Title: Evaluating the effectiveness of the alcohol reduction smartphone app, Drink Less, compared with the NHS alcohol advice webpage, for the reduction of alcohol consumption among hazardous and harmful drinkers in the UK at six-month follow-up: a randomised controlled trial

Funding body: National Institute for Health Research (Public Health Research panel)

Funding Awarded: £1,002,756

Investigators: Dr Claire Garnett (UCL), Dr Elena Pizzo (Imperial), Dr Emma Beard (UCL), Dr Felix Greaves (Imperial), Dr Jamie Brown (UCL), Dr Robyn Burton (Kings), Mr Colin Angus (Sheffield), Professor Eileen Kaner (Newcatle), Professor Marcus Munafo (Bristol), Professor Matt Field (Sheffield), Professor Matthew Hickman (Bristol), Professor Susan Michie (UCL).

Project summary
Plain English summary: This research aims to evaluate whether recommending the improved version of Drink Less is effective and cost-effective for helping hazardous and harmful drinkers to reduce their alcohol consumption. Hazardous and harmful alcohol consumption is a leading cause of avoidable deaths, ill-health, disability, and cancer in the UK. Health practitioners can help people to cut down by regularly asking about drinking and offering advice. Unfortunately, less than 1 in 10 hazardous and harmful drinkers in England receive this help due to barriers such as lack of time. Using digital technology, such as smartphone apps, provides support that can overcome these barriers and has the added advantages of being widely accessible and available. Health inequalities are a particular concern with regards to alcohol consumption as the most deprived groups in society suffer the most alcohol-related harm. Digital interventions have the potential to reduce health inequalities and help disadvantaged groups when designed with input from these user groups. A recent review of apps to help people reduce their drinking available on UK App Stores showed that none were based on scientific evidence or theory. The app, Drink Less, was developed to help people reduce their alcohol consumption using a systematic and iterative process drawing on evidence and theory to inform its content. The app consists of multiple modules with users being prompted to track their drinks and set goals, provided with feedback on their goals and how their drinking compares with others in the UK, as well as information on the UK drinking guidelines and links for additional support. Drink Less, available on the UK App Store since 2016, has accumulated over 50,000 users. Its evaluation in a preliminary trial assessed the effectiveness of individual modules, allowing us to understand which modules were helping users to reduce their alcohol consumption. Based on these findings and user feedback, the app has been updated and improved. A randomised controlled trial will be conducted in which participants will be randomly recommended either the improved version of the Drink Less app or the NHS webpage with alcohol advice. The trial will be conducted online with adults (aged 18+) in the UK who consume hazardous or harmful levels of alcohol. Participants will be followed-up via email with a survey on their drinking behaviour using validated measures at one, three and six months. The study findings will indicate whether investment in promoting the app is warranted. Patient and public involvement (PPI) has informed the research plans and will continue throughout this project including: preparing recruitment adverts, information and consent forms; providing feedback on using Drink Less; analysing and interpreting findings, and dissemination. The research outcomes will be disseminated through: links with Public Health England; press releases; conferences; publications in peer-reviewed journals; blog posts co-written with a PPI member on relevant organisations websites (e.g. Cancer Research UK, Society for Study of Addiction, Alcohol Change UK), and through the Alcohol Discussion Group in Stirling. A workshop will be hosted in central London on completion of the trial to engage with stakeholders.