酒精依賴為對身體造成多處傷害的慢性病，且具有即使治療之後，仍容易復發的特性。對於酒精依賴患者，完成戒酒療程已是一項了不起的成就，但是回到日常生活中並持續戒酒對他們而言則是更艱困的挑戰。
本研究提出「戒酒小幫手」，一項運用智慧型手機系統協助酒精依賴患者於日常生活中進行自我監測及管理行為以維持戒酒。「戒酒小幫手」利用可攜式藍牙酒測器搭配安裝於智慧型手機上的「戒酒小幫手」客戶端軟體所提供的多樣功能來協助酒精依賴患者經由自我監測及管理來降低酒癮復發。本實驗對於從臺北市立聯合醫院精神醫學中心的14名酒精依賴患者進行研究並發現參與者在有「戒酒小幫手」的介入下，可以達成平均每日1.9次的自我酒測而且他們的飲酒量、飲酒日數及大量飲酒日數都有顯著的降低。與只經由一般療程的患者相比，參與「戒酒小幫手」實驗的患者有效降低的對於酒精的渴求及較低中止實驗的比例，顯示出「戒酒小幫手」具有提供協助患者降低復發率的可能性。

Alcohol dependence is a chronic disorder associated with severe harm in multiple areas, and relapsing is easy despite treatment. For alcohol-dependent patients, complet-ing alcohol withdrawal treatment is an achievement. However, returning to daily life and remaining sober are often more challenging tasks. This study proposes SoberDiary, a phone-based support system that enables alcohol-dependent patients to self-monitor and self-manage their behavior to remain sober in their daily lives. Through a portable Bluetooth breathalyzer wirelessly connected to the patients’ smartphones and various supporting functions provided by the SoberDiary client, SoberDiary can facilitate alco-hol-dependent patients’ self-monitoring and self-management to prevent relapse. The results from a 12-week user study involving 14 clinical patients from Taipei City Psy-chiatric Center show that patients can self-monitor their alcohol use by completing at least 1.9 breath alcohol tests per day and self-managing their alcohol use behavior to significantly reduce their total alcohol consumption and the number of drinking or heavy drinking days after intervention through SoberDiary. Compared with patients who received only standard treatment, SoberDiary users exhibited reduced alcohol craving and a lower drop-out rate, indicating that SoberDiary shows potential to provide continuing care for relapse prevention.

Index
Acknowledgement i
摘要 ii
Abstract iii
Figure Index viii
Table Index ix
Chapter 1 - Introduction 1
Chapter 2 - BACKGROUND AND THEORETICAL FOUNDATION 6
2.1 Background of Current Alcohol Withdrawal Treatment 6
2.2 Theoretical Foundation 8
Chapter 3 - System Overview 10
3.1 Portable Bluetooth Breathalyzer 11
3.2 Phone Application: SoberDiary 12
3.3 Backend Server 14
Chapter 4 - SOBERDIARY PHONE APPLICATION 15
4.1 User Interface 15
4.2 Supporting Functional Blocks 16
4.2.1 Alcohol use detection 16
4.2.2 Progress feedback 19
4.2.3 Storytelling visualization 22
4.2.4 Managing skill suggestion 26
4.2.5 Mood sampling 27
4.3 App Use Logging 28
4.4 Behavioral Data Store 28
Chapter 5 – IMPLEMENTATION 29
5.1 Hardware Component 29
5.2 Software Components 31
Chapter 6 - USER STUDY 32
6.1 Participants 33
6.2 Apparatus 37
6.3 Design and Procedure 37
6.4 Evaluation metrics 41
6.5 Quantitative Results 42
6.5.1 Completeness on taking BrAC test for self-monitoring 42
6.5.2 Impact of mouth alcohol on the screening threshold 43
6.5.3 Control-Case comparison 45
6.5.4 Application usage behavior and effectiveness 46
6.6 Qualitative results 49
6.6.1 Convenience and alcohol screening coverage 49
6.6.2 Coupon earning and encouragement 50
6.6.3 Relationship between storytelling visualization and craving reduction 50
Chapter 7 – Discussion 52
7.1 Breathalyzer maintenance 52
7.2 Substances containing alcohol and screening outcomes 52
7.3 Primary phone effects 53
Chapter 8 - RELATED WORK 54
Chapter 9 – CONCLUSION 57
Reference 58

[1] #34 Alcohol Content in Common Preparations. http://www.mssny.org/mssnycfm/mssnyeditor/File/CPH/AlcoholContent.pdf.
[2] A Humanist Alternative to AA’s Twelve Steps. http://www.silkworth.net/magazine_newspaper/humanist_jul_aug_1987.html.
[3] Arduino Programming Language. http://arduino.cc/en/Reference/HomePage.
[4] Atmel 8-bit AVR RISC-based microcontroller. http://www.atmel.com/devices/atmega328.aspx.
[5] Bosch BMP085 Digital Barometer. https://www.sparkfun.com/products/11282.
[6] EGBT-045MS Bluetooth Module. http://www.e-gizmo.com/KIT/egbt-04.htm.
[7] Guth Model 2100, Alcohol Breath Test Simulator. http://www.guthlabs.com/product.asp?item_id=184.
[8] MR 513 type Alcohol Sensor. http://www.futurlec.com/Alcohol_Sensor2.shtml.
[9] Standalone Linear Li-Ion Battery Charger. http://www.linear.com/product/LTC4054-4.2.
[10] S. M. Alessi and N. M. Petry. A Randomized Study of Cellphone Technology to Reinforce Alcohol Abstinence in the Natural Environment. Addiction, 108(5):900–909, May 2013.
[11] G. Caddy, M. Sobell, and L. Sobell. Alcohol Breath Tests: Criterion Times for Avoiding Contamination by “Mouth Alcohol”. Behavior Research Methods &; In-strumentation, 10(6):814–818, 1978.
[12] C. C. Chen, C. J. Kuo, S. Y. Tsai, and S. J. Yin. Relation of Genotypes of Alcohol Metabolizing Enzymes and Mortality of Liver Diseases in Patients with Alcohol Dependence. Addict. Biol., 9(3-4):233–237, 2004.
[13] M.-C. Chiu, S.-P. Chang, Y.-C. Chang, H.-H. Chu, C. C.-H. Chen, F.-H. Hsiao, and J.-C. Ko. Playful Bottle: A Mobile Social Persuasion System to Motivate Healthy Water Intake. In ACM Ubicomp ’09, pages 185–194, 2009.
[14] K. R. Conner and P. R. Duberstein. Predisposing and Precipitating Factors for Sui-cide among Alcoholics: Empirical Review and Conceptual Integration. Alcohol. Clin. Exp. Res., 28(5 Suppl):6S–17S, May 2004.
[15] S. Consolvo, D. W. McDonald, T. Toscos, M. Y. Chen, J. Froehlich, B. Harrison, P. Klasnja, A. LaMarca, L. LeGrand, R. Libby, I. Smith, and J. A. Landay. Activity Sensing in the Wild: A Field Trial of UbiFit Garden. In ACM CHI ’08, pages 1797–1806, 2008.
[16] J. Froehlich, M. Y. Chen, S. Consolvo, B. Harrison, and J. A. Landay. MyExperi-ence: A System for in Situ Tracing and Capturing of User Feedback on Mobile Phones. In ACM Ubicomp ’13, pages 57–70. ACM, 2007.
[17] D. M. D. G. Alan Marlatt. Relapse Prevention, Second Edition: Maintenance Strategies in the Treatment of Addictive Behaviors. The Guilford Press, 2007.
[18] D. H. Gustafson, B. R. Shaw, A. Isham, T. Baker, M. G. Boyle, and M. Levy. Ex-plicating an Evidence-based, Theoretically Informed, Mobile Technology-based System to Improve Outcomes for People in Recovery for Alcohol Dependence. Subst. Use Misuse, 46(1):96–111, 2011.
[19] D. S. Hasin, F. S. Stinson, E. Ogburn, and B. F. Grant. Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch. Gen. Psychiatry, 64(7):830–842, Jul 2007.
[20] J. H. Krystal, J. A. Cramer, W. F. Krol, G. F. Kirk, and R. A. Rosenheck. Naltrex-one in the Treatment of Alcohol Dependence. New England Journal of Medicine, 345(24):1734–1739, 2001.
[21] Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov''t ]
Laaksonen, E, Koski-Jannes, A, Salaspuro, M, Ahtinen, H, Alho, H (2008). A ran-domized, multicentre, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol., 43, 1:53-61.
[22] R. Litten, J. Allen, N. I. on Alcohol Abuse, and A. (U.S.). Measuring Alcohol Con-sumption: Psychosocial and Biochemical Methods. Drug and alcohol abuse reviews. Humana Press, 1992.
[23] J. R. McKay, T. R. Franklin, N. Patapis, and K. G. Lynch. Conceptual, Methodo-logical, and Analytical Issues in the Study of Relapse. Clin. Psychol. Rev., 26(2):109–127, Mar 2006.
[24] F. M. McTavish, M. Y. Chih, D. Shah, and D. H. Gustafson. How Patients Recov-ering from Alcoholism Use a Smartphone Intervention. J. Dual Diagn., 8(4):294–304, 2012.
[25] K. C. Morley, M. Teesson, S. C. Reid, C. Sannibale, C. Thomson, N. Phung, M. Weltman, J. R. Bell, K. Richardson, and P. S. Haber. Naltrexone versus Acampro-sate in the Treatment of Alcohol Dependence: A Multi-centre, Randomized, Dou-ble-blind, Placebo-controlled Trial. Addiction, 101(10):1451–1462, Oct 2006.
[26] D. S. Moskowitz and S. N. Young. Ecological Momentary Assessment: What It Is and Why It Is a Method of the Future in Clinical Psychopharmacology. J. Psychia-try Neurosci., 31(1):13–20, Jan 2006.
[27] A. Natarajan, A. Parate, E. Gaiser, G. Angarita, R. Malison, B. Marlin, and D. Ga-nesan. Detecting Cocaine Use with Wearable Electrocardiogram Sensors. In ACM Ubicomp ’13, pages 123–132. ACM, 2013.
[28] J. Nowinski. Twelve Steps Facilitation Therapy Manual: A Clinical Research Guide for The Therapists Treating Individuals with Alcohol Abuse and Dependence. Di-ane Publishing Company, 2010.
[29] D. J. Nutt, L. A. King, and L. D. Phillips. Drug Harms in the UK: A Multicriteria Decision Analysis. Lancet, 376(9752):1558–1565, Nov 2010.
[30] J. L. Obermayer, W. T. Riley, O. Asif, and J. Jean-Mary. College Smoking-cessation using Cell Phone Text Messaging. J. Am. Coll. Health, 53(2):71–78, 2004.
[31] E. Ozdalga, A. Ozdalga, and N. Ahuja. The Smartphone in Medicine: A Review of Current and Potential Use among Physicians and Students. J. Med. Internet Res., 14(5):e128, 2012.
[32] I. L. Petrakis. A Rational Approach to the Pharmacotherapy of Alcohol Depend-ence. J. Clin. Psychopharmacol., 26 Suppl 1:3–12, Dec 2006.
[33] U. W. Preuss, M. A. Schuckit, T. L. Smith, G. P. Danko, K. Buckman, L. Bierut, K. K. Bucholz, M. N. Hesselbrock, V. M. Hesselbrock, and T. Reich. Comparison of 3190 Alcohol-dependent Individuals with and without Suicide Attempts. Alcohol Clin. Exp. Res., 26(4):471–477, Apr 2002.
[34] K. Richardson, A. Baillie, S. Reid, K. Morley, M. Teesson, C. Sannibale, M. Welt-man, and P. Haber. Do Acamprosate or Naltrexone Have an Effect on Daily Drink-ing by Reducing Craving for Alcohol? Addiction, 103(6):953–959, Jun 2008.
[35] S. Rosner, S. Leucht, P. Lehert, and M. Soyka. Acamprosate Supports Abstinence, Naltrexone Prevents Excessive Drinking: Evidence from a Meta-analysis with Un-reported Outcomes. J. Psychopharmacol. (Oxford), 22(1):11–23, Jan 2008.
[36] John Hicks, Nithya Ramanathan, Donnie Kim, Mohamad Monibi, Joshua Selsky, Mark Hansen, and Deborah Estrin. 2010. AndWellness: an open mobile system for activity and experience sampling. In Wireless Health 2010 (WH ''10). ACM, New York, NY, USA, 34-43.[11]
[37] Cohn, AM, Hunter-Reel, D, Hagman, BT, Mitchell, J (2011). Promoting behavior change from alcohol use through mobile technology: the future of ecological mo-mentary assessment. Alcohol. Clin. Exp. Res., 35, 12:2209-15.
[38] Fei Yu; Albers, J.; Tian Gao; Minghao Wang; Bilberg, A.; Stenager, E., "A smartphone application of alcohol resilience treatment for behavioral self-control training," Engineering in Medicine and Biology Society (EMBC), 2012 Annual In-ternational Conference of the IEEE , vol., no., pp.1976,1979, Aug. 28 2012-Sept. 1 2012.
[39] Eric C. Larson, Mayank Goel, Gaetano Boriello, Sonya Heltshe, Margaret Rosen-feld, and Shwetak N. Patel. 2012. SpiroSmart: using a microphone to measure lung function on a mobile phone. In Proceedings of the 2012 ACM Conference on Ubiquitous Computing (UbiComp ''12). ACM, New York, NY, USA, 280-289.
[40] Collins, RL, Kashdan, TB, Gollnisch, G (2003). The feasibility of using cellular phones to collect ecological momentary assessment data: application to alcohol consumption. Exp Clin Psychopharmacol, 11, 1:73-8.
[41] Gustafson, DH, McTavish, FM, Chih, MY, Atwood, AK, Johnson, RA, Boyle, MG, Levy, MS, Driscoll, H, Chisholm, SM, Dillenburg, L, Isham, A, Shah, D (2014). A smartphone application to support recovery from alcoholism: a randomized clinical trial. JAMA Psychiatry, 71, 5:566-72.
[42] Lucht, MJ, Hoffman, L, Haug, S, Meyer, C, Pussehl, D, Quellmalz, A, Klauer, T, Grabe, HJ, Freyberger, HJ, John, U, Schomerus, G (2014). A surveillance tool using mobile phone short message service to reduce alcohol consumption among al-cohol-dependent patients. Alcohol. Clin. Exp. Res., 38, 6:1728-36.