News — In a large group of frequent drinkers who used a digital application offering tailored text-based support for reducing their alcohol intake, weekly drink amounts fell by 1/3 over 12 weeks. The study of real-world users shows promise for people who are uncomfortable with their drinking habits but may not meet the criteria for alcohol use disorder (AUD). Although they may be unlikely to aim for abstinence or to seek formal treatment, many are open to moderating their drinking. Digital interventions, such as self-guided online programs and smartphone apps, are easily accessible and engaging. Studies have shown that text-based messaging interventions can result in short- and medium-term reductions in alcohol use. Digital programs that tailor content according to users’ evolving outcomes, similar to clinical care, may be particularly effective. Outcomes data are limited, however. For the study in Alcohol: Clinical & Experimental Research, researchers evaluated an adaptive, tailored digital application aimed at reducing excessive drinking among community-based users.
The study involved a commercially available application rooted in health behavior change theory that received public attention during the COVID-19 pandemic. The app incorporated elements of motivational interviewing, cognitive-behavioral approaches, tracking, and personalized feedback. Researchers analyzed the data of 46,400 self-selected users aged 21+ who logged their alcohol consumption for at least 1 day during their first 12 weeks of membership. Participants completed a baseline survey assessing their drinking habits, goals, level of concern about their alcohol use (0 representing no concern, 5 high concern), and optional demographic information. They received automated daily check-ins, reminders to track drinking in real-time, and various supportive messages. Personalized elements included motivational reminders, custom goals and tips based on their drinking habits and progress, and peer coaches available via text messaging. Researchers used statistical analysis to explore daily and weekly alcohol use during participants’ first 12 weeks of enrollment and which individual characteristics related to outcomes.
At baseline, users consumed 27 drinks a week on average; 2 out of 3 reported typically drinking daily. The most common motivation for cutting back was improved overall health and wellness, followed by weight loss and avoiding hangovers. Nearly 8 in 10 rated concern about their drinking at 3 or more on a scale of 0–5. During the tracking period, participants’ self-reported drinks per week decreased most in the initial weeks and slowed thereafter, with an overall 1/3 reduction in weekly drink counts. Daily drink amounts were reduced by 9%. People with more alcohol use or higher concern at baseline drank more throughout the program but also showed greater reductions in drinking. Younger users were more likely to sustain their rate of reduction over time than older users.
The findings suggest that a digital intervention featuring tailored and adaptive weekly goal setting, live drink tracking, and supportive messaging may be effective in reducing alcohol intake. It points to the potential for self-change among people concerned about excessive drinking. The approach allowed for a far larger community-based sample than a clinical trial could typically accommodate, and the findings are consistent with randomized clinical trials of text-based interventions. More clinical trials of digital behavior-change interventions are needed.
Self-reported alcohol consumption during participation in a text messaging-based online drinking moderation platform. N. Vadhan, H. Treloar Padavano, F. J. Muench, S. Levak, N. Allen.
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