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Do Daily Fluctuations in Psychological and App-Related Variables Predict Engagement With an Alcohol Reduction App? A Series of N-Of-1 Studies

Perski, O; Naughton, F; Garnett, C; Blandford, A; Beard, E; West, R; Michie, S; (2019) Do Daily Fluctuations in Psychological and App-Related Variables Predict Engagement With an Alcohol Reduction App? A Series of N-Of-1 Studies. JMIR Mhealth Uhealth , 7 (10) , Article e14098. 10.2196/14098. Green open access

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Abstract

BACKGROUND: Previous studies have identified psychological and smartphone app-related predictors of engagement with alcohol reduction apps at a group level. However, strategies to promote engagement need to be effective at the individual level. Evidence as to whether group-level predictors of engagement are also predictive for individuals is lacking. OBJECTIVE: The aim of this study was to examine whether daily fluctuations in (1) the receipt of a reminder, (2) motivation to reduce alcohol, (3) perceived usefulness of the app, (4) alcohol consumption, and (5) perceived lack of time predicted within-person variability in the frequency and amount of engagement with an alcohol reduction app. METHODS: We conducted a series of observational N-of-1 studies. The predictor variables were measured twice daily for 28 days via ecological momentary assessments. The outcome variables were measured through automated recordings of the participants' app screen views. A total of nine London-based adults who drank alcohol excessively and were willing to set a reduction goal took part. Each participant's dataset was analyzed separately using generalized additive mixed models to derive incidence rate ratios (IRRs) for the within-person associations of the predictor and outcome variables. Debriefing interviews, analyzed using thematic analysis, were used to contextualize the findings. RESULTS: Predictors of the frequency and amount of engagement differed between individuals, and for the variables 'perceived usefulness of the app' and 'perceived lack of time', the direction of associations also differed between individuals. The most consistent predictors of within-person variability in the frequency of engagement were the receipt of a daily reminder (IRR=1.80-3.88; P<.05) and perceived usefulness of the app (IRR=0.82-1.42; P<.05). The most consistent predictors of within-person variability in the amount of engagement were motivation to reduce alcohol (IRR=1.67-3.45; P<.05) and perceived usefulness of the app (IRR=0.52-137.32; P<.05). CONCLUSIONS: The utility of the selected psychological and app-related variables in predicting the frequency and amount of engagement with an alcohol reduction app differed at the individual level. This highlights that key within-person associations may be masked in group-level designs and suggests that different strategies to promote engagement may be required for different individuals.

Type: Article
Title: Do Daily Fluctuations in Psychological and App-Related Variables Predict Engagement With an Alcohol Reduction App? A Series of N-Of-1 Studies
Location: Canada
Open access status: An open access version is available from UCL Discovery
DOI: 10.2196/14098
Publisher version: https://doi.org/10.2196/14098
Language: English
Additional information: ©Olga Perski, Felix Naughton, Claire Garnett, Ann Blandford, Emma Beard, Robert West, Susan Michie. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 02.10.2019 This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.
Keywords: Apps, behavior change, engagement, excessive alcohol consumption, mHealth, n-of-1, time series analysis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science
URI: https://discovery.ucl.ac.uk/id/eprint/10083079
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