Crane David, Garnett Claire, Brown James, West Robert, Michie Susan
Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
J Med Internet Res. 2015 May 14;17(5):e118. doi: 10.2196/jmir.4060.
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.
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.
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.
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.
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.
手机应用程序有潜力以具有成本效益的方式减少过量饮酒。尽管有数百种与酒精相关的应用程序可供使用，但关于它们所包含的行为改变技术（BCTs），或者它们基于证据或理论的程度以及这与它们的受欢迎程度和用户评分之间的关系，几乎没有相关信息。
我们的目的是评估英国可用的流行酒精相关应用程序中专注于减少酒精摄入的比例，确定它们所包含的BCTs，并探讨BCTs或对理论或证据的提及是否与应用程序的受欢迎程度和用户评分相关。
我们在iTunes和谷歌应用商店中搜索了“酒精”和“饮料”等关键词，前800个结果被分类为减少酒精摄入、娱乐或血液酒精含量测量。在那些被分类为减少酒精摄入的应用中，所有免费应用程序和排名前10的付费应用程序都针对BCTs以及对证据或理论的引用进行了编码。提取了受欢迎程度和用户评分的指标。
在识别出的800个应用程序中，662个是独特的。其中，13.7%（91/662）被分类为减少酒精摄入（95%置信区间11.3 - 16.6），53.9%（357/662）为娱乐（95%置信区间50.1 - 57.7），18.9%（125/662）为血液酒精含量测量（95%置信区间16.1 - 22.0），13.4%（89/662）为其他（95%置信区间11.1 - 16.3）。51个免费减少酒精摄入应用程序和排名前10的付费应用程序平均包含3.6个BCTs（标准差3.4），约12%（7/61）不包含任何BCTs。最常使用的BCTs是“促进自我记录”（54%，33/61），“提供过量饮酒和戒酒后果的信息”（43%，26/61），“提供表现反馈”（41%，25/61），“提供额外和后续支持的选项”（25%，15/61）以及“提供/指向适当的书面材料”（23%，14/61）。这些应用程序也很少包含其他健康行为改变干预中常用的22个BCTs中的任何一个（平均2.46，标准差2.06）。16.4%的应用程序提到了证据，没有任何应用程序提到理论。多变量回归显示，包含环境重构建议的应用程序与较低的用户评分相关（β = -46.61，P = 0.04，95%置信区间 -91.77至 -1.45），“建议/促进使用社会支持”技术（β = 2549.21，P = 0.04，95%置信区间96.75 - 5001.67）和对证据的提及（β = 1376.74，P = 0.02，95%，置信区间208.62 - 2544.86）都与应用程序的受欢迎程度相关。
只有少数与酒精相关的应用程序促进健康，而大多数应用程序含蓄或明确地促进了酒精的使用。促进健康的与酒精相关的应用程序包含的BCTs很少，且没有提及理论。对证据的提及与更受欢迎的应用程序相关，但受欢迎程度和用户评分与BCT内容的关联较弱。
