Brief report: Aging adult utilization of an mHealth intervention for problem drinking.

Alcohol consumption among aging adults is a growing concern due to its potential to exacerbate age-related health conditions. Developing accessible interventions for this demographic is imperative. Mobile health (mHealth) interventions offer a promising avenue, but their effectiveness and engagement among aging adults remain uncertain.

Engagement with mHealth Alcohol Interventions: User Perspectives on an App or Chatbot-Delivered Program to Reduce Drinking.

Research suggests participant engagement is a key mediator of mHealth alcohol interventions' effectiveness in reducing alcohol consumption among users. Understanding the features that promote engagement is critical to maximizing the effectiveness of mHealth-delivered alcohol interventions. The purpose of this study was to identify facilitators and barriers to mHealth alcohol intervention utilization among hazardous-drinking participants who were randomized to use either an app (Step Away) or Artificial Intelligence (AI) chatbot-based intervention for reducing drinking (the Step Away chatbot).

Stand Down-Think Before You Drink: protocol for an effectiveness-implementation trial of a mobile application for unhealthy alcohol use with and without peer support.

Introduction: Mobile apps can increase access to alcohol-related care but only if patients actively engage with them. Peers have shown promise for facilitating patients' engagement with mobile apps. However, the effectiveness of peer-based mobile health interventions for unhealthy alcohol use has yet to be evaluated in a randomised controlled trial.

U.S. veterans' experiences and factors associated with use of a smartphone application to self-manage unhealthy alcohol use.

Unhealthy alcohol use is common among Operations Enduring and Iraqi Freedom (OEF/OIF) veterans, yet barriers discourage treatment-seeking. Mobile applications (apps) that deliver alcohol interventions have potential to address these barriers and increase treatment receipt. Few studies have qualitatively assessed users' experiences with apps to manage alcohol use.

Contrasting a Mobile App With a Conversational Chatbot for Reducing Alcohol Consumption: Randomized Controlled Pilot Trial.

Background: Mobile apps have shown considerable promise for reducing alcohol consumption among problem drinkers, but like many mobile health apps, they frequently report low utilization, which is an important limitation, as research suggests that effectiveness is related to higher utilization. Interactive chatbots have the ability to provide a conversational interface with users and may be more engaging and result in higher utilization and effectiveness, but there is limited research into this possibility.

Objective: This study aimed to develop a chatbot alcohol intervention based on an empirically supported app (Step Away) for reducing drinking and to conduct a pilot trial of the 2 interventions.

Usability and Acceptability of a Mobile App for the Self-Management of Alcohol Misuse Among Veterans (Step Away): Pilot Cohort Study.

Background: Alcohol misuse is common among Operation Enduring Freedom and Operation Iraqi Freedom veterans, yet barriers limit treatment participation. Mobile apps hold promise as means to deliver alcohol interventions to veterans who prefer to remain anonymous, have little time for conventional treatments, or live too far away to attend treatment in person.

Objective: This pilot study evaluated the usability and acceptability of Step Away, a mobile app designed to reduce alcohol-related risks, and explored pre-post changes on alcohol use, psychological distress, and quality of life.

Using peers to increase veterans' engagement in a smartphone application for unhealthy alcohol use: A pilot study of acceptability and utility.

Mobile apps can only increase access to alcohol treatment if patients actively engage with them. Peers may be able to facilitate such engagement by providing supportive accountability and instruction and encouragement for app use. We developed a protocol for peers to support engagement in the Stand Down app for unhealthy alcohol use in veterans and tested the acceptability and utility of the protocol.

From "Step Away" to "Stand Down": Tailoring a Smartphone App for Self-Management of Hazardous Drinking for Veterans.

Background: US military veterans who screen positive for hazardous drinking during primary care visits may benefit from a mobile app. Step Away is an evidence-based mobile intervention system for the self-management of hazardous drinking. However, Step Away was not designed for veterans, and differences between veterans and civilians could limit the reach and effectiveness of the app with this population.

Customizing a clinical app to reduce hazardous drinking among veterans in primary care.

Within the Veterans Health Administration (VHA), 15-30% of patients seen in primary care are identified as hazardous drinkers, yet the vast majority of these patients receive no intervention. Time constraints on providers and patient-level barriers to in-person treatment contribute to this problem. The scientific literature provides a compelling case that mobile-based interventions can reduce hazardous drinking and underscores the role of peer support in behavioral change.

Comparisons of Alcohol Consumption by Time-Line Follow Back vs. Smartphone-Based Daily Interviews.

This study compared alcohol consumption data collected through daily interviews on a smartphone with data collected via the Timeline Follow-Back (TLFB) during a 6-week pilot study of a smartphone-based alcohol intervention system. The focus of the study was to assess for discrepancies between the two measurement methodologies on commonly utilized alcohol outcome variables. Twenty-five participants between 22 and 45 years of age and were drinking heavily at study incipience completed a 6-week alcohol intervention delivered by a smartphone application that monitored drinking through a daily interview.

Smartphone-based, momentary intervention for alcohol cravings amongst individuals with an alcohol use disorder.

Smartphone-based alcohol interventions represent an innovative strategy for providing in-the-moment intervention to individuals with an alcohol use disorder. While early research into their overall effectiveness is promising, little is known about the efficacy of specific intervention tools in reducing drinking subsequent to a cued craving. This study examined the influence of smartphone-delivered in-the-moment coping strategies on drinking after experiencing a craving among participants utilizing the Location-Based Monitoring and Intervention for Alcohol Use Disorders (LBMI-A).

The "Health Benefits" of Moderate Drinking in Older Adults may be Better Explained by Socioeconomic Status.

Objectives: To assess whether a relationship between alcohol use and health exists for older adults before and after controlling for proxy and full indicators of socioeconomic status (SES).

Method: Secondary analysis of data from 2,908 participants in the New Zealand Longitudinal Study of Ageing (2012) completing measures of alcohol use, health, SES proxies (income, education) and SES. Sample mean age was 65, 52% were female, more than 80% were drinkers, and more than 75% had educational qualifications.

Comparison of a smartphone app for alcohol use disorders with an Internet-based intervention plus bibliotherapy: A pilot study.

Objective: To date, no research has evaluated the efficacy of a stand-alone, smartphone-based intervention for individuals with an alcohol use disorder. The current pilot study evaluated the short-term outcomes of a smartphone-based intervention for alcohol use disorders compared with an Internet-based brief motivational intervention plus bibliotherapy.

Method: Adults (18 to 45 years old) with an alcohol use disorder received either the Location-Based Monitoring and Intervention for Alcohol Use Disorders (LBMI-A; n = 28), a smartphone-based intervention, or the online Drinker's Check-up plus bibliotherapy (DCU + bib; n = 26).

Examining perceptions of a smartphone-based intervention system for alcohol use disorders.

Background: This study presents results from qualitative interviews conducted with participants in a study on the effectiveness of the Location-Based Monitoring and Intervention System for Alcohol Use Disorders (LBMI-A), a smartphone-based, stand-alone intervention application (app) for adults with alcohol use disorders.

Materials And Methods: Participants were provided an LBMI-A-enabled smartphone to use during a 6-week pilot study. The LBMI-A was composed of psychoeducational modules, assessment and feedback of alcohol use patterns, geographic high-risk location monitoring and alerts, and in vivo assessment and intervention for alcohol cravings and help with managing psychological distress.

Results of a pilot test of a self-administered smartphone-based treatment system for alcohol use disorders: usability and early outcomes.

Background: This paper provides results from a pilot study focused on assessing early-stage effectiveness and usability of a smartphone-based intervention system that provides a stand-alone, self-administered intervention option, the Location-Based Monitoring and Intervention for Alcohol Use Disorders (LBMI-A). The LBMI-A provided numerous features for intervening with ongoing drinking, craving, connection with supportive others, managing life problems, high-risk location alerting, and activity scheduling.

Methods: Twenty-eight participants, ranging in age from 22 to 45, who met criteria for an alcohol use disorder used an LBMI-A-enabled smartphone for 6 weeks.

Smartphone-Based, Self-Administered Intervention System for Alcohol Use Disorders: Theory and Empirical Evidence Basis.

Advances in mobile technology provide an opportunity to deliver in-the-moment interventions to individuals with alcohol use disorders, yet availability of effective "apps" that deliver evidence-based interventions is scarce. We developed an immediately available, portable, smartphone-based intervention system whose purpose is to provide stand-alone, self-administered assessment and intervention. In this paper, we describe how theory and empirical evidence, combined with smartphone functionality contributed to the construction of a user-friendly, engaging alcohol intervention.

Perceived control as a longitudinal moderator of late-life stressors on depressive symptoms.

Objectives: This study examined perceived control as a moderator of the relationship between late-life stressors and depressive symptoms among a sample of older New Zealanders.

Method: Data were drawn from a longitudinal study with two data collection periods, one year apart. The Time 1 sample consisted of 1489 participants ranging in age from 65 to 94 years and 72% percent participated at Time 2.

Volunteering predicts happiness among older Māori and non-Māori in the New Zealand health, work, and retirement longitudinal study.

Objectives: This study sought to understand the relationship between volunteer activity and happiness among a sample of older adult New Zealanders. It specifically sought to determine if ethnicity (Māori vs. non-Māori) and economic living standards (ELS) functioned as moderators of the relationship between volunteering and happiness.

Estimating older hazardous and binge drinking prevalence using AUDIT-C and AUDIT-3 thresholds specific to older adults.

Background: This study aimed to provide hazardous and binge drinking prevalence, odds and risk attributable to specific demographic correlates in community dwelling older adults using both the standard and new older-specific AUDIT-C thresholds.

Methods: Hazardous drinking was assessed using the AUDIT-C in a cross-sectional postal survey of 6662 New Zealanders aged 55-70 years old (m=60.94, SD=4.

Avoidance of potentially traumatic stimuli mediates the relationship between accumulated lifetime trauma and late-life depression and anxiety.

This study examined the influence of lifetime accumulated trauma on late-life mental health in a sample of 1,216 older adults, 65-94 years old, residing in New Zealand. Multiple regression analyses indicated that accumulated trauma predicted both depression and anxiety in this sample. The hypothesis that avoidance of memories and situations surrounding prior trauma mediates relationships between cumulative trauma and depression and anxiety was supported.