The Drink Less smartphone app: the project so far | Claire Garnett

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‘Drink Less’ is a smartphone app for iOS devices that aims to help people reduce their alcohol consumption (drinklessalcohol.com) – you can download it here.

It was developed and evaluated by a team of researchers at University College London using evidence and theory from the field of behavioural science.

Smartphone apps have a wide reach and can be provided to many users at a low cost though few have been evaluated. This means there’s little information on whether and how they work. When the Drink Less app was launched in 2016, many of its users agreed to participate in a study and have their anonymous data used for scientific research to test it.

normative-feedbackThe study tested the five separate app modules (you can read more about the app’s different features in a previous UKCTAS blog post) which each focused on a different behaviour change strategy. Nearly 700 users were recruited to the trial and different groups were randomly given either intensive or minimal versions of each of the app modules. The effectiveness of each was then measured by comparing levels of drinking before using the app and after one-month.

On average, over the month following download, people logged-in 12 times and drank four fewer units of alcohol. People who received a more intensive version of a module did not reduce their alcohol consumption significantly more than people who got a less intensive version of the same module. However, combinations of specific modules led to a greater reduction in alcohol consumption where users had the intensive versions of both modules. This evaluation has recently been published and you can read about it in more detail here.

User testimonials

Drink Less seems to be a popular app amongst users. It has been downloaded over 21,000 times and the app consistently appears amongst the top results for the ‘alcohol’ search term on the Apple App Store and has an average 4-star rating (based on 26 ratings as of 23/3/2018).

In addition to that, the researchers at UCL have received a lot of positive feedback about the app, some of which is shared below (with their permission):

Well researched and brilliantly designed. It’s both easy and thorough to track drinking and how it affects all areas your life. It’s designed so it’s not preaching because mostly you capture and listen to your own advice – very individualised and very powerful. A great tool to help consider past consequence and create better future behaviours around use of alcohol.”

dashboard“Excellent app that is so useful. Would definitely recommend it.”

“Lots of these apps around but this one is easy to use, non-judgemental and backed up by theory. Really like it. I was surprised by my results. Tracker, goal setting and ideas about how my drinking compares with others. I was surprised!”

“I would like to thank the developers who have worked on the app – it’s been a real help for me as I had become a seriously habitual drinker – I have now settled into a good routine, limiting my intake to under 14 units/week and only imbibing on Friday and Saturday evenings. I couldn’t have done it without your help, thank you. I have told many friends about my success with the app…it really has proved to be a game changer.”

“I love your app. In 2 weeks it’s helped me understand my consumption and learn to plan which has helped me cut down. I like the fact it’s contributing to wider research too. I’d tried a number of apps that help you monitor your alcohol consumption, most of them I stopped using after a week or two… but that did change when I started to use the Drink Less app. What I learned was that I needed to think ahead and plan when I was going to drink…

I’m never going to stop drinking, I love a glass of wine, but it has stopped me casually drinking without thinking. I now understand that I must have been passively consuming way way too much. You hear that all the time, but nothing made it as tangible as this app… I work in an industry where alcohol plays a large part of the culture, so gaining this understanding helped me manage those work situations where alcohol was central much better.”

“I’ve been participating with your Drink Less App for the last 14 weeks. During which I’ve made significant changes to my drinking consumption and life style. I feel I’m getting back some control over my drinking which was controlling me…my GP has me down as having average consumption at 27 alcohol units per week. It’s been like that for many years. That’s before I found and started working with your Drink Less app. So getting it down to 13 units / wk is something my wife and I are proud of. Thanks again for your help and please keep up the good work.”

Plans for the future

Drink Less is in a good position to be built upon as an already successful app. Initial findings suggest that it has the potential to help excessive drinkers in the UK reduce their alcohol consumption at a low incremental cost per user.

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Next up for the Drink Less app is to create an optimised version based on user feedback and the findings from the screening trial. This research is part of an 18-month project funded by the NIHR SPHR. And as part of this project, a funding application will be submitted for a confirmatory trial to determine whether the Drink Less app can provide an effective alternative to the help people usually receive for alcohol reduction.

All of the related scientific papers on the Drink Less app are available here.

Acknowledgements

This research was funded by the UK Centre for Tobacco and Alcohol Studies (UKCTAS), the Society for Study of Addiction (SSA), the NIHR School for Public Health Research (NIHR SPHR) and Cancer Research UK (CRUK). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

The Drink Less app was built by Greg Plumby, Edward Warrender and Chris Pritchard (from Portable Pixels) and Hari Karam Singh.

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Alcohol Policy in Practice | Continuing Professional Development Course | 11th-13th September 2018

Following the successful Alcohol CPD courses held in 2014-2017; we are delighted to announce the line-up for our 2018 course, featuring some exciting new inputs!

This year’s course will feature inputs from Prof. Anna Gilmore and colleagues from the University of Bath, Dr Carol Emslie from Glasgow Caledonian University, Dr James Nicholls from Alcohol Research UK, and Professor Karine Gallopel-Morvan from the EHESP School of Public Health, France. We also welcome the return of highly-rated inputs from leading experts such as Katherine Brown from the Institute of Alcohol Studies and Colin Shevills of Balance North East.

What previous participants said:

“Great range of content and world-class speakers. Organisers did an amazing job including looking after us all while we were here. The mix of lectures / Q & As / panel discussions was great. Really worth taking time away from work/home to attend this.”
“Extremely informative course and relevant to current alcohol policy challenges. Good venue, convenient location and lovely setting. Module well organised and brilliant range of speakers.”
“Thank you very much. It was a great privilege to listen and attend this course. Lectures and lecturers were outstanding.”
“Very informative useful training, well worth my time and travel.”
“Wonderful networking opportunity.”
“Thank you for such a brilliant training event – the content was spot on, all the presentations and sessions were really, really good and I came away feeling that I had learned masses: a rich diet of fact and opinion. I can honestly say that I have rarely – if ever – enjoyed such an event quite as much as this one.”

Anyone wishing to gain an in-depth understanding and up to date insight into evidence and innovative practice in alcohol policy in the UK and internationally.
Previous participants have included people working in public health, local and national alcohol policy, or alcohol research; from Iceland to New Zealand.
Places are filling up fast and the early-bird rate applies until Friday 15th June 2018! 

Apply Here!

New Systematic Review: Effectiveness of Mass Media Campaigns to Reduce Alcohol Consumption and Harm

This systematic review, published in Alcohol and Alcoholism, assessed the effectiveness of mass media messages to reduce alcohol consumption and related harms. Eight databases were searched along with reference lists of eligible studies. Studies of any design in any country were included, provided that they evaluated a mass media intervention targeting alcohol consumption or related behavioural, social cognitive or clinical outcomes. This was the first comprehensive systematic review of evidence of the effectiveness of mass media to reduce alcohol consumption, allowing those who make decisions about whether and how to develop and implement such campaigns to do so informed by a synthesis of the evidence base.
a&a1The search produced 10,212 results and 24 studies were included in the review. Most of the campaigns used TV or radio in combination with other media channels. There was little evidence of reduction in alcohol consumption associated with exposure to campaigns based on 13 studies which measured consumption, although most did not state this as a specific aim of the campaign. There were some increases in treatment seeking and information seeking and mixed evidence of changes in intentions, motivation, beliefs and attitudes about alcohol. Campaigns were associated with increases in knowledge about alcohol consumption, especially where levels had initially been low.The evidence suggests mass media health campaigns about alcohol can be recalled by individuals and can achieve changes in knowledge, attitudes and beliefs about alcohol, based mainly on weak quality studies. Findings of studies that measured alcohol consumption suggest campaigns have not reduced consumption, although most did not state that they directly aim to do so.

The finding that campaigns can be recalled suggests appropriate media channels, targeting strategies, durations and intensities have been utilized to reach target audiences. These campaign characteristics were not always reported by studies so it is not possible to draw a link between types of campaign strategies and levels of recall or exposure. Recall of tobacco mass media campaigns has been shown to be positively associated with smoking cessation (Jepson et al., 2007) so the outcome may be an important first step towards subsequent behaviour change in populations.

Most campaigns that aimed to improve knowledge were shown to be effective. This was particularly evident in areas where knowledge was initially low, for example, knowledge of unit consumption guidelines and of the link between alcohol and cancer. Mass media can yield sustained knowledge, which may lay the groundwork for reductions in consumption that are achieved using other public health measures.

There was evidence of increases in information seeking and treatment seeking. However, alcohol campaigns have not presented the simple call to action of tobacco messages (‘quit’) or provided offers of tangible help such as ‘quitlines’. Furthermore, as alcohol support services have historically been aimed at very heavy drinkers there may be a perception that current services do not cater for those who drink less. Mass media might therefore have limited utility in promoting service uptake.

Most studies found no impact on alcohol consumption, consistent with the conclusion of a previous review that there should be modest expectations of behaviour change from such campaigns (Snyder et al., 2004). Longer term evaluations conducted following sustained and repeated exposure to campaigns might be expected to be better able to detect effects on behaviour. However, the relationship between tobacco mass media campaign duration and effectiveness has been difficult to gauge due to confounding influences and trends over time (Durkin et al., 2012). The context in which alcohol health promotion campaigns operate is particularly challenging because of the ubiquity and power of alcohol marketing (de Bruijn et al., 2016) and pro-alcohol cultural norms (Gordon et al., 2012). This is another key difference to tobacco, where health campaigns in recent years have run in a context where most tobacco marketing has been banned or strictly regulated and social norms have become increasingly anti-smoking. The current review found evidence of impact on short term intermediate outcomes, suggesting mass media can play a supportive role for other actions which are more likely to have an impact on behaviour. These might include price-based measures (Babor et al., 2010), advertising restrictions (Siegfried et al., 2014), limiting availability and access to alcohol (Anderson et al., 2009) with the targeting of high risk groups (Foxcroft et al., 2015).

Alcohol and Alcoholismhttps://doi.org/10.1093/alcalc/agx094
Published: 10 January 2018

Society for the Study of Addiction – Annual Conference 2017

9th – 10th November 2017
Crowne Plaza, Newcastle, UK

Confirmed sessions include:

  • Sport & exercise in addiction and recovery with personal reflections from Clarke Carlisle.
  • End of life care for people with substance problems.
  • The psychedelic renaissance in addiction treatment.
  • Pathways to amphetamine type stimulant use.

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NEW for 2017: The ADDICTION DEBATE

‘This Society believes it is appropriate to expand the concept of addiction to behaviours such as internet use’

With Professor Robert West & Professor Mark Griffiths


SSA PhD Symposium 2017

New for 2017, the SSA’s PhD Symposium will be held the day before our annual Conference, in the same venue.

The SSA’s symposium for PhD students is now in its ninth year. This event aims to bring together PhD students studying addiction-related topics so they can network, present their work in a low-key, supportive environment and share their ups and downs. It welcomes full and part-time students, studying in a range of disciplines including social sciences, laboratory sciences and health services research. The day includes presentations from students at various stages in the PhD process and some close to or who have recently submitted their thesis.

There is a social event in the evening of the PhD Symposium, and throughout the day there is plenty of opportunity to talk to other delegates.

 

For more information about this event please visit: www.addiction-ssa.org/symposium

 

Photos from the UKCRC conference June 2017 – Progress & Pathways

The UKCRC Public Health Research Centres of Excellence are building academic capacity, increasing infrastructure and promoting multi-disciplinary working in public health research in the UK. The Centres are bringing leading research experts together with practitioners, policy makers and wider stakeholders to tackle complex public health issues.

The seventh annual UKCRC Centres conference was co-hosted by DECIPHer, Fuse, and the Centre of Excellence for Public Health Northern Ireland, in partnership with CEDAR, UKCTAS and SCPHRP. This year the event focused on the successes of the UKCRC initiative over the last nine years, showcasing the achievements of the public health research Centres in relation to three themes:

  • capacity development
  • systems change and partnerships; and
  • impact through innovation.

The one day conference was an opportunity for public health researchers, policy makers, practitioners and funders across the UK to exchange knowledge on world class research, innovative public health practices and successful collaborations. Researchers from UKCTAS presented at the conference on a number of different topic including, harm reduction, e-cigarettes, public engagement and development of the UK’s drinking guidelines.

Below are a few pictures from the event, more can be seen on our twitter feed.

Prof Linda Bauld on E-cigarette use during pregnancy at GFN 2017

Global Forum on Nicotine 2017 – ‘Reducing Harm, Saving Lives’

E-cigarette use during pregnancy – What do we know?

At the June Global Forum on Nicotine event Professor Linda Bauld from the University of Stirling and Deputy Director of the UK Centre for Tobacco and Alcohol Studies, presented an update on e-cigarette use during pregnancy. In the presentation Linda highlights the latest research, a brief overview of smoking in pregnancy and why pregnant women who are still smoking should be encouraged to switch to e-cigarettes.

External link for video: E-cigarette use during pregnancy – Professor Linda Bauld

Other links:

Smokefree action’s info-graphic on e-cigarettes in pregnancy

To see other presentations from the conference click here.

Latest press release from UKCTAS:

Vaping may help explain the record fall in UK smoking rates

 

Enough alcohol was sold in Scotland in 2016 for every adult to significantly exceed safe drinking levels each week

New figures published this week reveal that enough alcohol is being sold in England and Wales for every drinker to consume 21 units of alcohol a week – far more than the low-risk level of 14 units per week for both men and women recommended by the UK’s chief medical officers. The figures reveal that the situation is even worse in Scotland, with enough alcohol being sold for every drinker to consume 24 units a week. The data was released by NHS Health Scotland, who also looked at consumption in England and Wales in order to compare patterns across the UK. In 2016 10.5 litres of pure alcohol were sold per adult in Scotland, equivalent to 20.2 units per person per week!

“As a nation we buy enough alcohol for every person in Scotland to exceed the weekly drinking guideline substantially” Lucie Giles (author of the report)

The annual report from NHS Health Scotland brings together data on alcohol retail sales, price and affordability, self-reported consumption and alcohol-related deaths, hospital admissions and social harms. It found that in 2015 an average of 22 people per week died in Scotland due to an alcohol-related cause, a figure 54 per cent higher than that recorded in England and Wales. In the most deprived areas of Scotland alcohol-related death rates were six times higher than in the wealthiest areas. Rates of alcohol-related hospital stays were also nine times higher.

However, the report said there were some signs that Scots were curtailing their drinking habits, with self-reported data showing that the proportion of tee-totallers has also risen.

“This has harmful consequences for individuals, their family and friends as well as wider society and the economy. The harm that alcohol causes to our health is not distributed equally; the harmful effects are felt most by those living in the most disadvantaged areas in Scotland.” Lucie Giles

To tackle high levels of alcohol-related deaths and illness, Scotland is set to introduce a minimum unit price for alcohol; designed to target cheap, high-% alcohol drinks favoured by vulnerable and harmful drinkers.. The Scottish government passed minimum unit pricing over 5 years ago, though implementation of the measure has so far been delayed due to legal challenges from the alcohol industry. Minimum unit pricing formed part of the Westminster government’s alcohol strategy in 2012, though has yet to be implemented in England and Wales. 

“This report shows that, whilst some progress has been made in tackling alcohol misuse, we need to do more. Over the last few years, more than half of alcohol sold in supermarkets and off-licences was sold at less than 50p per unit, and enough alcohol was sold in the off-trade alone to exceed the weekly drinking guideline by a considerable amount. That is why we need minimum unit pricing, which will largely impact on the off-trade and will increase the price of the cheap, high strength alcohol.”  Public Health Minister Aileen Campbell

Responding to the publication of the figures, Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said: 

“These figures are shocking and show why minimum unit pricing is needed in Scotland, as well as in the rest of the UK. As a result of the legal challenges from the alcohol industry, lives will undoubtedly have been lost in Scotland. We hope and expect minimum unit pricing to be ruled legal in the final court hearing in this case in July, so that implementation in Scotland can follow.

“If minimum unit pricing is ruled legal in Scotland, a decision by Westminster to delay would be a death sentence for some, including many from the lowest income groups. The evidence is already clear – minimum unit pricing saves lives, prevents illness and lowers hospital admissions.”

The NHS Health Scotland figures are available here.

For more information on Minimum Unit Pricing, check out a report from the University of Sheffield’s Alcohol Research Group.

More posts related to this one:
Alcohol-related Hospital Admissions are at a Record High!
“Government has ‘no sense of direction’ in reducing devastating alcohol harm” Lord Brooke
Experts call for action on HIGH STRENGTH CIDER to protect the homeless and the vulnerable.