Refining the content and design of an alcohol reduction app, , to improve its usability and effectiveness: a mixed methods approach.

Digital interventions have the potential to reduce alcohol consumption, although evidence on the effectiveness of apps is lacking. is a popular, evidence-informed app with good usability, putting it in a strong position to be improved upon prior to conducting a confirmatory evaluation. This paper describes the process of refining to improve its usability and likely effectiveness. The refinement consisted of three phases and involved qualitative and quantitative (mixed) methods: i) identifying changes to app content, based on findings from an initial evaluation of , an updated review of digital alcohol interventions and a content analysis of user feedback; ii) designing new app modules with public input and a consultation with app developers and researchers; and iii) improving the app's usability through user testing. As a result of the updated review of digital alcohol interventions and user feedback analysis in Phase 1, three new modules: 'Behaviour Substitution', 'Information about Antecedents' and 'Insights', were added to the app. One existing module - 'Identity Change' - was removed based on the initial evaluation of . Phases 2 and 3 resulted in changes to existing features, such as improving the navigational structure and onboarding process, and clarifying how to edit drinks and goals. A mixed methods approach was used to refine the content and design of , providing insights into how to improve its usability and likely effectiveness. is now ready for a confirmatory evaluation.