CBT by Phone to Promote Use of Alcohol Related Care and Reduce Drinking

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The COVID-19 pandemic has major implications for alcohol use and treatment utilization for alcohol use disorder (AUD), and there are pronounced racial disparities in COVID-19 experiences including higher rates of COVID-19 infections, hospitalizations, and deaths in Blacks, serving as the foci of this COVID-19 supplement. More specifically, this supplement covers the final 2 years of a 4-year randomized controlled trial (RCT) to examine the efficacy of a one-session phone intervention, Cognitive Behavioral Therapy for Treatment Seeking (CBT-TS), to increase AUD treatment utilization and reduce drinking. Subjects are adult volunteers with AUD recruited from the Rochester, New York area through social media who have no prior history of AUD treatment. Following a baseline assessment, subjects are randomized to CBT-TS or a control condition (being read an information pamphlet on AUD treatment) and followed for 6 months. One year into recruitment for the RCT, in March 2020, a statewide executive order was issued in response to the COVID-19 pandemic that swept into New York City, with sudden and dramatic effects throughout the state. A month later, the study team began to administer a detailed assessment of COVID-19 experiences to assess subjects' personal exposure to COVID- 19, exposure of family members, stress related to COVID-19, and alcohol use affected by COVID-19. Through this supplement, these data at the population level (marked by the executive order) and at the individual level (obtained through the COVID-19 assessment) are used to analyze COVID-19 related experiences and their prospective associations with AUD treatment utilization, drinking outcomes, and response to the study intervention (Specific Aim 1) and to explore racial disparities through comparisons of Blacks and white non- Hispanics (Specific Aim 2). Moreover, pilot research suggests that Blacks may be especially responsive to the CBT-TS intervention, underscoring the importance of further study of the intervention in this population. To achieve the two study aims, the supplement provides resources to increase the length of follow-up (from 6 months to 12 months) which is needed to model effects of COVID-19 experiences over time, and to increase the sample size (from n=450 to n=500), with a priority on increased recruitment of Blacks (to reach n=100) to facilitate sub-analyses and comparisons with white non-Hispanics. This supplement is in response to NOT-OD- 20-097 and addresses the emphases in the NOSI on “downstream health impacts resulting from (COVID-19 related) social, behavioral, and economic impacts, including (race) differences in risk and resiliency.” Moreover, it is responsive to its call for “active grants studying existing longitudinal cohorts, particularly those cohorts with considerable data relevant to COVID-19 social and behavioral factors prior and subsequent to the (COVID-19) outbreak.” Along these lines, the statewide executive order was issued at the midpoint of data collection, optimal for the examination of the cohort before and after exposure to COVID-19.