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BACKGROUND Heavy alcohol use is prevalent among young adults and may contribute to obesity. However, measurement tools for assessing caloric intake from alcohol are limited and rely on self-report, which is prone to biases. OBJECTIVE The purpose of the pilot study was to conduct feasibility testing of SmartIntake®, a photo-based smartphone app, to assess alcohol use among young adults. Aims consisted of 1) quantifying the ability of SmartIntake® to capture drinking behavior; 2) assessing app usability with the Computer System Usability Questionnaire (CSUQ); 3) conducting a qualitative interview; and 4) comparing preference, compliance, and alcohol use estimates (calories, grams per drinking episode) between SmartIntake® and online diet recalls that participants completed for a parent study. METHODS College students (N=15) who endorsed a pattern of heavy drinking were recruited from a larger study examining the impact of drinking on weight. Participants used SmartIntake® to send photographs of all alcohol and food intake over a three-day period, and then completed a follow up interview and the CSUQ. CSUQ items range from 1-7, with lower scores indicating greater usability. Total number of drinking occasions was determined by adding the number of drinking occasions captured by SmartIntake® plus the number of drinking occasions participants reported that they missed capturing. Compliance was defined by the number of days participants provided food/beverage photo data through the app, or the number of diet recalls completed. RESULTS The SmartIntake® app captured 13 of 15 (87%) drinking occasions. Participants rated the app as highly usable in the CSUQ (M= 2.28). Most participants (93%) preferred using SmartIntake® vs. recalls and compliance was significantly higher with SmartIntake® than recalls (93% vs 78%; P= .04). Alcohol grams and calories per drinking occasion were not significantly different between the two methods (P values range .25-.99); however triple the number of participants submitted alcohol reports with SmartIntake® compared to the diet recalls (SmartIntake® 9/15 vs recalls 3/15; P=.06). CONCLUSIONS SmartIntake® was well accepted by college students who drink heavily and captured most drinking occasions. Participants had higher compliance with SmartIntake® compared to diet recalls and triple the number of participants reported alcohol use with SmartIntake®, suggesting this method may be well suited to assessing alcohol use in young adults.

Background: Daily alcohol intake in quantities as small as half a drink/day significantly increases the risk of breast cancer recurrence for postmenopausal survivors. Interventions designed to modify alcohol use among survivors have not been studied; however, lifestyle interventions that target change in dietary intake may affect alcohol intake. Objective: To evaluate change in alcohol use during a weight loss intervention for obese, rural-dwelling breast cancer survivors. Methods: Data were derived from an 18-month trial that included a 6-month weight loss intervention delivered via group conference calls, followed by a 12-month randomized weight loss maintenance phase in which participants received continued group calls or mailed newsletters. Participants who reported regular alcohol use at baseline (N=37) were included in this study. Results: Mean daily alcohol intake significantly decreased from baseline to 6 months during the weight loss intervention (19.6-2.3 g; P=.001). Mean alcohol intake did not significantly increase (b=0.99, P=.12) during the weight loss maintenance phase (months 6-18) and did not depend on randomization group (b=0.32, P=.799). Conclusions: Findings provide preliminary evidence that a weight loss intervention may address obesity and alcohol use risk factors for cancer recurrence. Minimal mail-based contact post weight loss can maintain alcohol use reductions through 18 months, suggesting durability in these effects. These results highlight a possibility that lifestyle interventions for survivors may modify health behaviors that are not the main foci of an intervention but that coincide with intervention goals. Trial Registration: Clinicaltrials.gov NCT01441011; https://clinicaltrials.gov/ct2/show/NCT01441011 (Archived by WebCite at http://www.webcitation.org/6lsJ9dMa9) [JMIR Cancer 2016;2(2):e15]