Behavior Change Techniques in Popular Alcohol Reduction Apps

Crane, David; Garnett, Claire; Brown, James; West, Robert; Michie, Susan

doi:10.2196/jmir.4060

Cited by 177Mobile Health and mHealth ApplicationsSubstance Abuse Treatment and OutcomesDigital Mental Health Interventions

Behavior Change Techniques in Popular Alcohol Reduction Apps

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Crane, David, Garnett, Claire, Brown, James, West, Robert, Michie, Susan·2015·Journal of Medical Internet Research

DOI 10.2196/jmir.4060PMC PMC4468601

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Abstract

BACKGROUND: Mobile phone apps have the potential to reduce excessive alcohol consumption cost-effectively. Although hundreds of alcohol-related apps are available, there is little information about the behavior change techniques (BCTs) they contain, or the extent to which they are based on evidence or theory and how this relates to their popularity and user ratings. OBJECTIVE: Our aim was to assess the proportion of popular alcohol-related apps available in the United Kingdom that focus on alcohol reduction, identify the BCTs they contain, and explore whether BCTs or the mention of theory or evidence is associated with app popularity and user ratings. METHODS: We searched the iTunes and Google Play stores with the terms "alcohol" and "drink", and the first 800 results were classified into alcohol reduction, entertainment, or blood alcohol content measurement. Of those classified as alcohol reduction, all free apps and the top 10 paid apps were coded for BCTs and for reference to evidence or theory. Measures of popularity and user ratings were extracted. RESULTS: Of the 800 apps identified, 662 were unique. Of these, 13.7% (91/662) were classified as alcohol reduction (95% CI 11.3-16.6), 53.9% (357/662) entertainment (95% CI 50.1-57.7), 18.9% (125/662) blood alcohol content measurement (95% CI 16.1-22.0) and 13.4% (89/662) other (95% CI 11.1-16.3). The 51 free alcohol reduction apps and the top 10 paid apps contained a mean of 3.6 BCTs (SD 3.4), with approximately 12% (7/61) not including any BCTs. The BCTs used most often were "facilitate self-recording" (54%, 33/61), "provide information on consequences of excessive alcohol use and drinking cessation" (43%, 26/61), "provide feedback on performance" (41%, 25/61), "give options for additional and later support" (25%, 15/61) and "offer/direct towards appropriate written materials" (23%, 14/61). These apps also rarely included any of the 22 BCTs frequently used in other health behavior change interventions (mean 2.46, SD 2.06). Evidence was mentioned by 16.4% of apps, and theory was not mentioned by any app. Multivariable regression showed that apps including advice on environmental restructuring were associated with lower user ratings (Β=-46.61, P=.04, 95% CI -91.77 to -1.45) and that both the techniques of "advise on/facilitate the use of social support" (Β=2549.21, P=.04, 95% CI 96.75-5001.67) and the mention of evidence (Β=1376.74, P=.02, 95%, CI 208.62-2544.86) were associated with the popularity of the app. CONCLUSIONS: Only a minority of alcohol-related apps promoted health while the majority implicitly or explicitly promoted the use of alcohol. Alcohol-related apps that promoted health contained few BCTs and none referred to theory. The mention of evidence was associated with more popular apps, but popularity and user ratings were only weakly associated with the BCT content.

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The physical design of our environment influences how we interact with features and other people in that environment.
“The physical design of our environment (i.e. the structure, layout, and aesthetics) influences how we interact with features and other people in that environment, which has been captured by studies demonstrating the effect of environmental restructuring on health and social behaviours in young people such as bullying [33] and alcohol intake [34].”
From Facilitators and barriers to social distancing for young people during the COVID-19 pandemic (2022) · cites this paper as [34]
The Results section (page unavailable) lists ‘advise on environmental restructuring’ as a technique present in 5 of 61 alcohol-reduction apps. The paper does not report whether restructuring a physical environment affects alcohol intake in young people, or how physical design influences interactions with people and features. I searched for environmental restructuring, physical design, and effects on alcohol intake. (LLM, conf=0.76)
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Identification of behaviour change techniques and engagement strategies to design a smartphone app to reduce alcohol consumption using a formal consensus method
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Authors: Crane, D., Garnett, C., Brown, J., West, R., & Michie, S.
Affiliations: University College London (GB)
Cancer Research UK (GB)
Corresponding author: Crane, David
ORCID: Crane, David
Garnett, Claire
West, Robert
Michie, Susan
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2015-05-14
Volume: 17
Issue: 5
Pages: e118
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/jmir.4060
PMC: PMC4468601
OpenAlex: W1481085698
Cited by: 177
References: 49
Citations by year: 2026: 4 · 2025: 15 · 2024: 9 · 2023: 8 · 2022: 16 · 2021: 26 · 2020: 21 · 2019: 14 · 2018: 27 · 2017: 22 · 2016: 7 · 2015: 8
FWCI: 39.01
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal of Medical Internet Research (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Cancer Research UK (14135)
National Institute for Health and Care Research
Medical Research Council (MR/K023195/1)
School for Public Health Research
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords: behaviour change techniques, mobile health apps, excessive alcohol consumption, app popularity, user ratings, evidence-based interventions, theory-based design, self-recording, performance feedback, entertainment apps, app store search, harm reduction, digital health interventions
MeSH terms: Alcohol Drinking, Behavior Therapy, Humans, Male, Health Behavior, Telemedicine, Cell Phone, Mobile Applications

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Behavior Change Techniques in Popular Alcohol Reduction Apps

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