results: Among 15,262 participants with complete survey data, 2,898 (19.0%) were former drinkers. During an average follow-up of 17.4 years, there were 380 cases of incident AF in former consumers. Both before and after adjustment for potential confounders, a longer duration of alcohol abstinence was associated with a lower risk of developing AF; previously consuming alcohol for a longer duration and consuming a greater quantity of alcohol were each associated with a higher risk of developing AF (Table). Conclusions: Among former drinkers, the number of years of drinking and the amount of alcohol consumed may each confer an increased risk of AF. Given that a longer duration of abstinence was associated with a decreased risk of AF, modification of alcohol use could potentially play a role in AF prevention.

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Notifications to Improve Engagement With an Alcohol Reduction App: Protocol for a Micro-Randomized Trial

JMIR Research Protocols ◽

10.2196/18690 ◽

2020 ◽

Vol 9 (8) ◽

pp. e18690 ◽

Cited By ~ 3

Author(s):

Lauren Bell ◽

Claire Garnett ◽

Tianchen Qian ◽

Olga Perski ◽

Henry W W Potts ◽

...

Keyword(s):

Alcohol Consumption ◽

Behavior Change ◽

Randomized Trial ◽

Research Ethics ◽

Adult Population ◽

Ethics Committee ◽

Perceived Usefulness ◽

Self Report ◽

London School ◽

Research Ethics Committee

Background Drink Less is a behavior change app that aims to help users in the general adult population reduce hazardous and harmful alcohol consumption. The app includes a daily push notification, delivered at 11 am, asking users to “Please complete your mood and drinking diaries.” Previous analysis of Drink Less engagement data suggests the current notification strongly influences how users engage with the app in the subsequent hour. To exploit a potential increase of vulnerability of excess drinking and opportunity to engage with the app in the evenings, we changed the delivery time from 11 am to 8 pm. We now aim to further optimise the content and sequence of notifications, testing 30 new evidence-informed notifications targeting the user’s perceived usefulness of the app. Objective The primary objective is to assess whether sending a notification at 8 pm increases behavioral engagement (opening the app) in the subsequent hour. Secondary objectives include comparing the effect of the new bank of messages with the standard message and effect moderation over time. We also aim to more generally understand the role notifications have on the overall duration, depth, and frequency of engagement with Drink Less over the first 30 days after download. Methods This is a protocol for a micro-randomized trial with two additional parallel arms. Inclusion criteria are Drink Less users who (1) consent to participate in the trial; (2) self-report a baseline Alcohol Use Disorders Identification Test score of 8 or above; (3) reside in the United Kingdom; (4) age ≥18 years and; (5) report interest in drinking less alcohol. In the micro-randomized trial, participants will be randomized daily at 8 pm to receive no notification, a notification with text from the new message bank, or the standard message. The primary outcome is the time-varying, binary outcome of “Did the user open the app in the hour from 8 pm to 9 pm?”. The primary analysis will estimate the marginal relative risk for the notifications using an estimator developed for micro-randomized trials with binary outcomes. Participants randomized to the parallel arms will receive no notifications (Secondary Arm A), or the standard notification delivered daily at 11 am (Secondary Arm B) over 30 days, allowing the comparison of overall engagement between different notification delivery strategies. Results Approval was granted by the University College of London’s Departmental Research Ethics Committee (CEHP/2016/556) on October 11, 2019, and The London School of Hygiene and Tropical Medicine Interventions Research Ethics Committee (17929) on November 27, 2019. Recruitment began on January 2, 2020, and is ongoing. Conclusions Understanding how push notifications may impact engagement with a behavior change app can lead to further improvements in engagement, and ultimately help users reduce their alcohol consumption. This understanding may also be generalizable to other apps that target a variety of behavior changes. International Registered Report Identifier (IRRID) DERR1-10.2196/18690

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ASSESSMENT OF ALCOHOL USE BY POPULATION AND RELATED PROBLEMS

Клінічна та профілактична медицина ◽

10.31612/2616-4868.4(10).2019.03 ◽

2019 ◽

Vol 4 (9-10) ◽

pp. 93-99

Author(s):

V. B. Zamkevich ◽

M. D. Diachuk ◽

T. S. Gruzieva

Keyword(s):

Public Health ◽

Information System ◽

Risk Factor ◽

Alcohol Consumption ◽

Alcohol Use ◽

Fatal Outcome ◽

Significant Proportion ◽

Public Health Problem ◽

Well Being ◽

Negative Consequences

Introduction. The development of the public health system provides for the solution of the basic operational functions of public health, including surveillance and assessment of the state of health and well-being of the population, taking into account risks to public health.Given the importance of alcohol as a risk factor for the development of diseases, the study of its prevalence in the population, consumption patterns and health effects is an important public health problem. The aim of the study. To identify current trends in alcohol consumption and the associated risk factor for health damage in Ukraine and countries of the WHO European Region.Materials and methods. Bibliographic, medical, statistical and information-analytical methods were used in the study. The key scientific base were the European Health for All Database, the Global Information System on Alcohol and Health (GISAH) and the European Information System on Alcohol and Health (EISAH). Results. Significant differences were found in the prevalence of alcohol consumption by population in different regions of the world per capita per year, up to 16 times, with the highest rates in the WHO ER. Ukraine is characterized by high levels of alcohol consumption (8.6 liters) and negative tendencies for their growth during 1991-2016 by 45.8%. At the same time, in Ukraine the consumption of strong alcoholic drinks predominates, while in the countries of the European Union - wine and beer. The increase in alcohol consumption in Ukraine and the prevalence of strong drinks in the structure of consumed products (51.5%) is an unfavorable prognostic indicator and requires the adoption of preventive measures. The negative consequences of alcohol consumption are the prevalence of alcohol dependence (2.2%), alcohol-related disorders (6%), a significant proportion of deaths (20.5%) due to this risk factor in the overall structure of all deaths, etc. Significant is the contribution of alcohol to the formation of indicators of road traffic injuries, including those with a fatal outcome, crime rates, etc. Conclusions. Surveillance of the prevalence of alcohol use, patterns of consumption and assessment of alcohol-related public health problems is an important basis for determining directions, justification and taking countermeasures.

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A 6-Month Randomized Trial of a Smartphone Application, UControlDrink, in Aiding Recovery in Alcohol Use Disorder

European Addiction Research ◽

10.1159/000519945 ◽

2021 ◽

pp. 1-12

Author(s):

Conor Farren ◽

Aoife Farrell ◽

Aisling Hagerty ◽

Cliodhna McHugh

Keyword(s):

Alcohol Use ◽

Text Messaging ◽

Alcohol Use Disorder ◽

Positive Impact ◽

Controlled Trial ◽

Intervention Group ◽

Heavy Drinking ◽

Smartphone Application ◽

Smartphone App ◽

Control Group

Background and Aims: Alcohol use disorder (AUD) is a substantial problem, causing early death and great economic burden. Research has highlighted the potential positive impact of technological interventions, such as smartphone applications (app) in treatment of AUD. The aim of this study was to explore the effectiveness of a smartphone app, incorporating computerized cognitive behavioural therapy and text messaging support, on alcohol outcomes over 6 months in a post-rehabilitation setting. Methods: A total of 111 participants with AUD were recruited into this randomized controlled trial, following completion of a 30-day rehabilitation programme. The intervention group (n = 54) used the smartphone app “UControlDrink” (UCD) over 6 months with treatment as usual (TAU), and the control group (n = 57) received TAU. All subjects suffered from AUD as the primary disorder, with other major psychiatric disorders excluded. All intervention subjects used the UCD smartphone app in the treatment trial, and all subjects underwent TAU consisting of outpatient weekly support groups. Drinking history in the previous 90 days was measured at baseline and at 3- and 6-month follow-ups. Additional measurements were made to assess mood, anxiety, craving, and motivation. Results were analysed using intention-to-treat analyses. Results: Retention in the study was 72% at 3 months and 52% at 6 months. There was a significant reduction in heavy drinking days in the intervention group relative to TAU over the 6 months, p < 0.02. Conclusions: The UCD smartphone app demonstrates a significant benefit to reducing heavy drinking days over a 6-month post-rehabilitation period in AUD.

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Alcohol Use Disorder and Comorbid Depression: A Randomized Controlled Trial Investigating the Effectiveness of Supportive Text Messages in Aiding Recovery

Alcohol and Alcoholism ◽

10.1093/alcalc/agz060 ◽

2019 ◽

Vol 54 (5) ◽

pp. 551-558 ◽

Cited By ~ 3

Author(s):

Helen O’Reilly ◽

Aisling Hagerty ◽

Seamus O’Donnell ◽

Aoife Farrell ◽

Dan Hartnett ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Controlled Trial ◽

Text Messages ◽

Comorbid Depression ◽

Randomized Controlled ◽

Lower Alcohol ◽

The Impact

This randomized controlled trial examined the impact of daily supportive text messages over a six-month treatment period on mood and alcohol consumption in individuals with a dual diagnosis of alcohol use disorder (AUD) and depression. Results highlighted mood benefits at 3-month and lower alcohol consumption at 6-month treatment points.

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Perception that Mothers and / or Guardians of Overweight or Obese Preschool Children Have of a Text Messaging Program to Support Behaviour Change in their Children

Global Pediatric Health ◽

10.1177/2333794x20961575 ◽

2020 ◽

Vol 7 ◽

pp. 2333794X2096157

Author(s):

Solange Parra-Soto ◽

Alejandra Ortega ◽

Carlos Celis-Morales ◽

Juliana Kain

Keyword(s):

Preschool Children ◽

Childhood Obesity ◽

Behavior Change ◽

Behaviour Change ◽

Text Messaging ◽

New Technologies ◽

Text Messages ◽

Lifestyle Behavior ◽

Depth Interviews

In most childhood obesity preventive programs, parents are targeted as they are key in achieving lifestyle behavior change in their children. Because their participation is generally low, new technologies, such as text messaging, are being tested to assess if their participation increases. The objective of this study was to determine the perception that mothers of overweight/ obese preschool children have of a textmessaging program developed to support their children’s lifestyle behavior change. Text messages were sent to 60 mothers twice a week for 12 weeks; 58 of them said they received all of them. During the process mothers were contacted twice regarding their opinion on all aspects related to the messages. At follow-up, we determined perception by in depth interviews administered to participants. Results show that text messaging implemented in a personalized manner was considered successful in regards to providing useful information to support their children’s behavior change.

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Prevalence and correlates of alcohol consumption in Northeast states, India (evidence from district levels household survey: 2012-13)

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20164708 ◽

2016 ◽

Vol 4 (1) ◽

pp. 30 ◽

Cited By ~ 1

Author(s):

Jeetendra Yadav ◽

Subhash Gautam ◽

Kh Jitenkumar Singh

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Family Health ◽

Household Survey ◽

Well Being ◽

High Prevalence ◽

Important Health ◽

Using Data ◽

Educated Person ◽

Harmful Effects

Background: Despite the increased awareness of adverse effects of alcohol consumption, India is a one of the countries with high prevalence of alcohol use. The third round of National Family Health Survey (2005-06) estimated that 32% men consume alcohol. Evidence suggests the magnitude of alcohol use is likely to be higher among Northeast who residing in adverse geographical settings. The objective of the study was to analyzed prevalence and determinants of alcohol use in Northeast states, India.Methods: The study using data from the fourth round of District Level Household Survey (2012-13). The outcome variables included in the study was alcohol consumption. The study used bivariate and multivariate to determine the prevalence, differentials and determinants of alcohol consumption.Results: The result shows that alcohol consumption was significantly high among the young age group of 25-34 years. The prevalence of alcohol consumption was high among male as compared to female and alcohol consumption is slightly low among more educated person. Alcohol consumption was high in Meghalaya and Mizoram as compared to other Northeast states.Conclusions: We conclude by this study that, the prevalence of alcohol consumption in Northeast was very high and alarming. There are really an important health concerns and they need to be counselled about the ill effect of alcohol consumption. Establishment of de-addiction centers or strong referral to de-addiction centers among those consuming alcohol is a might be a novel step for well-being of Northeast people. Government specially, Doctors and media should play their roles and spread information regarding harmful effects of alcohol consumption.

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Improving Mood Through Community Connection and Resources Using an Interactive Digital Platform: Development and Usability Study

JMIR Mental Health ◽

10.2196/25834 ◽

2021 ◽

Vol 8 (2) ◽

pp. e25834

Author(s):

Robin Ortiz ◽

Lauren Southwick ◽

Rachelle Schneider ◽

Elissa V Klinger ◽

Arthur Pelullo ◽

...

Keyword(s):

Emergency Department ◽

Text Messaging ◽

Local Community ◽

Negative Mood ◽

Well Being ◽

Text Messages ◽

Chi Square ◽

Interactive Tool ◽

Mood Rating ◽

Health And Well Being

Background COVID-19 continues to disrupt global health and well-being. In April-May 2020, we generated a digital, remote interactive tool to provide health and well-being resources and foster connectivity among community members through a text messaging platform. Objective This study aimed to prospectively investigate the ability of a health system–based digital, remote, interactive tool to provide health and well-being resources to local community participants and to foster connectivity among them during the early phases of COVID-19. Methods We performed descriptive and nonparametric longitudinal statistical analyses to describe and compare the participants’ mood ratings over time and thematic analysis of their responses to text messages to further assess mood. Results From among 393 individuals seeking care in an urban emergency department in an academic setting, engaged in a two-way text messaging platform, we recorded 287 mood ratings and 368 qualitative responses. We observed no difference in the initial mood rating by week of enrollment [Kruskal-Wallis chi-square H(5)=1.34; P=.93], and the average mood rating did not change for participants taken together [Friedman chi-square Q(3)=0.32; P=.96]. However, of participants providing mood ratings at baseline, mood improved significantly among participants who reported a low mood rating at baseline [n=25, 14.97%; Q(3)=20.68; P<.001] but remained stable among those who reported a high mood rating at baseline [n=142, 85.03%; Q(3)=2.84; P=.42]. Positive mood elaborations most frequently included words related to sentiments of thankfulness and gratitude, mostly for a sense of connection and communication; in contrast, negative mood elaborations most frequently included words related to anxiety. Conclusions Our findings suggest the feasibility of engaging individuals in a digital community with an emergency department facilitation. Specifically, for those who opt to engage in a text messaging platform during COVID-19, it is feasible to assess and respond to mood-related queries with vetted health and well-being resources.

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Digital Parenting of Emerging Adults in the 21st Century

Social Sciences ◽

10.3390/socsci10120482 ◽

2021 ◽

Vol 10 (12) ◽

pp. 482

Author(s):

Michaeline Jensen ◽

Emily Haston ◽

Andrea M. Hussong

Keyword(s):

Emerging Adults ◽

21St Century ◽

Text Messaging ◽

Objective Assessment ◽

Text Message ◽

Emerging Adult ◽

Well Being ◽

Text Messages ◽

Digital Pressure ◽

First Time

In emerging adulthood, when many young people are away from their families for the first time, mobile phones become an important conduit for maintaining relationships with parents. Yet, objective assessment of the content and frequency of text messaging between emerging adults and their parents is lacking in much of the research to date. We collected two weeks of text messages exchanged between U.S. college students (N = 238) and their parents, which yielded nearly 30,000 parent-emerging adult text messages. We coded these text message exchanges for traditional features of parent-emerging adult communication indexing positive connection, monitoring and disclosures. Emerging adults texted more with mothers than with fathers and many messages constitute parental check-ins and emerging adult sharing regarding youth behavior and well-being. Findings highlight that both the frequency and content of parent-emerging adult text messages can be linked with positive (perceived text message support) and negative (perceived digital pressure) aspects of the parent-emerging adult relationship. The content of parent-emerging adult text messages offers a valuable, objective window into the nature of the parent-emerging adult relationships in the digital age of the 21st century.

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