UH-VA ALCOHOLISM TREATMENT MATCHING CRU

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This proposal will demonstrate that a University of Houston-Veterans Administration Clinical Research Unit would provide an excellent site to conduct a multiyear trial of patient-treatment matching capable of responding to the NIAAA cooperative agreement request (RFA AA-89-02B). The clinical population consists of approximately 500 patients r year who enter the alcoholism treatment program rehabilitation unit (Ward 210) from e Detox unit which treats male, middle aged veterans with extensive histories of problematic drinking and serious psychosocial adjustment problems. All have a primary diagnosis of alcoholism. The current treatment consists of a 28 day structured broad based program. For consideration at this site as well as other possible settings, the UH-VA CRU proposes two specific treatment matchings based on the stages and processes of change the transtheoretical model. The stages of change represent a temporal and motivational aspect of the process of change with individuals moving from Precontemplation Contemplation to Action and then to Maintenance. Individuals in the early stages of change will be matched with a motivational/decisional component. Those in the later stages of action and maintenance will be matched with a self-efficacy based intervention. Matched, unmatched mismatched subjects are hypothesized to respond differentially to a regular care condition, a decisional/motivational enhanced condition and an efficacy enhanced intervention condition. Hierarchical Linear Modeling Analytic procedures will be used to t these hypotheses in addition to more traditional mixed model ANOVA designs. The available patient population, the conceptual and theory based matchings, a research oriented treatment setting and a solid group of investigators who have treatment matching experience make the UH-VA CRU well qualified to be an active participant this collaborative treatment matching project.