Efficacy of a Smartphone-Based Just-In-Time Adaptive Intervention to Reduce Drinking Among Adults Experiencing Homelessness
University of Oklahoma
Summary
Approximately 1 out of every 3 adults experiencing homelessness has a current alcohol use disorder (AUD). Alcohol use plays a central role in increased morbidity and mortality in this population, with some studies suggesting it plays a direct role in as many as 17% of deaths. Alcohol is also a leading cause of homelessness and contributes to its chronicity by inhibiting progress toward obtaining employment and a stable living environment. Shelter-based treatments are common, but compliance is often poor. There are many documented challenges to effectively implementing traditional evidence-based interventions in shelter settings. In the current project, we will conduct a randomized controlled trial. Adults currently experiencing homelessness who report hazardous alcohol use (N = 600) will be recruited from five shelters across the Dallas, TX and Oklahoma City, OK metropolitan areas. Individuals will attend screening and training visits, then complete one week of self-monitoring (via smartphone app) before being randomized to receive either standard shelter-based treatment (Usual Care; UC), or the Smart-T Alcohol intervention + UC. The Smart-T Alcohol intervention offers on-demand content and automated contextually tailored messages to reduce alcohol consumption. The intervention period will span eight-weeks (i.e., weeks 2-9), with follow-up assessments occurring at weeks 9, 13, and 26. All participants will complete brief daily smartphone-based surveys for 13 weeks. Aims of the project will be to assess the effects of the Smart-T Alcohol intervention on alcohol use and alcohol-related problems (Aim 1), intervention effects on key drinking risk indicators and their mediation of use outcomes (Aim 2), and identify specific subpopulations (e.g., women, racial/ethnic minorities, younger adults; Exploratory Aim 3) for which the intervention is most effective. Findings will provide a rigorous evaluation of the efficacy of the Smart-T Alcohol intervention and guide future smartphone-based interventions for this population.
Description
The study will test the efficacy of a novel smartphone-based alcohol use reduction intervention (i.e., Smart-T Alcohol) relative to Usual Care in an RCT of heavy-drinking adults experiencing homelessness (N = 600). Participants will complete a screening visit on-site at one of our partnering shelters. Eligible participants will receive training in our smartphone-based assessment platform and may be provided with a compatible device if they do not own one. All participants will use the app to complete four brief (1-2 minute) daily EMAs for 1 week to obtain baseline drinking levels and psychosoc…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * At least 18 years old * 8 or above on the AUDIT * Receiving shelter-based services * Consuming 1 or more standard drink of alcohol in the past week * Score of 4 or higher on the REALM-SF * Score under 8 on the 6CIT Exclusion Criteria: * Under 18 years old * Not meeting other inclusion criteria
Interventions
- OtherSmart-T Alcohol
The Smart-T Alcohol intervention offers on-demand content and automated contextually tailored messages to reduce alcohol consumption. The intervention period will span eight-weeks (i.e., weeks 2-9), with follow-up assessments occurring at weeks 9, 13, and 26. All participants will complete brief daily smartphone-based surveys for 13 weeks.
- OtherUsual Care
Participants will receive standard shelter-based treatment (Usual Care) along with completing surveys and assessments.
Location
- University of Oklahoma Health Sciences CenterOklahoma City, Oklahoma