The Digital–Alcohol Risk Alertness Notifying Network for Adolescents and Young Adults Project (D-ARIANNA): Risk estimation model and impact of a mobile eHealth Intervention on Binge Drinking in Young People

Background. The Digital–Alcohol Risk Alertness Notifying Network for Adolescents and Young Adults Project (D-ARIANNA) addresses a topic of growing interest in the field of substance abuse among adolescents and young adults, i.e., risk estimation models for binge drinking (BD) using eHealth apps. According to relevant research, this study novelty value may bring an important contribution to the substance abuse community. BD is common among young people, but often risk is not recognized. eHealth apps, attractive for young people, may be useful to enhance awareness of this problem. We aimed to develop a risk estimation model for BD, incorporated into an eHealth app, D-ARIANNA, for young people. Methods. A longitudinal approach with phase 1 (risk estimation), phase 2 (design), phase 3 (feasibility study) was followed. Ten risk and two protective factors identified from the literature were used to develop a current risk estimation model for BD. Relevant odds ratios were pooled through meta-analytic techniques, deriving weighted estimates to be introduced in a final model. The model, nested in an eHealth app interview, provided in percent an overall risk score, accompanied by appropriate images and a summary message with factors that mostly contributed. The D-ARIANNA questionnaire, matching identified risk factors, was assessed for wording, content and acceptability. Feasibility study was a quasi-experimental, pre-/post-test study. Subjects were recruited in pubs, discos, or live music events in Milan urban locations. They were requested to self-administer D-ARIANNA and were re-evaluated after 2 further weeks. Feasibility Study Results. Young (18–24 years) people (N = 590) reported reduced two-week BD (18% vs. 37% at baseline). Most of subjects considered D-ARIANNA helpful. To exclude systematic errors involving those lost at follow-up (14%), the diminution in BD was also evaluated through an appropriate generalized estimating equation model. Conclusions. D-ARIANNA is the first evidence-based eHealth app for BD in young people, cited in the European Monitoring Centre for Drugs and Drug Addiction (http://www.emcdda.europa.eu/html.cfm/index98829EN.html) and the NHS health apps libraries (http://apps.nhs.uk/apps/alcohol/). Although a more advanced study is pending by through of an adequately powered trial, the promising results point to the potential of a smartphone tool for preventing relapse in BD and its application in real word practice, thus enabling further studies. D-ARIANNA, focused on personal communication and BD risk awareness, influences responsible drinking, and could be tested in an environmental-based community intervention.