N/A
N=119
Development and Testing of a Just-in-Time Adaptive Smart Phone Intervention to Reduce Drinking Among Homeless Adults
Alcohol Use Disorder · Treatment · Homelessness
Bottom Line
View on ClinicalTrials.gov: NCT03746808 ↗Enrolled (actual)
119
Serious AEs
0.0%
Results posted
Nov 2022
Primary outcome: Primary: Satisfaction With App Treatment Messages — 3.9; 3.6; 3.8; 4.0 score on a scale
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- EMA + App/Treatment Messages (Behavioral)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- University of North Texas Health Science Center
- Primary completion
- Jul 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Satisfaction With App Treatment Messages |
3.9; 3.6; 3.8; 4.0 | — |
| SECONDARY Number of Drinking Days |
13.9; 11.2 | — |
| SECONDARY Number of Heavy Drinking Days |
3.42; 3.64 | — |
Summary
Homeless adults are 8 times as likely to be alcohol dependent compared with adults in the general population, yet few studies have examined the precipitants of alcohol use in this vulnerable population. Ecological momentary assessments (EMAs) that involve repeated assessment of thoughts/mood/behaviors (e.g., via smart phone) is currently the most accurate way to assess individuals in real-time in their natural environments. Advances in smartphone technology also allow for the collection of continuous geolocation and other passive sensing data. Thus, researchers can now link environmental risks and protective factors to outcomes, without reliance on subjective reporting alone. Building on prior work, this study will use a three-phase study to develop and test a "just in time" adaptive intervention to reduce alcohol use in homeless men and women. Phase I will use smartphones and passive sensing technologies to monitor geolocation, psychosocial variables (e.g., stress, affect, urge to drink), and alcohol use in a group of 80 homeless adults with an AUD who are receiving shelter-based treatment. Phase I will identify environmental (i.e., geolocation), cognitive, and behavioral antecedents of alcohol use over 4 weeks. Phase II will use this information to create a risk algorithm and tailored treatment messages that anticipate and intervene to prevent drinking. The resulting app will assess imminent risk of alcohol use after each EMA and will deliver relevant treatment messages that match a person's current risk factors. Phase III will test the feasibility, acceptability and preliminary efficacy of the app in a sample of 40 homeless adults with an AUD who receive the EMA plus treatment messages over 4 weeks. Drinking will be determined via self-report, supplemented by a transdermal alcohol sensor (i.e., SCRAM) worn by participants. This project will be the first to combine geolocation and psychosocial variables to identify real-time antecedents of drinking. If effective, this smartphone app could significantly improve treatment engagement, drinking outcomes, and quality of life among homeless adults with alcohol use disorders.
Eligibility Criteria
Inclusion Criteria
- Score ≥ 8 on the AUDIT
- Report consuming ≥ 1 drink of alcohol in the past week
- Receiving treatment at Metrocare;
- Willing and able to complete the baseline and follow-up visits;
- Score ≥ 4 on the REALM-SF, indicating > 6th grade English literacy level
- Score ≥ 24 on the Mini-Mental State Exam
Exclusion Criteria
- Circulation problems, neuropathy, deep vein thrombosis, leg ulcers, tendonitis, diabetes, pregnancy, history of swelling or nickel or other metal allergies that would prohibit wearing the SCRAM ankle bracelet.
- Self-reported discomfort wearing an alcohol sensing bracelet for 4 weeks.
- Previously participated in Phase I (for Phase III recruitment).
Data sourced from ClinicalTrials.gov (NCT03746808). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.