Abstract
This is a process evaluation of a large UK-based randomised controlled trial (RCT) (n = 5602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants’ engagement (‘self-reported adherence’) and behavioural characteristics were mechanisms of action underpinning the effectiveness of Drink Less. Self-reported adherence with both digital tools was over 70% (Drink Less: 78.0%, 95% CI = 77.6–78.4; usual digital care: 71.5%, 95% CI = 71.0–71.9). Self-reported adherence to the intervention (average causal mediation effect [ACME] = −0.250, 95% CI = −0.42, −0.11) and self-monitoring behaviour (ACME = −0.235, 95% CI = −0.44, −0.03) both partially mediated the effect of the intervention (versus comparator) on alcohol reduction. Following the recommendation (self-reported adherence) and the tracking (self-monitoring behaviour) feature of the Drink Less app appear to be important mechanisms of action for alcohol reduction among increasing and higher risk drinkers.
| Original language | English |
|---|---|
| Article number | 174 |
| Journal | npj Digital Medicine |
| Volume | 7 |
| Issue number | 1 |
| Early online date | 29 Jun 2024 |
| DOIs | |
| Publication status | Published - 31 Dec 2024 |
Data Availability Statement
The anonymised data and data dictionary are available online at OSF (https://osf.io/2j9df/).Funding
This project is funded by the National Institute for Health and Care Research (NIHR) [Public Health Research Programme (project reference NIHR127651)]. The views expressed are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care, or Public Health England (PHE). C.G. is funded by NIHR (NIHR302923). E.B. and J.B. are also funded by Cancer Research UK (CRUK: PRCRPG-Nov21\100002). Drink Less was funded by the NIHR School for Public Health Research (SPHR), the UK Centre for Tobacco and Alcohol Studies (UKCTAS), the Society for the Study of Addiction (SSA) and CRUK. E.P. is supported by the NIHR ARC North Thames. M.H. acknowledges NIHR Health Protection Research Unit in Evaluation, and M.M. and M.H. acknowledge NIHR Biomedical Research Centre at Bristol. J.B. and M.M. are part of the SPECTRUM Consortium, UK. O.P. is supported by a Marie Skłodowska-Curie Postdoctoral Fellowship from the European Union (Grant Agreement number: 101065293). E.K. is supported by an NIHR Senior Investigator and is Director of the NIHR funded Applied Research Collaboration Northeast and North Cumbria. The funders played no role in the design, conduct or analysis of the study, nor in the interpretation or reporting of study findings.
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Health Informatics
- Computer Science Applications
- Health Information Management