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Development and evaluation of a smartphone app to reduce excessive alcohol consumption: Self-regulatory factors

Author D. Crane
Author S. Michie
Author R. West
Author J. Brown
Abstract Alcohol consumption is a major public health issue. Alcohol is responsible for millions of deaths each year, is a causal factor in over 200 diseases and conditions and is a leading contributor to the global burden of disease. Brief interventions to reduce alcohol consumption have demonstrated a record of effectiveness, whether delivered face-to-face or digitally. Most digital behaviour change interventions (DBCIs) for alcohol reduction have been performed on a computer. Smartphone apps are a new and, due to their widespread adoption and rich technological capacities, potentially very useful modality for delivering DBCIs. However, there is currently little evidence of the effectiveness of health behaviour change apps in general and alcohol reduction apps in particular. This thesis describes the development and evaluation of an app to help people reduce their consumption of alcohol. The aim is to identify which behaviour change techniques (BCTs) may be most effective in helping people reduce their alcohol consumption when delivered in this modality. In a series of three studies, BCTs have been selected for evaluation and their implementation refined. The first study examined the BCTs used in existing popular alcohol-reduction apps; the second undertook a meta-regression of the effectiveness of BCTs used in DBCIs; the third determined how the implementation of the BCTs selected for evaluation could be improved in response to user feedback. Accompanying work reviewed the literature for potentially effective BCTs for alcohol reduction. In the fourth and final study, the BCTs chosen for inclusion in the app were placed into a series of five modules: self-monitoring and feedback, action planning, normative feedback, identity change and cognitive bias retraining, and were evaluated in a factorial randomised control trial (RCT).