A Problem-Solving Therapy With Apple Watch Support for College Students With Alcohol Use Disorder Symptoms: Pilot Randomized Controlled Trial

Alcohol use disorder (AUD) involves an impaired ability to stop or control alcohol use despite adverse consequences and represents a major public health problem. While AUD is most prevalent among college students, integrated evidence-based treatments for this population are lacking.

The objectives of our study were to test the feasibility and acceptability of a newly developed behavioral intervention, problem-solving therapy and Apple Watch (PST-APPLE), and to preliminarily investigate the effectiveness of PST-APPLE among college students with symptoms of AUD.

Participants were recruited through online advertising and on campus at universities in the Chicago area between May and September 2024. They were randomized in a 1:1 ratio using block randomization to the intervention group (PST-APPLE: n=12 individuals) or the control group (education-only: n=14 individuals), with the data analyst blinded to treatment assignment. Participants in the intervention group completed 12 weeks of the PST-APPLE intervention, delivered remotely via Zoom videoconferencing and interactions with the Apple Watch. Participants in the control group were asked to watch a 20-minute abstinence-motivation video and then participate in a 30-minute group discussion via Zoom. All participants completed follow-up assessments at 3 months. Outcomes included alcohol-related problems (Alcohol Use Disorders Identification Test [AUDIT] and Rutgers Alcohol Problem Index [RAPI]) and drinking motivation (Drinking Motives Questionnaire Revised [DMQR]).