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Exploring Fit in a Mobile Health Intervention for Alcohol Use Disorder: Qualitative Study.

Nora Jacobson^1,2, Linda S Park³, Alice Pulvermacher³

¹Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.

JMIR Mhealth and Uhealth

|October 14, 2025

Summary

This summary is machine-generated.

This study examined the fit of the Tula mobile health app for reducing risky drinking. Findings highlight areas of good fit and misfit, offering insights for improving digital health intervention implementation and sustainment.

Keywords:

EPIS framework alcohol use disorder drinking behavior effectiveness fit implementation trial mHealth mHealth app motivations opinions qualitative study

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Area of Science:

Digital Health Interventions
Implementation Science
Behavioral Health

Background:

Implementation frameworks stress intervention-context fit, crucial for success.
Lack of fit is a barrier, yet under-researched in implementation.
This study analyzes the fit of the Tula mobile health app for mild to moderate alcohol use disorder.

Purpose of the Study:

Understand trial results for the Tula app.
Provide guidance for implementing digital health interventions in healthcare.

Main Methods:

Conducted semistructured interviews with 18 Tula trial participants and 7 implementers.
Participants represented high and low engagement across all trial arms.
Interviews analyzed using rapid qualitative analysis with deductive and inductive components.

Main Results:

Identified both fit and misfit between the Tula app and its context.
Good fit observed between implementer theories and participant experiences; app versatility enhanced fit.
Misfit noted in the app's limited ability to foster connection and peer mentor role disjunction.

Conclusions:

Focusing on fit can guide future Tula app iterations.
Addressing fit and misfit areas can improve intervention sustainment.
Insights applicable to broader digital health intervention implementation.