Q&A: App may help college students reduce unhealthy drinking
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Key takeaways:
- The app had a significant impact on the number of standard drinks that college students consumed weekly, binge drinking and more.
- PCPs can recommend the app as a prevention tool to patients.
Access to a smartphone application for 1 year was associated with a reduction in the volume of alcohol that college students consumed, according to researchers.
Unhealthy alcohol use is a leading cause of morbidity and mortality, highlighting the need for public health interventions, Nicolas Bertholet, MD, MSc, an associate professor in the department of psychiatry at Lausanne University Hospital in Switzerland, and colleagues wrote in The BMJ.
Considering the prominence of heavy drinking among students, the researchers conducted a study to evaluate the effectiveness of an alcohol intervention based on a smartphone app among 1,770 students at four universities in Switzerland who were assigned to the intervention group (n = 884) or a control group (n = 886).
Bertholet and colleagues found that the intervention had a significant impact on the number of standard drinks participants consumed each week, the maximum number of drinks consumed on one occasion and heavy drinking days.
Healio spoke with Bertholet to learn more about the app and its clinical implications.
Healio: Will you briefly describe the app and its intended use? How does it work?
Bertholet: Our app provides personalized feedback, more precisely normative feedback (ie, a comparison of the user’s drinking to the drinking of people of the same age/sex), feedback on health risks and calories contained in alcohol. Another important feature is a goal-setting tool. The aim is to allow people to think about their drinking and, possibly, to modify it. We have observed that people who had access to the app decreased their drinking over the 12 months’ duration of the study.
Healio: Why does the app specifically target college students?
Bertholet: Unhealthy alcohol use is a health risk factor, particularly among young adults. Student social life and academic demands can lead to unhealthy behaviors, among them unhealthy alcohol use, and we have some evidence that students tend to drink more alcohol than nonstudents of the same age. Thus, targeting unhealthy alcohol use among students is adequate from a public health point of view. Also, we were able to work with students in designing the app and its content.
Healio: What are the clinical implications of your findings?
Bertholet: Providing access to a smartphone app intervention for unhealthy alcohol use can lead to decreases in drinking and in heavy drinking days. Thus, it is one additional selective prevention tool that can be used to limit the negative impact of unhealthy alcohol use on the population.
Healio: Do you think your findings would translate to a U.S. population?
Bertholet: It is challenging to extrapolate any study results beyond its studied population; nonetheless, interventions providing personalized feedback and goal setting have a good evidence base for internet interventions across multiple countries, including the U.S. Our results indicate that smartphone interventions with similar features can have a significant impact, and that these interventions can be successfully transferred (although with modifications) from an internet-based format to a smartphone format. Testing its impact in other populations will be important to further establish its potential efficacy as a selective prevention intervention.
Healio: What is the take-home message for primary care physicians?
Bertholet: We did not specifically study the impact of this app in a primary care population. Nonetheless, because universal screening and brief interventions are recommended in primary care, electronic screening and brief intervention have the potential to be helpful tools for PCPs who could recommend it to their patients. This could be used as a brief intervention for people with unhealthy use (and more adequately for people without an alcohol use disorder). So, this app and other similar internet interventions/apps are useful when alcohol use is approached as a health risk factor.
This type of tool should not be seen as an alternative for the treatment of alcohol use disorders (for which there are electronic alternatives but that are clearly different from this app). People with an alcohol use disorder are likely to want and require more intensive/personalized care (including pharmacological treatment).