Symposia
Addictive Behaviors
Nehal P. Vadhan, Ph.D. (he/him/his)
Northwell Health Zucker Hillside Hospital
Glen Oaks, New York
Nick Allen, B.A. (he/him/his)
CEO and co-founder
Cutback Coach, Inc.
San Francisco, California
Hayley Treloar Padovano, Ph.D. (she/her/hers)
Assistant Professor
Alpert Medical School of Brown University
Providence, Rhode Island
Purpose: Publicly available, technology-supported resources offer accessible, flexible tools to reach the vast majority of drinkers who do not seek alcohol treatment but instead attempt self-moderation, or do not attempt behavior change. This analysis characterizes changes in alcohol use patterns among individuals desiring moderation (n = 46,411) who self-selected to use Sunnyside® (formerly Cutback Coach), a privately developed smartphone application.
Methods: Current drinking, reasons for change, and moderation goals, as well as optional demographic information, were assessed at baseline. Sunnyside members received a weekly algorithmically-generated daily drink plan that considered baseline habits, individual user goals, and reported progress. Via text message, they received daily plan and tracking reminders, and optional peer coaching, and tracked their drinks.
Data: The first 12 weeks of tracking where tracking targets were set and at least one day was tracked were evaluated (n=261,144; 80.7%). Generalized mixed-effect growth models characterized change in counts of drinks consumed and daily drinking (binary) within participants, aggregated by week.
Results: During upfront onboarding, the majority or near-majority of members reported daily drinking (64.3%) and a primary goal of improving overall health and wellness (47.8%). Other frequently endorsed goals included weight loss, hangover/blackout avoidance, improved sleep/energy, and reduced reliance on alcohol in social situations. Of those who reported gender and age (ns=4,410, 32,350), most were cisgender female (81%) and aged 31-65 (89.2%). Drinking changes were curvilinear and varied across participants. Overall, drinks per week decreased 32.9% (b=−0.55, SE=.010, IRR=0.58, p < .001), with decreases decelerating over time (b=0.15, SE=.011, IRR=1.16, p< .001). Notably, the average predicted probability of daily drinking was consistently below .65 across all weeks for users who previously reported daily drinking. More severe alcohol-use patterns and concern over drinking at baseline were associated with greater relative benefit.
Conclusions: Excessive drinking patterns appeared to reduce during 12 weeks of daily drink tracking with Sunnyside®, a non-abstinence, harm-reduction-focused, app-assisted platform. Overall, findings of this naturalistic study, one of the first of its kind, supplement data from randomized clinical trials and support the use of adaptive, technology-assisted tools for alcohol moderation.