A SMART Evaluation of an Adaptive Web-based AUD Treatment for Service Members and Their Partners

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorStanford University

About this trial

The purpose of this study is to evaluate the efficacy of an adaptive web intervention (Partners Connect) on military spouse drinking behaviors (CPs) and service member help-seeking (SMs). The investigators want to identify for whom this intervention is most efficacious and on what drinking behaviors and mechanisms. The investigators hypothesize that the intervention will reduce concerned partner drinking and increase service member help-seeking, compared to website resources, and that phone-based CRAFT will increase help-seeking behaviors, compared to those who are guided via a CRAFT workbook.

Our outcome is to evaluate the efficacy of an adaptive CP intervention on CP well-being and service member help-seeking.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

at least 18 years of age;

be living together with their partner, with no plans to change that status in the next 2 months;

not be in the military themselves (to reduce concerns about mandated reporting of alcohol use);

score ≥4 on the AUDIT-C for females or ≥5 for males/other;

Disqualifiers

CPs in substance use treatment or their SM was in treatment in the last three months;

does not feel safe in the current relationship;

does not understand English fluently;

has an impaired capacity (cognitive, visual, or hearing);

Trial design

Design model

Parallel

Treatments tested in this trial

  • CRAFT Web-Based Intervention

    Behavioral

    Session 1 addresses CPs' mental health issues and drinking. CPs select reasons why they are seeking help and steps they will take towards those goals. Session 2 is focused on improving their relationship through communication exercises. Session 3 is focused on functional analysis of their partner's drinking, and how to positively reinforce their partner's sobriety and negatively reinforce their drinking. Finally, Session 4 focuses on continuing self-care and talking with their partner about their concerns while interacting with them in healthy ways. The WBI contains audio, video, text, and exercises that utilize digital storytelling and vignettes to convey teaching points - a method utilized by the military to address stigma and increase treatment utilization. Actresses portrayed different experiences that the CP may be going through and modeled skills. CPs clicked on the vignette that they most connected with and followed that character across all the sessions.

  • Phone-Based CRAFT

    Behavioral

    The phone-based CRAFT intervention consists of six individual sessions with a CRAFT clinician that will explore what they learned from the WBI and additional skills they need. Session content includes positive reinforcement of non-drinking SM behaviors, refraining from interfering in SM's consequences of alcohol use, communication skills, and self-care.

  • CRAFT Workbook

    Behavioral

    The self-directed CRAFT workbook Table 1.Partners Connect WBI has a parent and partner version that uses CRAFT to help the CP help with understanding, self-care, communication, and actions (e.g., how to react when a partner has been using substances and when they have not been using substances, how to talk to partner so that they are more likely to be heard) and includes more information about communicating than the WBI and several interactive worksheets.

  • Gottman Self-Guided Resources

    Behavioral

    To match time spent reviewing the website, CPs will receive an orientation guide that includes the website URL and a 4-week guide for how they can navigate this website for 20-30 minutes per week (e.g., read article "'It's Not My Fault!': Why Defensiveness is Damaging" and write down one tool to dissolve defensiveness you're willing to try). We will send reminder emails each week to visit the website and include questions in the emails and our first online follow-up survey asking CPs approximately how many times they visited the website and how long they spent viewing content on the website. Reminder emails will be programmed such that CPs get directed automatically to the website if the CP notes no time spent on it.

Treatment groups

744 Participants
are divided into 4 treatment groups
Group A: InterventionExperimental treatment 3 interventions
Group B: ControlActive comparator 1 intervention
Group C: Phone Based CRAFTExperimental treatment 2 interventions
Group D: CRAFT WorkbookActive comparator 2 interventions

Trial outcomes

Primary outcomes

1

CP Depression

Depression as measured by the global score on the Patient Health Questionnaire 9-item (PHQ-9)

Time frame
Baseline to 6 month follow-up
2

CP Anxiety

Anxiety as measured by the global score on the Generalized Anxiety Disorder 7-item scale (GAD-7)

Time frame
Baseline to 6 month follow-up
3

Service Member help-seeking

Completion of the personalized normalized feedback (PNF) component of the intervention as a signal of increase help-seeking behavior

Time frame
Baseline to 6 month

Secondary outcomes

Other outcomes

Sponsors and contacts

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Stanford University

Lead sponsor

University of Southern California

Collaborator

RAND

Collaborator

Northern California Institute of Research and Education

Collaborator

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator