Funding agency: The International Development Challenge Fund
Duration: 12 Months (21st January 2019 – 20th January 2020)
Principal Investigator: Prof. Aldo Badiani
Co-Investigator(s): Daniel Michelson; Richard De Visser, Abhijit Nadkarni
India is experiencing a remarkable period of rapid economic development and has become a major target of market expansion by producers of alcoholic beverages, leading to a steady increase in alcohol availability/consumption and alcohol use disorders (AUDs).
EMA (Ecological Momentary Assessment ) and EMI (Ecological Momentary Interventions ) applications allow for real-time, natural setting data collection. This will allow more reliable data in the monitoring of dynamic fluctuations in alcohol use. Such information can help to understand context of use and inform data-driven treatment decisions. This approach has significant scope in low-and-middle-income countries (LMICs), as smartphone applications are used extensively by young people and provide a novel way of delivering interventions to reduce hazardous drinking in young people.
Our project plans to collaborate with commercial developers to customize apps in order to suit both more stringent theoretical frameworks and the specific characteristics of the target population.
Our study will be unique in applying a structured methodology to adapt and evaluate such apps in India.
(1) Use a systematic methodology to adapt an existing EMA and EMI app to make it contextually suitable for the setting; and
(2) Examine, in the context of a LMIC, the feasibility of using an EMA and EMI app, and its acceptability to hazardous drinkers.
Study setting: This study will take place in Goa, India, which is a small state on the west coast of India. Goa has a population of about 1.4 million people, 62% of which live in urban areas. Alcoholic drinks are easily available at cheaper rates than neighbouring states, due to lower excise duties. Goa has a liberal, ‘wet’ culture towards drinking, reflected in low abstinence rates compared to most parts of India. Participants will be identified and recruited through screening in colleges in North Goa.
Design: The project will follow a sequential process with the steps having a feedback loop that allows iterative refinement of the intervention based on emergent findings. The first step of the process will be in the form of qualitative research with stakeholders, including in-depth interviews.
The data from this step will be used to refine the intervention content and delivery. The second stage of the study will be the adaptation of the apps. The third step will be the treatment cohort with before and after design and nested qualitative study. IDIs will be conducted with treatment completers and dropouts to further understand the acceptability, feasibility and perceived impact of the BI and the delivery method.
Research impact: This project will pave the way for the development of a contextually appropriate technology-delivered intervention for AUDs.
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