Family-focused vs. Drinker-focused Smartphone Interventions to Reduce Drinking-related Consequences of COVID-19

Not Applicable

Completed

Conditions: Family Members
Behavior, Addictive
Alcohol Use Disorder

Interventions: Behavioral: ACHESS
Behavioral: PartnerCHESS

Registration Number: NCT05419128

Lead Sponsor: University of Wisconsin, Madison

Brief Summary: 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.

Detailed Description: 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.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 398

Inclusion Criteria

Identified patients and their concerned significant others must give informed consent; agree to complete interviews at baseline, 4, 8, and 12 months; and not have a mental or physical condition that limits smartphone use. Identified patients must be age 18 or older and meet criteria for risky drinking (for men, >4 standard drinks in a day; for women, >3 in a day), or meet criteria for AUD (any severity) defined by DSM-5 and have had at least 1 drink in the past 3 months . Partner must be a committed romantic partner/spouse, close friend or family member (e.g. sibling, parent, grandparent, adult child age 21 or older).

Exclusion Criteria

Individuals were not eligible if they had current (last 6 months) evidence of serious mental illness (eg, active psychosis, active manic phase), or if either partner reported serious interpersonal violence, to avoid risk of violence from engagement on potentially sensitive subjects.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ACHESS-C	ACHESS	In ACHESS-C, both the drinker and the partner will receive a smartphone, but only the drinker will receive the ACHESS-C app. The partner will receive a smartphone with contact information for standard AUD, SUD, and crisis support.
FamCHESS-C	PartnerCHESS	In the FamCHESS-C arm, drinker and partner will both receive a smartphone with the FamCHESS-C app, which contains ACHESS-C services plus ABCT/ PartnerCHESS services.

Primary Outcome Measures

Name	Time	Method
% of Patient Risky Drinking Days	Baseline, 4, 8, and 12 months	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.
Psychological Distress	Baseline, 4, 8, and 12 months	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.

Secondary Outcome Measures

Name	Time	Method
% Days Abstinent	Baseline, 4, 8, and 12 months	% days abstinent will be measured through the Timeline Followback every 120 days.
Relationship Satisfaction	Baseline, 4, 8, and 12 months	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.