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Personalized prevention tools such as mobile apps designed to reduce alcohol consumption are widespread in mobile app stores accessible in Russia. However, the quality and content of these mobile apps have not been systematically evaluated.
This study aimed to identify Russian-language mobile apps for reducing alcohol use and to evaluate their quality and potential to change alcohol-related health behavior. It further aimed to identify apps that could facilitate screening and brief interventions in primary health care in Russia.
A systematic search for mobile apps available in Russia was carried out between April 1 and 15, 2020, December 1 and 15, 2020, and in March 2021 in the iPhone App Store, Google Play Store, and the 4PDA forum. App quality was assessed using the Mobile App Rating Scale (MARS), and structured searches in electronic libraries and bibliographic databases were used to evaluate the apps’ evidence base. The number of features facilitating changes in lifestyle behavior was assessed using the App Behavior Change Scale (ABACUS).
We identified 63 mobile apps for reducing alcohol use. The mean MARS quality ratings were high for the subscales of functionality (3.92 out of 5, SD 0.58) and aesthetics (2.96, SD 0.76) and low for engagement (2.42, SD 0.76) and information (1.65, SD 0.60). Additional searches in electronic libraries and bibliographic databases (eLibrary, CyberLeninka, Google Scholar) yielded no studies involving the identified apps. ABACUS scores ranged from 1 to 15 out of 25, with a mean of 5 (SD 3.24). Two of the identified apps might be useful for screening and brief interventions in Russian primary health care after improvements in content and scientific testing.
Russian-language mobile apps for reducing alcohol use are accessible in the app stores. Many of them are aesthetically pleasing, functional, and easy to use. However, information about their scientific trialing or testing is lacking. Most apps contain a low number of features that facilitate changes in lifestyle behavior. Further research should examine the context of Russian-language mobile apps for reducing alcohol use. Our findings underline the need to develop evidence-based apps to mitigate alcohol consumption in Russia and elsewhere.
PROSPERO International Prospective Register of Systematic Reviews CRD42020167458; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=167458
Alcohol is one of the leading risk factors contributing to the global burden of disease and mortality [
There is a large body of research supporting the effectiveness of SBI in reducing alcohol consumption and other alcohol-related outcomes [
The development of electronic systems to deliver or support SBIs can potentially address some of these challenges and support health care workers. For instance, electronic devices such as smartphones and tablets can be used instead of the traditional paper-and-pencil screening tests and facilitate counting standard drinks as part of the risk assessment and support the delivery of brief interventions. Moreover, electronic SBIs are also potentially more flexible and can be adapted to take into account the regional patterns of alcohol consumption and make the assessment more personalized. They can also potentially reach larger audiences beyond the health sector [
The growing popularity of mobile phones and the active development of mobile internet in all regions of Russia open up great opportunities for using mobile apps as tools to change individual health behavior [
The aim of this study was to conduct a systematic search and evaluation of Russian-language mobile apps for reducing alcohol use. The specific objectives were to (1) create an overview and establish a list of relevant apps available in Russia, (2) assess their overall quality and evidence base, and (3) evaluate if any of the available apps could be used to support the provision of AUDIT-based SBI in Russia and its broader implementation in PHC facilities.
The study was performed in 2 steps. In step 1, we conducted a systematic app store search to identify the apps for reducing alcohol use, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [
We defined mobile apps for reducing alcohol use as tools for tablets or smartphones that facilitate behavioral change related to alcohol use. We excluded apps that were clearly not aimed at the reduction of alcohol use, such as games, barcode scanners as part of the Unified State Automated Information System (EGAIS) tracking alcohol distribution and sales under the Russian Federal Service for Alcohol Market Regulation [
Six systematic searches in the iPhone App Store, Google Play Store, and a Russian internet forum of mobile apps, that is, 4PDA [
In the first step, we recorded the name, app icon, developer, store, platform, brief description, and URL of all the available alcohol-related mobile apps. Next, duplicates were removed, and app store descriptions were screened against inclusion criteria. We retained only 1 record if identical versions of an app were available for Android and iPhone operating systems (iOSs). All remaining apps were downloaded onto the study devices (Samsung Galaxy Tab A 7.0 SM-T285 8GB/Android version 9, Lenovo Tablet TB-X704L 64G/Android version 7, and iPhone 11/iOS version 14.0.1). Apps that could not be opened on these devices were excluded.
The following information was extracted for all the included apps: app name, the app’s star rating on the platform, number of installations, developer, current version, number of ratings for current version, last update, existence of a basic version and paid premium versions, and platform. All included apps were available and all data were updated in the last week of March 2021.
We used 2 scales to rate the identified mobile apps. The MARS scale, assessing the quality of the mobile apps, contains 23 items across 5 subscales: engagement, functionality, aesthetics, information, and subjective quality [
A full evaluation of all the included apps was carried out by a first rater. A second rater independently evaluated a random sample of 30% (19/63) of the apps. Both raters were prepared for their task by completing a MARS video training tutorial [
If the mobile app requested the input of demographic characteristics or consumption data, the following data were used: female gender, 30 years of age, body weight of 60 kg, height of 170 cm, and alcohol consumption on the last occasion as 200 ml of 40% vodka. If required, the maximum legal blood alcohol content was set to 0.3 ppm.
The identified apps were classified according to their main features. For this purpose, the following data were extracted: the app’s ability to estimate blood alcohol concentration and sobering time, its ability to record personal alcohol consumption, the presence of SBI elements, the presence of a “sobriety counter” to count the time since the last drinking occasion, and the app’s ability to support the reduction of alcohol use in a structured way. To investigate the potential of the available apps for supporting the provision of SBI in Russia, app descriptions and main features were reviewed against 2 criteria: (1) availability of AUDIT (2) whether the app provided any type of brief intervention.
Statistical analysis and data visualization were carried out in Excel (Microsoft Excel for Office 365) and SPSS Statistics 20 (IBM Corp). Measures of interrater reliability were obtained by calculating the ICCs for all MARS and ABACUS subscales [
A total of 620 alcohol-related apps were identified through keyword searches in the iOS App Store, Google Play Store, and 4PDA (
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow chart of app selection.
The included apps were grouped into 6 categories according to their main feature: apps estimating blood alcohol concentration and sobering time (n=29), apps recording personal alcohol consumption (n=15), apps for SBIs (n=2), apps counting the time since the last drinking occasion (sobriety counters, n=8), apps with structured support to reduce alcohol use (n=4), and other apps for reducing alcohol use (n=5). Most apps were designed for Android systems (n=51); a minority were available for iOS (n=5) or both operation systems (n=7). A total of 19 apps were created by commercial organizations; 1 app was developed by a science center [
The main feature of this group of apps (n=29) was the estimation of the maximum blood alcohol concentration and sobering time. Most apps (n=14) were based on Widmark’s equation [
Apps in this group (n=15) provided detailed drinking diaries (n=4), consumption calendars allowing users to indicate on what days they drunk alcohol (n=9), or both functions combined (n=2), featuring statistics of consumption per day, week, month, year. In some apps (n=4), users could calculate costs related to their alcohol use and see how much money they saved by cutting down their consumption.
We found only 2 Russian-language apps fulfilling our criteria to potentially facilitate SBI. Both apps allowed users to complete the AUDIT. The first app provided detailed instructions for brief interventions aimed at health care professionals and a standard drink calculator allowing users to choose consumed alcoholic drinks and calculate the number of standard drinks consumed. The second app provided information on the individual level of risk and alcohol-related harm according to AUDIT results.
We identified 8 apps in this group. Two of them consisted of a simple timer, counting the time since the last drinking occasion. The other 6 apps included additional motivation components such as a progress bar and achievements to be obtained (n=4) or inspiring citations (n=2). Two apps featured a chat where users could share their experiences. One app allowed users to consult with a medical specialist and to observe positive changes connected to alcohol abstinence in the physical appearance of the visualized avatars.
A total of 4 apps featured structured support to help users quit drinking or to reduce their alcohol consumption. Most of these apps provided a plan with daily tasks (n=3), a sobriety counter (n=4), a drinking diary (n=2), and motivation components. Motivation components included a progress bar and achievements to be obtained (n=3), inspiring articles or citations (n=4), daily notifications (n=4), encouraging pictures or videos (n=2), and a visualization of the positive health consequences of alcohol abstinence (n=2). One app had a community chat where users shared their experience of reducing consumption or quitting alcohol. One app provided a blood alcohol concentration calculator. Three apps allowed users to complete the AUDIT (n=2) or the Michigan Alcohol Screening Test (n=1) [
Five apps could not be assigned to any of the aforementioned categories. These included an app for audio hypnosis, an app allowing to record withdrawal symptoms, an app featuring notifications about alcohol-related harm, an app allowing to estimate the dose of consumption needed to relax, to get drunk or to have fun, and an app for counting unplanned alcohol drinking occasions after quitting drinking.
The number of behavior change features provided by each app as reflected in ABACUS scores (
The largest number of behavior change techniques was found in the categories of apps with structured support to reduce alcohol use and apps counting the time since the last drinking occasion (sobriety counters). Out of the 12 apps in these 2 groups, 9 apps featured more than 7 behavior change techniques. Apps estimating blood alcohol concentration and sobering time provided the lowest number of behavior change techniques, with an average ABACUS score of 2.38 (SD 1.37).
Behavioral change features in the apps for reducing alcohol use (N=63).
Behavioral change feature | Apps providing the feature, n (%) | |
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Ability to customize and personalize features | 32 (51) |
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Consistency with national guidelines or created with expertise | 3 (5) |
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Request for baseline information | 54 (86) |
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Instruction on how to perform the behavior | 6 (10) |
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Information about the consequences of continuing or discontinuing behavior | 22 (35) |
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Request for willingness for behavior change | 6 (10) |
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Setting of goals | 7 (11) |
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Ability to review goals, update, and change when necessary | 6 (10) |
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Ability to quickly and easily understand the difference between current action and future goals | 9 (14) |
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Ability to allow the user to easily self-monitor behavior | 36 (57) |
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Ability to share behaviors with others or allow for social comparison | 12 (19) |
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Ability to give the user feedback—either from a person or automatically | 45 (71) |
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Ability to export data from app | 4 (6) |
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Material or social reward or incentive | 7 (11) |
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General encouragement | 12 (19) |
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Reminders or prompts or cues for activity | 13 (21) |
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App encourages positive habit formation | 7 (11) |
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App allows or encourages for practice or rehearsal in addition to daily activities | 1 (2) |
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Opportunity to plan for barriers | 4 (6) |
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Assistance with or suggest restructuring the physical or social environment | 1 (2) |
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Assistance with distraction or avoidance | 3 (5) |
Average score of each Mobile App Rating Scale item in Russian-language apps for reducing alcohol use (N=63). MARS: Mobile App Rating Scale.
Out of the 63 identified mobile apps for reducing alcohol use, 4 apps contained the AUDIT, which is widely used in Russian PHC SBI. However, only 2 apps contained additional SBI elements and thus fulfilled both selection criteria. The 2 apps providing only the AUDIT (“I do not drink!” and “Sober One”) contained obvious errors. The
This study is the first systematic search and evaluation of Russian-language mobile apps for reducing alcohol use in Russia. We identified and assessed 63 eligible apps, 2 of which could potentially be used in SBIs in Russian PHC facilities after improvements in content and scientific testing. The MARS app quality scores of the evaluated apps showed good functionality, aesthetics, and ease of use. However, there is ample room for improvement, especially in the area of scientific support and evidence base; no information on scientific trialing or testing of any of the apps could be obtained. Further, ABACUS scores indicated that most apps provide only few features to facilitate human behavior change, casting doubt on their effectiveness to change alcohol consumption habits. These weaknesses seem to be common not only in Russian-language apps but in comparable apps worldwide. In a recent Australian study using both MARS and ABACUS, English-language apps for reducing alcohol use obtained similar ratings as the apps evaluated in this study [
The analysis of the apps’ main features revealed some specific weaknesses and strong points of different app categories. Apps for calculating blood alcohol concentration and sobering time mostly used the Widmark formula developed in 1932 [
Some international websites such as iMedicalApps offer expert comments and reviews of medical apps to patients and health care professionals [
Searches were carried out in the iOS App Store, Google Play Store, and the 4PDA forum. These stores regularly update their content, meaning that mobile apps may become unavailable over time. Furthermore, search options such as language and region settings affect the selection and order of results, thereby reducing the reproducibility of the searches. App contents were not analyzed in detail nor did we assess the apps’ potential to change human behavior in the long term. This assessment may represent an area for future research.
This study provides a structured overview of the main features, quality, and potential to change the alcohol-related health behavior of Russian-language apps for reducing alcohol use currently available in Russia. This overview can be used as a reference by alcohol consumers and health care professionals alike when choosing an app to facilitate the reduction of alcohol use. Although Russian-language apps for reducing alcohol use were found to be aesthetically pleasing, functional, and easy to use, most apps contained a low number of features that facilitate changes in lifestyle behavior and lacked information about scientific trialing or testing. Only 2 identified apps contained the AUDIT and additional brief intervention elements and could thus potentially be used for SBI in the Russian PHC after rigorous scientific evaluation of their effectiveness. Overall, our findings underline the need to develop evidence-based apps to mitigate alcohol consumption in Russia and elsewhere.
PROSPERO (Prospective Register of Systematic Reviews) protocol.
Russian-language mobile apps for reducing alcohol use.
App Behavior Change Scale
Alcohol Use Disorders Identification Test
Alcohol Use Disorders Identification Test-Consumption
intraclass correlation coefficient
iPhone operating system
Mobile App Rating Scale
primary health care
Prospective Register of Systematic Reviews
screening and brief intervention
World Health Organization
AB, MN, and BG conducted the app search and evaluation. AB and VW wrote the manuscript, and BG, CFB, and MN revised the manuscript.
None declared.