Military DrinksRation: a randomized controlled trial of a smartphone intervention to reduce alcohol consumption among regular UK Armed Forces personnel
Although the "Military DrinksRation" trial successfully identified at-risk drinking among serving UK Armed Forces personnel, it failed to generate sufficient outcome data to evaluate the smartphone intervention's effectiveness due to unexpectedly low recruitment and a complete lack of primary endpoint completion in the intervention arm.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Imagine the military as a giant, high-stakes sports team where every player needs to be sharp, fit, and ready to make split-second decisions. In this world, alcohol is a tricky opponent. It's like a friendly teammate that sometimes helps build camaraderie around a campfire, but if it stays too long at the party, it starts tripping the players, messing up their game plans, and causing injuries. Scientists have long known that too much drinking is a big problem for soldiers, leading to health issues and safety risks. To fight this, they've developed "digital coaches"—smartphone apps designed to help people drink less by tracking their habits and giving them friendly nudges. These apps have worked well for veterans (former soldiers), but the big question was: would they work for active-duty soldiers who are still in the thick of their daily duties, often far from home and under unique pressures? This is the story of a scientific experiment trying to find out if a digital coach could help current soldiers cut back on their drinks.
The researchers behind this study, called "Military DrinksRation," set up a massive digital experiment to test a specific smartphone app against the usual care soldiers get. They wanted to see if the app could actually lower alcohol consumption among active UK Armed Forces personnel who were drinking at risky levels. Think of it like a race where one group of runners gets a high-tech, GPS-guided training plan (the app), while the other group just gets the standard advice they'd normally hear from a doctor. The goal was to see if the high-tech group would finish the race with significantly fewer drinks in their weekly tally after 84 days.
However, the race hit a major snag before it could really begin. The team managed to screen over 600 soldiers and found that about 338 of them were drinking at levels that posed a risk. They invited these 338 soldiers to join the study, but only 113 said "yes" and got randomized into the two groups. The biggest surprise? The study couldn't actually finish the race. While the control group (the ones getting standard advice) managed to send in some results, the group using the app had a massive drop-off. By the time the 84-day finish line arrived, zero participants in the app group had completed the final check-in. Because of this, the researchers couldn't compare the two groups or prove whether the app worked or not. It's like trying to judge a cooking competition when all the chefs using the special new recipe walked out of the kitchen before serving their dishes.
Despite the inability to measure the app's effectiveness, the study did uncover some fascinating clues about why the experiment stalled. First, they found that soldiers who were drinking at risky levels were much less likely to sign up for the study than those drinking at lower levels. It seems that the people who needed the help the most were the least likely to raise their hands and say, "I need help." Second, there was a weird disconnect between using the app and doing the research. The 16 soldiers who actually downloaded and started using the app stayed engaged with it for an average of 12 weeks, logging their drinks and interacting with the features. They seemed to like the tool! But, they completely stopped filling out the research surveys. It's as if they were happily training with their digital coach but refused to show up for the weigh-ins.
The paper concludes that while the military's routine health checks are excellent at spotting soldiers who are drinking too much, getting those specific individuals to join a research study and stick with it is incredibly difficult. The study didn't prove the app is bad, nor did it prove it's good; it simply ran out of data to make a call. The main takeaway is that finding the problem is easy, but getting the people with the problem to participate in a study is the real challenge. The researchers suggest that future attempts to help soldiers with digital tools need to focus less on just building better apps and more on understanding why soldiers who are drinking at risky levels are so hesitant to join the research team in the first place. Until that hurdle is cleared, the true power of these digital interventions in the active military remains a mystery.
Drowning in papers in your field?
Get daily digests of the most novel papers matching your research keywords — with technical summaries, in your language.