Lessons on uptake and engagement of a smartphone application (APP) for people in recovery from alcohol and other drug problems: A qualitative study.

Joanne Neale, Alice Bowen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Mobile health (mHealth) applications (apps) promoting health and well-being have significant potential but suffer from low uptake and engagement. Barriers common to addiction treatment app uptake and engagement include poor access to mobile technology, WIFI, and/ or data, plus low motivation among non-treatment-seeking users to cut down or quit. Working with people who used substances, we had previously designed and published an app to support recovery from alcohol and other drug problems. The app, which is freely available from the Apple App Store and Google Play, is called ‘SURE Recovery’.

Objective: Two team members undertook a qualitative study to ascertain end-users’ views and experiences of the SURE Recovery app, including how it might be improved. The objective of this paper is to present findings on uptake and engagement to assist other researchers and app developers working on similar apps for people experiencing alcohol and other drug problems.

Methods: Semi-structured telephone interviews were conducted with 20 people (12 male; 8 female; ages 25-63 years; all identifying as White British) who had varied patterns of using the app. Audio recordings were transcribed and the data were coded and analysed via Iterative Categorization.

Results: Analyses identified three main factors relevant to ‘uptake’ (i. discoverability of the app; ii. personal relevance; and iii. expectations and motivations) and three main factors relevant to ‘engagement’ (i. the appeal and relevance of specific features; ii. perceived benefits; and iii. the need for improvements). Findings on uptake and engagement were largely consistent with our own earlier developmental work and with other published literature. However, we additionally found that uptake was strongly affected by first impressions, including trust and personal recommendations; that users were attracted to the app by their needs for support and curiosity but had relatively modest expectations; that engagement increased if the app made users feel positive; and that people were unlikely to download or engage if they could not relate to, or identify with, aspects of the app’s content.

Conclusions: Incorporating end-user views into app design and having a network of supportive partners (that is, credible organisations and individuals who will champion the app) appear to increase uptake and engagement amongst people experiencing alcohol and other drug problems. Whilst better digital literacy and access to devices and data are needed if addiction recovery apps are to reach their full potential, we should not evaluate them based only on observable changes in substance use behaviours. How using an app makes a person feel is more transient and difficult to quantify but also relevant to uptake and engagement.
Original languageEnglish
JournalJournal of Medical Internet Research Human Factors
Publication statusAccepted/In press - 19 Dec 2021


  • Apps; Digital Literacy; MHealth; Substance Use; Recovery; Qualitative


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