"Information about Drinking for Ex-serving personnel (InDEx)" - Development of a personalised alcohol app

It is well known that alcohol problems are more common in the military than in the rest of the population. Levels of alcohol consumption and binge drinking (drinking lots of alcohol in a short space of time) are almost twice as high. Whilst this difference could be explained by the peer pressure of being in a military unit, with others who are drinking heavily, it is surprising that levels of drinking do not seem to decrease when someone leaves the Armed Forces. Previous research has shown that people who drink heavily (both in the military and the general population) do not seem to recognise that they have a problem, so they are unlikely to change their drinking without any prompts. There may be a benefit in providing a treatment (also known as an intervention) to people when they are leaving the military, to help them to reduce their drinking, at a time when the peer pressure of military life may lessen. There is limited evidence on what interventions or treatments might be suitable for ex-serving personnel who need to lower their drinking, but who are not dependent on alcohol. Existing research has shown that electronic interventions (such as computer or mobile phone applications), which aim to help someone lower the amount they drink, can be helpful. These treatments, which have been developed for the general population, may also be suitable for people from the military. But it is likely that some changes will need to be made.
The aim of this research is to develop an electronic intervention, which can be delivered through a mobile phone, to help people leaving the Armed Forces to lower their alcohol consumption and to drink less in a single session. There isn't a lot of research in this area so an early study would be helpful before testing the intervention on a larger scale. There are a number of questions we want to answer in this early study; these are: 1) to look at the reasons why people who are currently in, or leaving, the Armed Forces drink heavily; 2) to use this information to design a mobile phone application that is relevant and meaningful to the ex-serving military population, and so should help them to reduce their drinking, and 3) to test if this intervention is acceptable to a small number of ex-serving personnel and to find out how they think that it could be improved. Once these questions have been answered then it should be possible to test the intervention with a larger number of people.
The benefits of this research are that it can help us understand why people in the Armed Forces drink heavily and why they don't lower their drinking when they leave. This information will be relevant to a number of organisations, such as health services and veterans' charities. It will also help us to develop a treatment that is more likely to be successful, because it will be more relevant to these individuals. There are lots of possible benefits to reducing the amount ex-service people drink; it can help to lower the risk of many conditions such as liver disease and cancer, it can improve how productive people are in their daily lives and can lower the number of times people visit their doctor with alcohol related injuries and illness. As well as benefitting the individuals, these changes could also save money for employers and public services.

Hazardous alcohol use remains high among Service personnel even after they have left service, more than twice as high as in the general population. Binge drinking is also very common, with established negative health consequences. Yet there is poor recognition of this misuse within personnel, little understanding of the motivations and beliefs leading to heavy alcohol use and a lack of tailored alcohol interventions, with none tested in the UK. The effectiveness of electronic brief alcohol interventions has been evidenced in the general population, with effects maintained up to 12 months. The aims for this research are to study the effectiveness of a tailored electronic alcohol app 'Information about Drinking for Ex-serving personnel' (InDEx) to reduce the frequency of binge drinking in ex-serving personnel who meet criteria for hazardous use. The aims for the early phase study are to 1) to identify what are the motivations for drinking in a military population, how they may differ in ex-serving personnel, and associations with drinking patterns; 2) develop a tailored brief alcohol mobile phone app for ex-serving personnel and 3) to examine the acceptability and usability of this alcohol app in a small number of ex-serving personnel. This research is novel because there is no UK data on motivations for drinking in ex-serving personnel, which is required to develop relevant health messages. The InDEx app also focuses on patterns of alcohol use and the social context of drinking, which differs to existing apps that focus on consumption. InDEx will be a tailored intervention that uses personalised information to target the motivational drivers of binge drinking and hazardous use. This early phase work will lead into a larger randomised trial through the platform for the InDEx app, quantitative data on adherence and usage, qualitative data on acceptability and usability, and information on the feasibility of recruitment in Defence Dental Services.