Contingency Management to Reduce Alcohol Use in a Soup Kitchen Sample

Study Overview
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Brief Summary
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Alcohol use and alcohol-related disorders are highly prevalent in soup kitchen users, and this population is overrepresented by minorities and disproportionately affected by alcohol-related morbidity and mortality. Contingency management is a behavioral intervention effective in reducing substance use, but few studies have evaluated the efficacy of contingency management in the context of soup kitchens or homeless programs. The investigators found that contingency management, using a twice weekly testing and reinforcement schedule, had benefits for decreasing drinking in individuals receiving services at a homeless shelter. This study will replicate and extend these earlier findings to a soup kitchen population using more sophisticated alcohol monitoring procedures to better assess the extent of drinking in this group and in response to a contingency management intervention reinforcing submission of negative breath samples. Specifically, 40 hazardous drinkers recruited from a soup kitchen will be randomly assigned to one of two conditions: alcohol monitoring or the same plus reinforcement for provision of daily negative breath alcohol samples. The interventions will be in effect for 3 weeks, and all participants will also wear transdermal continuous alcohol monitors during the intervention period. Objective and subjective indices of alcohol consumption will be evaluated and compared between and within the treatment conditions. This pilot project will provide information regarding the effect size of contingency management reinforcing negative breath samples in an important health disparities group, and results from this study will guide subsequent grant applications focusing on methods to decrease drinking in this underserved population.

Conditions
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Alcohol Abuse, Contingency Management

Intervention / Treatment
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* Behavioral: breath alcohol monitoring
* Behavioral: contingency management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age ≥18 frequent soup kitchen users who drink alcohol willing to wear transdermal alcohol monitor for 3 weeks willing to sign a property transfer form and return SCRAMx equipment Exclusion Criteria: uncontrolled, severe psychopathology and/or severe cognitive impairment non-English speaking in recovery for pathological gambling has a medical condition that would interfere with transdermal alcohol readings legal charges pending that are likely to lead to incarceration

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: breath alcohol monitoring<br>Breath alcohol samples and self-reports of drinking will be collected once daily at lunch and will be used as objective indicators of recent alcohol use. | Behavioral: breath alcohol monitoring<br>* Daily breath alcohol monitoring<br>|
| Experimental: breath monitoring plus prize contingency management<br>Breath alcohol samples and self-reports of drinking will be collected once daily at lunch and will be used as objective indicators of recent alcohol use. Participants of this group earn opportunities to draw cards from a prize bowl for negative breath samples. | Behavioral: breath alcohol monitoring<br>* Daily breath alcohol monitoring<br>Behavioral: contingency management<br>* Participants can earn chance to win prizes for negative breath alcohol samples.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| efficacy of contingency management relative to monitoring only | longest duration of abstinence | week 4 |