This R01 project titled "Family-focused vs. Drinker-focused Smartphone Interventions to Reduce Drinking-related Consequences of COVID-19" is a Hybrid II RCT/implementation study to modify and test two of our alcohol smartphone interventions to address the fallout from COVID. We propose a three-arm RCT comparing a smartphone control group vs. a drinker-focused intervention vs. a family-focused intervention. All study arms recruit dyads comprising a person who drinks and a family partner.
The current randomized controlled trial tested whether PartnerCHESS (an ACHESS intervention along with aspects of Alcohol Behavioral Couple Therapy designed specifically for individuals with alcohol use disorder and their concerned significant other) could reduce high-risk drinking and improve quality of life. For this trial, 199 dyads (398 participants) were recruited from the community and randomized 1:1:1 to the PartnerCHESS intervention, ACHESS intervention, or smartphone control for 8 months with a follow-up at 12 months. Participants were part of a dyad: identified patients met criteria for high-risk drinking (defined by the DSM-5) and had at least one drink in the past month, concerned significant others were the identified patient's romantic partner, family member, or close friend aged 21 or older. Primary outcomes were identified patient percent high-risk drinking days, and quality of life for both identified patients and concerned significant others. Participants were surveyed at baseline, 4, 8, and 12 months; PartnerCHESS and ACHESS usage data were continuously collected. We found significant difference in both PartnerCHESS and ACHESS arms compared to smartphone control in percent high-risk drinking days as well as identified patient quality of life. Additionally, PartnerCHESS had significantly lower percent high-risk drinking days than ACHESS at 12 months, suggesting a stronger long-term impact. We also found significantly less distress among ACHESS concerned significant others as compared to those in PartnerCHESS and the smartphone control arms.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
398
The following ABCT services, from PartnerCHESS, will be available in the PartnerCHESS app but not in ACHESS: ABCT tutorials. Interactive e-learning modules explaining key ABCT skills. Agreements between identified patient and concerned significant other to follow key principles. Trigger identification and removal. Cravings discussion. Relapse plan. Reminders.
ACHESS offers the following, which are also available in PartnerCHESS: Covid content, Instant Library, Discussion Groups, Personal Stories, Location Monitor, Surveys and Ecological Momentary Assessments, Guided Relaxation, Healthy Activities, Crisis Button, Skills Reminders
University of Wisconsin
Madison, Wisconsin, United States
% of Patient Risky Drinking Days
Risky drinking day will be defined as greater than 4 drinks for men and greater than 3 drinks for women and will be measured through the Timeline Followback every 120 days.
Time frame: Baseline, 4, 8, and 12 months
Psychological Distress
The OQ45 measures the patient's and partner's outcomes during treatment by assessing three sub-domains, Symptom Distress, Interpersonal Relations, and Social Role. Scores from the Outcomes Questionnaire-45 range from 0-180, the higher the score, the higher the symptoms of distress. Cut-off score: 63 or more - indicates symptoms of clinical significance A high score suggests that the client is admitting to a large number of symptoms of distress (mainly anxiety, depression, somatic problems and stress) as well as difficulties in interpersonal relationships, social role (such as work or school), and in their general quality of life. Reliable change: indicated when a client's score changes by 14 points or more.
Time frame: Baseline, 4, 8, and 12 months
% Days Abstinent
% days abstinent will be measured through the Timeline Followback every 120 days.
Time frame: Baseline, 4, 8, and 12 months
Relationship Satisfaction
Determined by use of the Dyadic Adjustment Scale - 7 (DAS-7) which is a brief version of the 32 question Dyadic Adjustment Scale (DAS) and assesses the quality of marriage and similar dyads. Possible range is 0-36. Higher scores indicate more positive relationship quality. Scores less than 21 are considered to indicate a relationship in distress.
Time frame: Baseline, 4, 8, and 12 months
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