Interventions for Unemployed Hazardous Drinkers
Condition: Unemployment; Hazardous Drinking
Study type: Interventional

Summary: 
      Despite recent improvements in the US economy, unemployment remains a significant concern,
      and estimates indicate that one-third of unemployed persons drink at hazardous levels,
      adversely impacting their health and abilities to find jobs. Reinforcement interventions are
      highly efficacious in reducing substance use, and they can be applied to increase job-seeking
      activities as well. In partnership with CT United Labor Agency, this project is designed to
      reduce hazardous drinking and enhance active participation in job-seeking activities among
      those with job loss. It will evaluate the independent and combined effects of reinforcing
      negative breathalyzer samples and job-seeking activities to ascertain the simplest and most
      cost-effective approach to improving outcomes in this population. Unemployed individuals with
      hazardous drinking (N = 280) will be randomly assigned to one of four conditions using a 2 x
      2 design: standard care, standard care with reinforcement for submitting negative
      breathalyzer samples, standard care with reinforcement for job-seeking activities, or
      standard care plus reinforcement for both negative breathalyzer samples and job-seeking
      activities. Participants in all conditions will receive usual services part of CT United
      Labor Agency, along with a novel remote breath alcohol monitoring procedure. The study
      interventions will be in effect for three months, and participants will be followed for one
      year. Alcohol and other drug use, employment, psychiatric symptoms, and global measures of
      health will be assessed throughout treatment and follow-up. Reinforcing negative breathalyzer
      samples is expected to significantly reduce drinking, and reinforcing job-seeking activities
      is expected to increase re-employment rates and reduce time until job attainment. Reinforcing
      both negative breathalyzer samples and job-seeking activities is hypothesized to improve
      outcomes along both domains. The reinforcement interventions may also decrease psychiatric
      distress and slow progression of physical decline, common among the unemployed. If
      efficacious and cost-effective, results from this study may stimulate adoption of
      reinforcement interventions in the context of unemployment services. Reducing the adverse
      consequences of hazardous drinking and improving job re-entry may have pronounced benefits in
      a highly vulnerable segment of the US population.
    


Intervention name(s): Contingency management for alcohol abstinence; Contingency management for completing job related activities; Job relelated activity contracting
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Participants will earn reinforcement (incentives) for each alcohol negative breath test provided (when prompted to submit a test) during the 12-week intervention period.; Participants will earn reinforcement (incentives) for completing specific job-related activities during the 12-week intervention period.; Participants will complete job-related activity contracts each week with the goal of obtaining employment.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Treatment