Reducing alcohol consumption in UK armed forces veterans: Feasibility of using personalized push notifications with AI

This study assessed the feasibility of deploying RationAI, a personalized AI-supported messaging framework, to reduce alcohol consumption among UK Armed Forces veterans. Participants were given DrinksRation, a mobile phone app, and allocated to receive either personalized or generic behavior change messages over 12 weeks. A total of 2,871 participants registered for an account during the study period. Feasibility was evaluated through recruitment (n = 2,871), retention (25.4% met engagement criteria), app usage and message delivery. Of those eligible, 343 participants were allocated to the personalized messaging group and 385 to the generic message group. The personalized group had higher early engagement, with app usage peaking at 212.4 (95% CI: 207.32 to 217.45) seconds in Week 2 compared to 183.7 seconds in the control group (95% CI: 178.90 to 188.46; p < 0.001) and received more notifications on average, reflecting additional personalized and event-triggered messages delivered as part of the intervention (47.7 [SD = 18.8] vs 16.3 [SD = 5.3]). Alcohol consumption declined in both groups over the 12-week period, with the personalized group showing a greater reduction from 31.08 to 13.20 units per week, compared to 31.24 to 15.17 units in the control group. Statistically significant between-group differences were observed at Week 2 (p = 0.027), Week 3 (p = 0.041), Week 4 (p = 0.008), and Week 10 (p = 0.049), favoring the personalized group, although between-group differences attenuated towards Week 12. Despite high attrition, the app engaged participants from an important population. These findings suggest the feasibility of personalized digital interventions for alcohol reduction, but there is a need for improved strategies to enhance long-term engagement.