The goal of this study is to find the most effective and efficient version of the THRIVE app. The THRIVE app is the first app-based preventative intervention that has been found to reduce alcohol misuse and posttraumatic stress in people who have recently experienced sexual assault. In this trial, participants are randomly assigned to receive different versions of the THRIVE app to compare their impact. The THRIVE app is currently only available to participants in this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
464
Participants will engage in activity scheduling in the app (i.e., "Activities" module). On the first day of using the app, users will create a list of valued/important and avoided activities (e.g., spending time with friends, going to the gym), and then have the option to add alcohol protective behavioral strategies (e.g., adding ice to drinks, alternating alcoholic and nonalcoholic beverages) to activities that the user identifies as being likely to involve drinking. On subsequent days, users will be encouraged to complete at least one activity from their list.
Participants will engage in cognitive restructuring in the app (i.e., "Thoughts" activities). Users first go through an activity involving the identification of maladaptive cognitions and create a list of their maladaptive cognitions. On subsequent days, they engage in a guided in-app activity involving cognitive restructuring of maladaptive cognitions from their list.
Participants will receive 10-20 minute weekly coaching calls during the app use period (4 total, including coaching provided in the enrollment call). All coaching calls will, at minimum, include a check-in, troubleshooting of technical issues, check-in about experience with symptom self-monitoring, and offers of referrals. Coaching calls in conditions involving activity scheduling will involve assistance with the Activities module. Coaching calls in conditions involving cognitive restructuring will involve assistance with the Thoughts module.
All participants, regardless of condition, will receive the following non-core THRIVE components. * 21 days of brief self-report surveys in the app assessing their PTSD symptoms and alcohol use in the prior 24 hours. * A banner in their app displaying rotating non-personalized encouraging messages from other users. All app users will have the option of submitting encouraging statements to be displayed to all other users. Statements will be vetted by study staff before posting. * Lists of referral options specific to each recruitment site via the "Resources" section of the app. * Answers to frequently asked questions about the study, the study consent form, and contact information for the study team via the "Information" section of the app. * One call with a study "point person" within the first week following randomization to ensure they were able to access the app and troubleshoot access issues
University of Washington
Seattle, Washington, United States
RECRUITINGPast-month alcohol problems
Assessed using the 16-item Short Form Rutgers Alcohol Problem Index (S-RAPI). Minimum score = 0, maximum score = 64, higher scores mean greater severity of problems.
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, 1 year
Past-month number of drinks
Assessed via the online Timeline Followback (TLFB)
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, 1 year
Past-month number of drinking days
Assessed via the online Timeline Followback (TLFB)
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, 1 year
Past-month peak drinks
Assessed via the online Timeline Followback (TLFB)
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, 1 year
Past-month frequency of heavy episodic drinking
Assessed via the online Timeline Followback (TLFB)
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, 1 year
Past-month posttraumatic stress symptom severity
Assessed using the PTSD Checklist (PCL-5) in relation to the index assault. Minimum score = 0, maximum score = 80, higher scores mean greater severity of posttraumatic stress.
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, 1 year
Past-month provisional diagnosis of posttraumatic stress disorder
Assessed using the PTSD Checklist (PCL-5) in relation to the index assault. Provisional posttraumatic stress disorder diagnosis is defined as a score greater than or equal to 31.
Time frame: Baseline, 1 month, 3 months, 6 months, 9 months, 1 year
Drug use & problems
Assessed using the The Tobacco, Alcohol, Prescription medications, and other Substance (TAPS) Tool Part 2 (not including alcohol questions)
Time frame: Baseline, 3 months, 6 months, 9 months, 1 year
Cannabis use & problems
Assessed using the Cannabis Use Disorder Identification Test - Revised (CUDIT-R). Minimum score = 0, maximum score = 32, higher scores indicate hazardous cannabis use/possible cannabis use disorder.
Time frame: Baseline, 3 months, 6 months, 9 months, 1 year
Depression
Assessed using the Center for Epidemiologic Studies Depression Scale - 10 item version. Minimum score = 0, maximum score = 30, higher scores mean greater depressive mood symptoms
Time frame: Baseline, 3 months, 6 months, 9 months, 1 year
Anxiety
Assessed using the Generalized Anxiety Disorder-7 scale. Minimum score = 0, maximum score = 21, higher scores indicate greater severity of generalized anxiety symptoms.
Time frame: Baseline, 3 months, 6 months, 9 months, 1 year
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