A smartphone app designed to help reduce unhealthy alcohol consumption
Research
By
Melody Kwong
Unhealthy alcohol use is widespread and can cause considerable harm. Despite this, most people with unhealthy alcohol use will never seek formal treatment. As an alternative, smartphone apps have been developed as one means to provide help to individuals concerned about their alcohol use. In this study, Dr. John Cunningham and his team tested the potential effectiveness of the smartphone app SMAART in a randomized control trial. The results of this randomized control trial – the second of its kind demonstrating an impact of this same app – provide some supportive evidence that smartphone apps can aid in reducing unhealthy alcohol consumption.
Along with other studies being done on the efficacy of technology-based treatments (such as the work of Dr. Lena Quilty at CAMH exploring the potential role of e-health interventions in treatment settings), there is the potential for this type of research to make a significant public health impact. Continued research in this field is uncovering a larger number of avenues and treatments for individuals who are hoping to seek help in addressing their concerns with alcohol use.
Dr. John Cunningham
What motivated this research?
JC: The large majority of people who drink in a hazardous fashion never seek or receive help for their alcohol concerns. However, many are interested in tools to help them assess their drinking and to cut down on their alcohol consumption. This project is one of a series of studies that I have conducted over the last 25-30 years focussed on evaluating different methods to help people cut down on their drinking without necessarily seeking face-to-face treatment. The earlier studies involved paper and pencil interventions. We then moved to Internet-based interventions and have now progressed to smartphone app interventions as technology evolves.
How does the smartphone app to reduce unhealthy alcohol consumption work?
JC: I wish I had a good answer to this question. I’m not a clinician myself but I have great admiration for the work that clinicians do to help others. My focus has been to modify interventions found to be effective in face-to-face settings to a self-administered format. This work has been done in collaboration with clinician researchers and with input from those with lived experience. The app contains a number of modules with such an evidence base – including personalized normative feedback that compares the participant’s drinking to others in the general population, goal setting, and a diary to track drinking. These are all tools that have been used in a variety of different interventions. The primary developer of the app was Professor Nicolas Bertholet at CHUV University in Switzerland. We have worked together on several interventions in the past with this experience informing the content of the current app.
What was the most important finding of this study, in your opinion?
JC: Participants who received the full app reduced their usual weekly drinking by about two and a half drinks per week more than participants who did not receive the full app over the six-month follow-up period. This is a small effect but it does have potential significance because interventions like this app can be widely distributed at low cost. Thus, there is the potential for a significant public health impact.
How does this change treatment in the future?
JC: There is a need to integrate self-help interventions such as smartphone apps into a continuum of care for those with alcohol concerns that includes access to more formal treatment options. This might encourage those who want more help than that provided by an app to seek alternative types of services.
Any next steps?
JC: One interesting issue observed in this study was that most people who used that app did not access the content more than a few times. Further research is needed to explore ways to engage participants with the app to a greater extent, based on the assumption that greater use might be related to improved outcomes.
What is the major take home message for the public?
JC: There are multiple pathways to recovery from alcohol problems. Providing a large number of options to promote reductions in alcohol consumption, including smartphone apps, may help more people address their alcohol concerns.