Abstract
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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).
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