TY  - JOUR
AU  - Oldham, Melissa
AU  - Dina, Larisa-Maria
AU  - Loebenberg, Gemma
AU  - Perski, Olga
AU  - Brown, Jamie
AU  - Angus, Colin
AU  - Beard, Emma
AU  - Burton, Robyn
AU  - Field, Matt
AU  - Greaves, Felix
AU  - Hickman, Matthew
AU  - Kaner, Eileen
AU  - Michie, Susan
AU  - Munafò, Marcus R
AU  - Pizzo, Elena
AU  - Garnett, Claire
PY  - 2024
DA  - 2024/7/18
TI  - Evaluating the Acceptability of the Drink Less App and the National Health Service Alcohol Advice Web Page: Qualitative Interview Process Evaluation
JO  - J Med Internet Res
SP  - e42319
VL  - 26
KW  - alcohol reduction
KW  - digital intervention
KW  - acceptability
KW  - mobile health
KW  - mHealth
KW  - mobile phone
AB  - Background: The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy. Objective: In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in the United Kingdom participating in a randomized controlled trial evaluating the effectiveness of the Drink Less app. Methods: A subsample of 26 increasing- and higher-risk drinkers (Alcohol Use Disorders Identification Test score≥8) assigned to the intervention group (Drink Less; n=14, 54%; female: n=10, 71%; age: 22-72 years; White: n=9, 64%) or usual digital care group (NHS alcohol advice web page; n=12, 46%; female: n=5, 42%; age: 23-68 years: White: n=9, 75%) took part in semistructured interviews. The interview questions were mapped on to the 7 facets of acceptability according to the Theoretical Framework of Acceptability: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Alongside these constructs, we also included a question on perceived personal relevance, which previous research has linked to acceptability and engagement. Framework and thematic analysis of data was undertaken. Results: The Drink Less app was perceived as being ethical, easy, user-friendly, and effective for the period the app was used. Participants reported particularly liking the tracking and feedback sections of the app, which they reported increased personal relevance and which resulted in positive affect when achieving their goals. They reported no opportunity cost. Factors such as negative affect when not meeting goals and boredom led to disengagement in the longer term for some participants. The NHS alcohol advice web page was rated as being easy and user-friendly with no opportunity costs. However, the information presented was not perceived as being personally relevant or effective in changing drinking behavior. Most participants reported neutral or negative affect, most participants thought the alcohol advice web page was accessible, and some participants reported ethical concerns around the availability of suggested resources. Some participants reported that it had acted as a starting point or a signpost to other resources. Participants in both groups discussed motivation to change and contextual factors such as COVID-19 lockdowns, which influenced their perceived self-efficacy regardless of their assigned intervention. Conclusions: Drink Less appears to be an acceptable digital intervention among the recruited sample. The NHS alcohol advice web page was generally considered unacceptable as a stand-alone intervention among the recruited sample, although it may signpost and help people access other resources and interventions. 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e42319
UR  - https://doi.org/10.2196/42319
DO  - 10.2196/42319
ID  - info:doi/10.2196/42319
ER  -