Behavioral Economic Treatment to Enhance Rural (BETTER) Living

Not Applicable

Completed

Interventions: Behavioral: Volitional choice
Behavioral: Monitoring only
Behavioral: Episodic Future thinking

Brief Summary: The purpose of this trial is to get feedback to help develop programs delivered by phone and text messages to improve wellness and health behaviors. This study will enroll adult participants that have been seen in primary care settings and live in rurally designated areas.

Detailed Description: This study will evaluate acceptability and feasibility of two remotely-delivered behavioral economic intervention components, alone and in combination, using remote text message delivery. The two intervention components are an episodic future thinking component and a volitional choice component. The goal of this work is to develop and determine acceptability and feasibility of a well-specified, accessible, and theory-driven mobile health intervention to reduce harmful alcohol use in people living in rural regions.

Recruitment & Eligibility

Inclusion Criteria

adults presenting in Michigan Medicine primary care
home address in a rurally designated area (e.g., zip code, county),
documented alcohol use in the Electronic Health Record (EHR) (e.g., alcohol use disorder diagnosis, alcohol misuse or heavy alcohol consumption).

Baseline inclusion criteria:

an Alcohol Use Disorders Identification Test (AUDIT-C) score of ≥3 in females or ≥4 in males
regular access to an internet-enabled device (e.g., smart phone, computer, tablet).

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Volitional choice (VC)	Volitional choice	VC creates structured if-then plans to dismantle context-linked alcohol use. Participants will receive up to 3 messages a day that include assessment and intervention messages.
Monitoring only	Monitoring only	This is a control group in which participants will receive general psychoeducation.
Episodic Future thinking (EFT)	Episodic Future thinking	Participants will receive up to 3 messages a day that include assessment and intervention messages.The messages will describe positive, non-alcohol related events at future time points to facilitate extension of temporal consideration toward future-focused perspectives.
Episodic Future thinking plus Volitional choice	Volitional choice	Participants will receive both EFT and VC interventions with text messages.
Episodic Future thinking plus Volitional choice	Episodic Future thinking	Participants will receive both EFT and VC interventions with text messages.

Primary Outcome Measures

Name	Time	Method
Feasibility of the Intervention - Enrollment	Day 1 of Intervention	Percent of participants who elect to receive text messages
Feasibility of the Intervention - Screening	Day 1 of Intervention	Percent of participants who complete intervention phone call
Intervention Acceptability: Number of Participants Who Rated the Intervention as Acceptable	2 Weeks Post-Intervention	Number of participants with positive acceptability ratings who indicated enjoying the intervention at least a little bit. In a phone survey, participants were asked to rate their enjoyment of the intervention on a scale of 1-5, where 1 was "not at all" and 5 was "extremely". Scores of 2 ("a little bit") or more were considered to be positive indicators of acceptability.

Secondary Outcome Measures

Name	Time	Method
Alcohol Consumption	The 2 weeks (14-days) of the intervention period	Average number of standard drinks consumed during the 2-week intervention period per person. A "standard drink" was considered to be 12 oz beer, 1.5 ounce shot of liquor, or 5 oz glass of wine.