Discussion
Insights on how individuals trying to reduce their alcohol consumption negotiate this behavioural change can be readily collected during digital intervention trials through, for example, modules inviting individuals to write prompts for their future selves. Such insight can be useful for improving intervention design by highlighting (mis)alignment in priorities (e.g., health vs. financial motivations), differences in favoured goal direction (e.g., approach positive vs. avoid negative consequences) and even how these vary by demographic factors. Such a prompts module was included in a digital support tool, the effectiveness of which was recently tested in a recent RCT conducted in Sweden [Quantitative analysis of the factors associated with the odds of writing a prompt at all, as well as a prompt belonging to one of the five identified themes, provided data on who authored prompts as well as the frequency of different types of content. The patterns observed and how the results can contribute to future intervention design are discussed below. Because the data and approach are novel, there are limited comparisons possible with existing literature. The importance of reinforcing motivation to continue to pursue the behaviour change involved in reducing drinking, as well as the potential important role of reflection upon one’s own behaviour [Although engagement with the prompts module was not especially high, women and individuals living with children (with or without a partner), and older individuals were more likely to use this module. Interventions targeting these populations may therefore benefit from offering individuals the possibility to write their own prompts or keep a record of their experiences. Those who rated themselves as having higher know-how on reducing their alcohol consumption were also more likely to write a prompt, suggesting that this module may also be more attractive to those who already know what they may want to write, or what could help them change their behaviour. By extension, individuals with lower baseline know-how may be more reliant on the advice and strategies suggested within the support tool. Higher baseline know-how individuals were also more likely to author a prompt giving reasons to change but less likely to write one indicating the use of a strategy or setting a goal. While this could be interpreted counterintuitively, it seems equally possible that these individuals did not feel the need to specify their strategy for drinking less and were instead using the prompts module to remind themselves why they want to change. Individuals for whom reducing their drinking was important were also more likely to write a prompt relating to the reasons they want to change their behaviour, perhaps suggesting that this module had the added benefit of allowing them to remind themselves of the personal reasons why they perceive change as important.It was observed that, as well being more likely to write a prompt at all, the intervention group were more likely to author prompts conveying pride/self-belief and self-control than the control group, whilst individuals in the control group were more likely to write a prompt suggesting goal setting or implementing a specific strategy to drink less. More diffuse subcategories (e.g., The experiences of the control group from the parent trial with which this work is associated are reported in detail elsewhere [Nonetheless, this issue highlights the relevance of understanding how individuals are affected by the information provided to them in a digital intervention setting. Specifically, the importance of providing information that helps people resolve their ambivalence in favour of moderating/avoiding alcohol consumption instead of inadvertently facilitating rationalising its consumption (or pushing individuals to behave defensively or feel discouraged) is emphasized. This is pertinent because, as noted above, individuals with lower know-how in changing their drinking habits may be more reliant on the information and advice provided in an intervention setting. For both groups here, approaching positive health goals was the most common It is interesting that Although baseline drinking metrics did not seem to markedly affect the odds of authoring a prompt, more frequent episodes of heavy drinking were somewhat related to greater odds of authoring a prompt categorized under 