Neale Joanne, Bowen Alice May
National Addiction Centre, King's College London, London, United Kingdom.
JMIR Hum Factors. 2022 Mar 8;9(1):e33038. doi: 10.2196/33038.
Mobile health apps promoting health and well-being have substantial potential but low uptake and engagement. Barriers common to addiction treatment app uptake and engagement include poor access to mobile technology, Wi-Fi, or mobile data, plus low motivation among non-treatment-seeking users to cut down or quit. Working with people who used substances, we had previously designed and published an app to support recovery from alcohol and other drug problems. The app, which is available for free from the Apple App Store and Google Play, is called SURE Recovery.
The aim of this paper is to undertake a qualitative study to ascertain end users' views and experiences of the SURE Recovery app, including how it might be improved, and present the findings on uptake and engagement to assist other researchers and app developers working on similar apps for people experiencing alcohol and other drug problems.
Semistructured telephone interviews were conducted with 20 people (n=12, 60%, men and n=8, 40%, women aged 25-63 years; all identifying as White British) who had varied patterns of using the app. The audio recordings were transcribed, and the data were coded and analyzed through Iterative Categorization.
Analyses identified three main factors relevant to uptake (discoverability of the app, personal relevance, and expectations and motivations) and three main factors relevant to engagement (the appeal and relevance of specific features, perceived benefits, and the need for improvements). The findings on uptake and engagement were largely consistent with our own earlier developmental work and with other published literature. However, we additionally found that uptake was strongly affected by first impressions, including trust and personal recommendations; that users were attracted to the app by their need for support and curiosity but had relatively modest expectations; that engagement increased if the app made users feel positive; and that people were unlikely to download, or engage with, the app if they could not relate to, or identify with, aspects of its content.
Incorporating end-user views into app design and having a network of supportive partners (ie, credible organizations and individuals who will champion the app) seem to increase uptake and engagement among people experiencing alcohol and other drug problems. Although better digital literacy and access to devices and mobile data are needed if addiction recovery apps are to reach their full potential, we should not evaluate them based only on observable changes in substance use behaviors. How using an app makes a person feel is more transient and difficult to quantify but also relevant to uptake and engagement.
促进健康和幸福的移动健康应用程序具有巨大潜力，但使用率和参与度较低。成瘾治疗应用程序在采用和参与方面常见的障碍包括难以获得移动技术、Wi-Fi或移动数据，以及非寻求治疗的用户减少或戒除成瘾行为的动机较低。我们曾与有药物使用问题的人合作，设计并发布了一款支持从酒精和其他药物问题中恢复的应用程序。该应用程序名为“肯定康复”（SURE Recovery），可从苹果应用商店和谷歌应用商店免费获取。
本文旨在进行一项定性研究，以确定最终用户对“肯定康复”应用程序的看法和体验，包括如何改进该应用程序，并呈现有关采用率和参与度的研究结果，以帮助其他研究人员和应用程序开发者为有酒精和其他药物问题的人开发类似应用程序。
对20名使用该应用程序模式各异的人进行了半结构化电话访谈（n = 12，60%为男性；n = 8，40%为女性，年龄在25至63岁之间；均为英国白人）。对录音进行了转录，并通过迭代分类法对数据进行编码和分析。
分析确定了与采用率相关的三个主要因素（应用程序的可发现性、个人相关性以及期望和动机）和与参与度相关的三个主要因素（特定功能的吸引力和相关性、感知到的益处以及改进的必要性）。关于采用率和参与度的研究结果在很大程度上与我们自己早期的开发工作以及其他已发表的文献一致。然而，我们还发现，首次印象对采用率有很大影响，包括信任和个人推荐；用户因需要支持和好奇心而被该应用程序吸引，但期望相对不高；如果应用程序让用户感觉良好，参与度就会提高；如果人们无法认同应用程序内容的某些方面，他们不太可能下载或使用该应用程序。
将最终用户的意见纳入应用程序设计，并拥有一个支持性合作伙伴网络（即会推广该应用程序的可靠组织和个人），似乎可以提高有酒精和其他药物问题的人的采用率和参与度。虽然如果成瘾康复应用程序要充分发挥潜力，需要提高数字素养以及改善设备和移动数据的获取，但我们不应仅根据物质使用行为的可观察变化来评估这些应用程序。使用应用程序给人带来的感受更短暂且难以量化，但也与采用率和参与度相关。
