Young Adults' Perspectives on an Ecological Momentary Intervention for Drinking to Cope: Qualitative Study

Young adults have high rates of mental health problems, such as mood or anxiety symptoms, and high rates of problematic drinking. Many young adults who undergo psychiatric hospitalization to address depression and anxiety symptoms also engage in risky drinking and tend to drink to cope with negative emotions. However, in many cases, treatment programs focusing on mood and anxiety symptoms often fail to adequately address problematic alcohol use in young adults.

This study aimed to address this treatment gap by investigating patient perspectives on a potential ecological momentary intervention mobile app. Researchers used qualitative methods to gather perspectives of young adults hospitalized for psychiatric care on their use of drinking to cope with negative emotions and their feedback for a prospective app designed to suggest healthy coping strategies when participants report low mood and cravings to drink.

We recruited a total of 12 young adults admitted to a partial hospitalization program to participate in a qualitative interview. To be eligible, participants needed to be aged 18-25 years and report drinking at least once weekly, binge drinking at least once monthly, drinking to cope with negative emotions, and depression and/or anxiety symptoms.

Qualitative analysis of our data resulted in 4 major themes. These included (1) motivations to use substances, (2) healthy coping, (3) general reactions to the proposed app, and (4) suggestions for the app. Participants generally had insight about their use of alcohol to cope and were able to identify several motivations for drinking; the most frequent motivations were to alleviate anxiety and depression, although many participants noted drinking to cope with other emotions, such as guilt or loneliness. Participants overall had positive responses to the prospective intervention and reported that they would appreciate the portability of a digital intervention in helping them "step down" from higher levels of psychiatric care. Participants also made several valuable suggestions about content, features, and usability, such as suggesting ways to "gamify" the app to increase use.

This feedback will be crucial in designing and testing an ecological momentary intervention designed to reduce drinking to cope in young adults hospitalized for psychiatric care.