Adjunctive Motivational Alcohol Intervention to Prevent IPV

Not Applicable

Recruiting

• Conditions: Alcohol Use and Intimate Partner Violence
• Interventions: Behavioral: Treatment as Usual; Behavioral: Motivational Enhancement Therapy; Behavioral: Alcohol Education Control; Behavioral: Strength at Home

• Registration Number: NCT05287711
• Lead Sponsor: VA Office of Research and Development

Brief Summary

This is a study to provide much-needed experimental data on the efficacy of a brief alcohol Motivational Enhancement Therapy (MET) pre-group intervention for Veterans receiving group treatment for IPV perpetration. The investigators will compare those assigned to receive this 2-session MET intervention to those receiving a 2-session Alcohol Education (AE) intervention or a 2-session standard treatment as usual (TAU) telephone monitoring intervention. The investigators will examine whether MET leads to greater reductions in alcohol use problems and IPV perpetration, and increased help-seeking behavior for alcohol use problems. Participants will be 300 Veterans drawn from the Strength at Home IPV intervention program across the entire Veterans Health Administration system.

Detailed Description

Veterans exposed to trauma are at elevated risk for perpetration of intimate partner violence (IPV) and for the development of alcohol-related problems. Despite commonly found associations between alcohol misuse and IPV, the investigators are aware of no prior research in Veterans examining the impact of adjunctive alcohol interventions for those receiving IPV intervention. The investigators propose to provide much-needed experimental data on the efficacy of a brief 2-session alcohol Motivational Enhancement Therapy (MET) pre-group intervention for Veterans receiving group treatment for IPV perpetration. More specifically, the investigators propose to examine whether those assigned to receive this 2-session MET intervention, relative to those receiving a 2-session Alcohol Education (AE) intervention or a 2-session standard treatment as usual (TAU) telephone monitoring intervention, evidence greater reductions in alcohol use problems and IPV perpetration, and increased help-seeking behavior for alcohol use problems. Participants will be 300 Veterans drawn from the Strength at Home IPV intervention program across the entire Veterans Health Administration system. Participants will be randomized to their pre-group conditions and then assigned to Strength at Home groups for IPV, and will receive referrals for substance use treatment in the VA system or the community. Participants with clinically relevant alcohol use problems, as determined by baseline screening measures, will complete assessments of alcohol use, readiness to change, IPV and help-seeking behavior at baseline, post IPV intervention group (3 months after completion of 2-session alcohol intervention), and four separate 3-month follow-ups after the post-treatment assessment. Differences between conditions on the major outcome variables involving alcohol use, IPV, help-seeking, and treatment engagement will be examined with random-effects regression models using an intent-to-treat approach. Study findings may assist in enhancing the efficacy of IPV interventions for the Veteran population to help ensure the safety and well-being of Veterans and their families.

Study Timeline

• Study First Submitted: 2022-03-09
• Study First Submitted QC: 2022-03-09
• Study First Posted: 2022-03-18
• Study Start: 2023-09-01
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-05
• Last Update Posted: 2024-12-11
• Primary Completion: 2027-09-30
• Study Completion: 2027-09-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 300

Inclusion Criteria

All Veteran participants must meet the following eligibility criteria:

• participant is a Veteran

• minimum age 18

• participant is enrolled in the Strength at Home program following program intake

• participant displays evidence of alcohol-related problems during program intake, as indicated by any of the following:

  • a report of physical IPV while under the influence of alcohol in the past year
  • a score of 8 or greater on the Alcohol Use Disorders Identification Test (AUDIT)
  • consumption of 6 or more standard drinks per occasion on one or more occasions in the previous 6 months
  • average weekly consumption of 14 or more standard drinks in the prior 6 months

• participant provides written consent to participate in the study

• inclusion for this study is broad because this is a population who possesses a number of comorbid problems and exclusion for those based on psychopathology or risk for aggression could potentially lead to a biased sample

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Telephone Monitoring	Treatment as Usual	Brief supportive telephone monitoring sessions that are commonly delivered while Veterans wait to begin their groups (treatment as usual).
Telephone Monitoring	Strength at Home	Brief supportive telephone monitoring sessions that are commonly delivered while Veterans wait to begin their groups (treatment as usual).
Motivational Enhancement Therapy	Motivational Enhancement Therapy	Motivational enhancement therapy for alcohol use problems, which includes empathic support, feedback and advice, strategies for enhancing self-efficacy, techniques for eliciting self-motivational statements from the participant, strategies for addressing participant ambivalence about change and participant resistance to change, and methods for eliciting and affirming commitment to a specific change plan (active intervention).
Alcohol Education Control	Strength at Home	Psychoeducational intervention intended to: (1) dispel myths about the effects of alcohol, (2) provide information about the general risks of drinking and process of recovery from alcohol problems, (3) provide information about the specific risks related to family relationships and IPV, (4) offer self-help program information and related strategies to address drinking problems, (5) promote and encourage healthy decision-making, and (6) reinforce the benefits of abstinence or controlled drinking.
Motivational Enhancement Therapy	Strength at Home	Motivational enhancement therapy for alcohol use problems, which includes empathic support, feedback and advice, strategies for enhancing self-efficacy, techniques for eliciting self-motivational statements from the participant, strategies for addressing participant ambivalence about change and participant resistance to change, and methods for eliciting and affirming commitment to a specific change plan (active intervention).
Alcohol Education Control	Alcohol Education Control	Psychoeducational intervention intended to: (1) dispel myths about the effects of alcohol, (2) provide information about the general risks of drinking and process of recovery from alcohol problems, (3) provide information about the specific risks related to family relationships and IPV, (4) offer self-help program information and related strategies to address drinking problems, (5) promote and encourage healthy decision-making, and (6) reinforce the benefits of abstinence or controlled drinking.

Primary Outcome Measures

Name	Time	Method
Quantity/Frequency of Alcohol Consumption, Self-Report (QFV)	Baseline, post-treatment, three-month, six-month, nine-month, and twelve-month follow-ups	Participants will be shown a standard drink equivalent chart and will answer questions about their typical alcohol consumption quantity (in standard drink units) on weekdays and weekend days, typical drinking frequency (number of consumption days per week) on weekdays and weekend days, and the highest number of standard drinks consumed at a single occasion during the prior 3 months. If participants work unusual schedules, they will be asked to define the weekend as their day or days off from work. If participants report periods of abstinence and periods of drinking in the previous 3 months, the questions will pertain to periods of drinking. Scores will not be reported on a scale, so there are no minimum and maximum values to report.

Secondary Outcome Measures

Name	Time	Method
Revised Conflict Tactics Scales (CTS2)	Baseline, post-treatment, three-month, six-month, nine-month, and twelve-month follow-ups	Intimate partner violence (IPV) will be measured using the CTS2, administered to the client regarding their IPV at baseline and follow-up assessments. We will administer only the Physical Assault (12 items) and Psychological Aggression (8 items) subscales to limit respondent burden and because these are most relevant to study hypotheses. The minimum value is 0 and the maximum value is 8. Higher scores represent higher rates of IPV, except for 7 and 8, which represent year and lifetime use and experience of IPV. Variety scores will be calculated for the CTS2 so that scores reflect the number of positively endorsed IPV behaviors (rather than estimates of IPV frequency). This scoring method is considered more reliable, less skewed, more balanced (since high frequency, less severe aggressive behaviors may outweigh the influence of more severe but less frequent violence), and less influenced by recall errors than other methods.

Trial Locations

Locations (3)

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA; 🇺🇸 Boston, Massachusetts, United States

VA Ann Arbor Healthcare System, Ann Arbor, MI; 🇺🇸 Ann Arbor, Michigan, United States

Minneapolis VA Health Care System, Minneapolis, MN; 🇺🇸 Minneapolis, Minnesota, United States