The Development of a Personalized, Real-time Intervention
Condition: Drinking, Alcohol
MeSH terms: Alcohol Drinking
Study type: Interventional

Summary: 
      The investigators propose to enhance our existing coping motive-specific normative feedback
      intervention (PFIcope intervention) by capitalizing on EMA/EMI technology to pair real-time
      affective monitoring with tailored real-time relapse prevention texts for individuals with
      anxiety and depression who drink to cope. The goals of the PFIcope+EMI study are to help
      individuals to identify motives for drinking and to utilize alternate coping strategies for
      negative affect in place of alcohol.
    

Detailed description: 
      Emerging adulthood (ages 18-25) represents and common and problematic time for alcohol use
      and mental health issues, particularly anxiety and depression. Anxiety and depression
      increase the likelihood of developing risky patterns of alcohol use. Indeed, individuals who
      drink alcohol to cope with negative affect, such as anxiety and depression, report more
      alcohol use and more severe use-related consequences. As such, it is important to address
      alcohol use, particularly among a psychiatric population of emerging adults. Despite their
      co-occurrence, treatment as usual for anxiety and depression typically does not address
      alcohol use, and alcohol interventions for emerging adults largely ignore anxiety and
      depression. Emerging research suggests interventions that specifically focus on drinking to
      cope with negative affect are promising in reducing problematic outcomes. For example, the
      investigators previously developed a brief, personalized feedback intervention that
      specifically targeted use of alcohol to cope with negative affect among a normative sample of
      emerging adults (Personalized Feedback Intervention for Coping - PFIcope), which resulted in
      decreased drinking to cope. In order to adapt PFIcope for a psychiatric population and
      augment treatment effects, the investigators propose adding ecological momentary assessment
      (EMA) and intervention (EMI) in order to identify when emerging adults are at most risk for
      problematic alcohol use and intervene when needed. EMA can assess symptoms in real time and
      identify high-risk situations for problematic use (i.e., when experiencing negative affect
      and reports intention to use), which can trigger an in-the-moment EMI during that high-risk
      situation (i.e., individually-chosen relapse prevention coping skills messages).

      The investigators propose to develop a 6-week PFIcope+EMI intervention for 20 emerging adults
      in a psychiatric partial hospitalization program who report drinking alcohol to cope with
      negative affect. This will include: 1) an in-person personalized feedback session to present
      normative information and feedback on problems associated with drinking to cope, to discuss
      the individual's use of alcohol to cope, and to generate relapse prevention coping skills
      messages to be used in the EMI text intervention; 2) EMA to monitor affect and intention to
      drink after discharge; 3) tailored text messages (EMI) based on EMA responses (i.e.,
      individualized coping skills messages when individuals report negative affect and intention
      to drink); and 4) additional EMA to monitor coping skills usage, alcohol use, and drinking to
      cope. The PFIcope+EMI intervention, including its associated real-time assessment and
      messaging systems, is low-cost, easy to program, and can deliver an intervention when
      individuals are at most risk for engaging in problematic alcohol use.
    

Intervention name(s): PFIcope+EMI
Intervention type(s): Behavioral
Intervention description(s): The intervention will be comprised of (1) an initial orientation session where the intervention is introduced, receipt of personalized normative information, motives feedback, and the development of an individual's personalized relapse prevention coping skills messages to be utilized through the course of the intervention; (2) EMA for monitoring of affect, drinking intention, alcohol use, and coping skills use; (3) EMI-tailored text messages sent based on EMA responses: individualized, self-chosen relapse prevention coping skills messages when participants report negative affect and intent to drink.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment