{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:59:24Z","timestamp":1791215964260,"version":"4.1.0"},"reference-count":48,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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]).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We enrolled 26 participants aged 18\u201025 years. The mean age was 22.5 (SD 2.20) years. We found reduced scores between preintervention and postintervention measures in the intervention group using 2-tailed paired\n t<\/jats:italic>\n tests and baseline-adjusted analysis of covariance, including reduced alcohol misuse and problems (AUDIT and RAPI scores) and reduced DMQR social and coping motivation scores. Baseline-adjusted mean differences comparing the intervention with the control group showed reductions in alcohol use (AUDIT; mean difference \u22124.70, 95% CI \u22128.69 to \u22120.70) and in DMQR social motivation (mean difference \u22120.85, 95% CI \u22121.51 to \u22120.18) and enhancement motivation scores (mean difference \u22120.75, 95% CI \u22121.47 to \u22120.04).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our study findings indicate that the PST-APPLE intervention is feasible, acceptable, and hypothesis generating among college students with AUD. While findings are promising, this pilot study was not powered for definitive efficacy testing. A fully powered randomized controlled trial is needed to confirm these effects. Future studies could adapt PST-APPLE to other wrist-worn electronic devices\/watches that capture physiological data (eg, Fitbit, Samsung Galaxy Watch) to increase reach and scalability, particularly among younger adults and digitally literate populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/88846","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:55:07Z","timestamp":1787601307000},"page":"e88846-e88846","source":"Crossref","is-referenced-by-count":0,"title":["A Problem-Solving Therapy With Apple Watch Support for College Students With Alcohol Use Disorder Symptoms: Pilot Randomized Controlled Trial"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-3984","authenticated-orcid":false,"given":"Hagar","family":"Hallihan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5480-9970","authenticated-orcid":false,"given":"Sangeun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8554-4503","authenticated-orcid":false,"given":"Ruth","family":"Adomah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6418-6148","authenticated-orcid":false,"given":"Robert","family":"Miranda Jr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6753-9874","authenticated-orcid":false,"given":"Kathleen","family":"Rospenda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"R1","unstructured":"Harmful and underage college drinking. 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