Reducing Drinking Among People Experiencing Homelessness: Protocol for the Development and Testing of a Just-in-Time Adaptive Intervention

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Adults who are homeless are more likely to have alcohol use disorders (AUDs) compared with domiciled adults. Although AUD treatments are commonly available, many factors (e.g., transportation limitations, inability to schedule appointments) contribute to low treatment completion rates and low success rates of these interventions among homeless adults. Most adults who are homeless own mobile phones, however, no interventions have been developed that use mobile devices to deliver and/or support AUD interventions for this population. Mobile phone-based AUD interventions may reduce barriers that have limited the use and utility of traditional interventions Objective: This study will (1) identify variables (e.g., affect, stress, geolocation, cravings) that predict drinking among homeless adults (Phase I), (2) develop a mobile intervention that utilizes an algorithm to identify moments of risk for drinking and deliver treatment messages that are tailored to the individual’s current needs in real time (Phase II), and (3) pilot test the intervention app (Phase III). Methods: In Phase I, homeless adults with an AUD (N=80) will complete baseline, equipment, 2-week, and 4-week follow-up visits in person. Participants will be prompted to complete five daily ecological momentary assessments on a study-provided smartphone for 28 days. The smartphone app will collect GPS coordinates every 5 minutes for the entire 28-day study period. Participants will wear a transdermal alcohol sensor that will objectively measure alcohol use. In Phase II, we will use Phase I data to develop an algorithm that identifies moments of heightened risk for drinking and develop treatment messages that address drinking risk factors. Phase III will pilot test the intervention in 40 homeless adults with AUD Results: Data collection for Phase I began in February 2019. Phase III data collection is expected to conclude in April 2020. Conclusions: This research will highlight intervention targets and develop a novel intervention for understudied and underserved homeless adults with AUD. Clinical Trial: Clinicaltrials.gov NCT03746808.