Engagement features judged by excessive drinkers as most important to include in smartphone applications for alcohol reduction: A mixed-methods study

Objective: Engagement with smartphone applications (apps) for alcohol reduction is necessary for their effectiveness. This study explored (1) the features that are ranked as most important for engagement by excessive drinkers and (2) why particular features are judged to be more important for engagement than others. Methods: Two studies were conducted in parallel. The first was a focus group study with adult excessive drinkers, interested in reducing alcohol consumption using an app (n(groups)=3). Participants individually ranked their top 10 features from a pre-specified list and subsequently discussed their rankings. The second was an online study with a new sample (n=132). Rankings were analysed using the intraclass correlation coefficient (ICC) to assess the level of agreement between raters for each study. Qualitative data were analysed using inductive thematic analysis. Results: There was low agreement between participants in their rankings, both in the focus groups (ICC=0.15, 95% confidence interval (CI)=0.03-0.38) and the online sample (ICC=0.11, 95% CI=0.06-0.23). 'Personalisation', 'control features' and interactive features' were most highly ranked in the focus groups. These were expected to elicit a sense of benefit and usefulness, adaptability, provide motivational support or spark users' interest. Results from the online study partly corroborated these findings. Conclusion: There was little agreement between participants, but on average, the features judged to be most important for inclusion in smartphone apps for alcohol reduction were personalisation, interactive features and control features. Tailoring on users' underlying psychological needs may promote engagement with alcohol reduction apps