Mobile Health Intervention to Increase Substance-Free Activities During Alcohol Treatment

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PROJECT SUMMARY/ ABSTRACT Alcohol Use Disorder (AUD) is a highly prevalent and significant public health problem. Behavioral treatments based in the principles of social learning theory and cognitive behavior therapy have been developed and tested for AUD, yet effect sizes are relatively small and rates of relapse following treatment are high. Theoretically informed adjunctive interventions may help to enhance the effects of extant AUD treatments. In particular, evidence suggests that environments lacking in substance-free (SF) activities contribute to the development and maintenance of AUD and that the availability of rewarding SF activities may serve as viable alternatives to compete with alcohol use. Building on the advantages of accessibility and low-cost option afforded by the use of mobile technology, this K23 Mentored Patient-Oriented Research Career Development Award proposal outlines a well-integrated research and training plan to investigate a mobile health intervention to increase engagement in rewarding SF activities among patients in AUD treatment. This proposed research aims to develop and evaluate a mobile phone ecological momentary assessment plus ecological momentary intervention (EMA+EMI; entitled: mobile – Rewarding Activity Centered Treatment (m-ReACT)) app to augment existing AUD treatment. The m-ReACT app will monitor self-reported rewarding SF activity engagement in real-time and deliver personalized feedback that encourages participants to engage in highly rewarding activities that are goal-oriented and support positive treatment outcomes. This proposed intervention will be developed in two phases. Phase 1 will develop the m-ReACT app through a series of focus groups and usability studies and Phase 2 will evaluate its efficacy in randomized control pilot trial with a sample of 50 AUD patients who have recently initiated outpatient AUD treatment. Participants in the pilot RCT will be randomly assigned to either the m-ReACT condition or an active control condition. It is hypothesized that m-ReACT will result in increased rates of percent days of alcohol abstinence and increased reinforcement from SF activities. This research plan provides the PI the essential hands-on learning and mentored training in development and delivery of technology enhanced interventions, design and implementation of EMA+EMI platforms, qualitative methodology, and advanced statistical approaches. Successful completion of this K23 award will provide the PI essential training to be able to transition to an independent investigator role examining novel interventions to enhance AUD treatment. This proposal is highly consistent with NIAAA’s current funding priorities of funding projects that use mobile technology to improve the effectiveness, accessibility, and use of behavioral interventions for AUD.