An Online Cognitive Behavioral Therapy and Positive Psychology Informed Resource to Manage Alcohol Use, Stress, and Negative Affect: A Usability and Descriptive Study. (Preprint)

BACKGROUND Research documents that drinking to cope behavior can be disrupted by enhancing emotion regulation and coping skills related to the experience of stress and negative affect. The Alpha Element protocol incorporates principles of cognitive behavioral therapy and positive psychology to redirect negative thinking and emotions and, therefore, has the potential to benefit individuals who use alcohol to cope with stress. OBJECTIVE This study aimed to evaluate satisfaction and usability of the online Alpha Element homework resource in order to inform the development of an expanded digital platform based on the Alpha Element protocol. METHODS Participants enrolled in the online resource as part of their clinical care were eligible to participate. Twenty individuals (14 women, 6 men) between ages 30-79 completed online questionnaires to assess product performance in areas such as ease of technology use, quality of videos and handouts, and the value of the activities. Participants also completed the System Usability Scale (SUS) and background and demographic information, including alcohol use. RESULTS Only one participant reported no alcohol use in the past year; 55% (n=11) of participants drank alcohol 2-4 times/month or less and 45% (n=9) reported drinking alcohol 2-3 times/week or more. The average SUS score of 76.38 (SD=17.85) is well above the commonly accepted threshold of 68, indicating high system usability. A majority of the sample (n=16;84%%) agreed or strongly agreed that the activities in the program inspired behavioral changes; and most agreed or strongly agreed that the program was engaging (n=16; 80%), well-organized (n=18;90%), and easy to follow (n=17;85%). Only two participants endorsed experiencing difficulty using the program on a smartphone. Over half of participants (n=13;65%) found email and text reminders beneficial. Suggestions for program improvements included expanding the platform, updating the web format, adding user interactivity, building a smartphone app, and enhancing navigation. CONCLUSIONS These data suggest that participants were generally satisfied with the online Alpha Element Homework Resource, and rated usability of the program as favorable. Importantly, a significant portion of participants reported that the program inspired behavioral changes. More research is needed with a larger sample to obtain specific data about alcohol consumption and investigate associations between alcohol use and program components, as well as examine gender differences. Data collected from this study will be used to expand the platform and improve user experience.