Oura Ring Behavioral Feedback Intervention for Alcohol Reduction in Young Adults: User Experience Evaluation of a Pilot Randomized Trial.

Background: Wearable fitness technologies, like the Oura Ring (Oura Health Oy), provide physiological metrics, like sleep and heart rate data, to a growing user base of young adults. However, these technologies and connected mobile apps do not measure young adults' alcohol use that contributes to these metrics. Personalized feedback on the impact of alcohol on sleep and heart rate may boost motivation to reduce drinking among young adults. Objective: For this pilot randomized controlled trial, we evaluated the acceptability, feasibility, and perceived effectiveness of a wearable personalized feedback intervention for alcohol reduction in young adults that integrated physiological and behavioral data. Methods: Recruitment took place offline and online via open access websites. Participants (N=60) wore the Oura Ring for 6 weeks and completed daily behavioral smartphone diaries. Only the feedback group (n=30) had full access to the Oura Ring app and personalized feedback reports every 2 weeks, received from the study team. The app included daily feedback on sleep and cardiovascular recovery. Feedback reports combined Oura Ring and diary data to show trends of alcohol use alongside sleep and cardiovascular data. We used artificial intelligence-driven convergent mixed methods to evaluate self-assessed exit surveys and face-to-face exit interviews, including natural language processing and researcher-coded qualitative analyses with interviews. Results: Half of participants (30/60, 50%) were men, 81.6% (49/60) were White, and they had a mean age of 22.02 (SD 1.98) years. Across both groups, the overall program was described as highly acceptable, feasible, and effective. Wearing the Oura Ring was highly acceptable and feasible. The smartphone diaries were moderately acceptable, moderately-highly feasible, and highly effective. The feedback reports were highly acceptable, feasible, and effective. Among feedback group participants, the Oura Ring and app were moderately effective. The feedback group participants also had high adherence using the app daily, and 80% (48/60) read all 3 feedback reports. Per natural language processing, the most common topic in the feedback interviews related to their behavior change due to multiple intervention components (Ɵk=0.18). This contrasted with the most common topic from assessment group participants about prechange learning (Ɵk=0.22). During the researcher-coded qualitative analysis, we identified themes in 3 categories. Most participants described helpful aspects of the Oura Ring and app, smartphone diaries, and feedback report. Most felt that the report had the right amount of information, and a large group reported they learned about their sleep deficits. Curiosity was the most common reason participants joined the study. SMS text messages and usability kept them engaged, and almost none considered dropping out. Conclusions: Commercial fitness wearables that integrate behavioral data may be acceptable and feasible and promote readiness to change drinking in young adults who are generally unconcerned about risky behaviors.