期刊
JMIR RESEARCH PROTOCOLS
卷 9, 期 8, 页码 -出版社
JMIR PUBLICATIONS, INC
DOI: 10.2196/18690
关键词
mobile health; digital behavior change; engagement; micro-randomized trial; push notifications; excessive alcohol consumption; smartphone app; alcohol; mHealth
资金
- MRC Network of Hubs for Trials Methodology Research [MR/L004933/2R18]
- National Institute for Health Research (NIHR) School for Public Health Research
- Cancer Research UK [CRUK: C1417/A22962]
- National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health [R01AA23187]
- National Institute on Drug Abuse of the National Institutes of Health [P50DA039838]
- National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health [U54EB020404]
- National Cancer Institute of the National Institutes of Health [U01CA229437]
- Health Data Research UK - UK Medical Research Council
- Engineering and Physical Sciences Research Council
- Economic and Social Research Council
- Department of Health and Social Care (England)
- Chief Scientist Office of the Scottish Government Health and Social Care Directorates
- Health and Social Care Research and Development Division (Welsh Government)
- Public Health Agency (Northern Ireland)
- British Heart Foundation
- Wellcome
- NIHR School for Public Health Research
- Society for the Study of Addiction
- Cancer Research UK
- UK Centre for Tobacco and Alcohol Studies (UKCTAS)
- Medical Research Council
- National Institute for Health Research under the UK Clinical Research Collaboration
- National University of Singapore's Institute of Mathematical Sciences
- MRC [MR/L004933/2] Funding Source: UKRI
Background: Drink Less is a behavior change app that aims to help users in the general adult population reduce hazardous and harmful alcohol consumption. The app includes a daily push notification, delivered at 11 am, asking users to Please complete your mood and drinking diaries. Previous analysis of Drink Less engagement data suggests the current notification strongly influences how users engage with the app in the subsequent hour. To exploit a potential increase of vulnerability of excess drinking and opportunity to engage with the app in the evenings, we changed the delivery time from 11 am to 8 pm. We now aim to further optimise the content and sequence of notifications, testing 30 new evidence-informed notifications targeting the user's perceived usefulness of the app. Objective: The primary objective is to assess whether sending a notification at 8 pm increases behavioral engagement (opening the app) in the subsequent hour. Secondary objectives include comparing the effect of the new bank of messages with the standard message and effect moderation over time. We also aim to more generally understand the role notifications have on the overall duration, depth, and frequency of engagement with Drink Less over the first 30 days after download. Methods: This is a protocol for a micro-randomized trial with two additional parallel arms. Inclusion criteria are Drink Less users who (1) consent to participate in the trial; (2) self-report a baseline Alcohol Use Disorders Identification Test score of 8 or above; (3) reside in the United Kingdom; (4) age >= 18 years and; (5) report interest in drinking less alcohol. In the micro-randomized trial, participants will be randomized daily at 8 pm to receive no notification, a notification with text from the new message bank, or the standard message. The primary outcome is the time-varying, binary outcome of Did the user open the app in the hour from 8 pm to 9 pm?. The primary analysis will estimate the marginal relative risk for the notifications using an estimator developed for micro-randomized trials with binary outcomes. Participants randomized to the parallel arms will receive no notifications (Secondary Arm A), or the standard notification delivered daily at 11 am (Secondary Arm B) over 30 days, allowing the comparison of overall engagement between different notification delivery strategies. Results: Approval was granted by the University College of London's Departmental Research Ethics Committee (CEHP/2016/556) on October 11, 2019, and The London School of Hygiene and Tropical Medicine Interventions Research Ethics Committee (17929) on November 27, 2019. Recruitment began on January 2, 2020, and is ongoing. Conclusions: Understanding how push notifications may impact engagement with a behavior change app can lead to further improvements in engagement, and ultimately help users reduce their alcohol consumption. This understanding may also be generalizable to other apps that target a variety of behavior changes.
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