Deposit Contracts to Increase Accessibility of a Contingency Management Intervention to Reduce Problematic Drinking

Study Overview
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Brief Summary
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This study will examine the effects of an incentive-based intervention (for reducing alcohol use) that would be sustainable, easily accessible intervention using remote alcohol monitoring and deposit contracts, targeting individuals who would not be reached by more traditional forms of treatment due to barriers such as time constraints, attitudes, and stigma.

Detailed Description
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Deposit contracts are effective at treating a wide variety of problems: smoking cessation, weight loss, and increasing physical activity. Despite the promise of deposit contracts, few earlier studies targeted problem drinking, since doing so required burdensome frequent monitoring - now overcome by remote alcohol monitoring. Earlier work relied on self- and collateral reports, breath alcohol concentrations during clinic visits, or an indirect non-specific marker of alcohol use. Despite these difficulties, earlier studies of deposit contracts were encouraging, with notable increases in: therapy participation; retention ; and abstinence duration compared to previous reports. Collectively, these studies show the potential of deposit contracts to reduce problem drinking but provide only limited evidence of its effectiveness. Still, these studies, and our recent success using contingency management with remote alcohol monitoring, provide a compelling rationale for examining whether a deposit contract program might provide a feasible, effective, and accessible way of helping people reduce drinking. Though there is limited systematic research on deposit contracts, deposit contract programs for various problems are widely available and have proven quite attractive. For example, a deposit contract weight loss website, has over 887,000 users with $62M in incentives paid. However, it is unclear if deposit contracts would be acceptable (and therefore feasible) to individuals interested in reducing their problem drinking. Therefore, we feel that the proposed deposit contract intervention utilizing remote alcohol monitoring could be a widely available and acceptable intervention for problem drinking for three reasons: (1) because of the effectiveness and convenience of our contingency management intervention using remote alcohol monitoring; (2) because of the widespread success of other deposit contract programs like DietBetã; and (3) because the potentially increased attractiveness and effectiveness of an intervention that can return an amount greater than the deposit. The adoption of a deposit contract intervention plus remote alcohol monitoring will only be accelerated by the FitBit-style alcohol monitoring devices being developed by many companies (we are currently independently evaluating one such device). However, making deposit contracts widely available will need evidence of their effectiveness, which requires large randomized controlled trials. The purpose of this R21 application is to develop this evidence by demonstrating that deposit contracts with remote alcohol monitoring are feasible and provide evidence of effectiveness needed to design and justify future studies.

Official Title
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Piloting Deposit Contracts to Increase Accessibility of a Contingency Management Intervention to Reduce Problematic Drinking

Conditions
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Alcohol Abuse, Alcohol Intervention, Transdermal Alcohol Monitoring, Contingency Management, Deposit Contract

Intervention / Treatment
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* Behavioral: Deposit Contract
* Other: Transdermal Alcohol Monitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: at least 21 years of age report > 8 heavy drinking episodes during the last 28 days want to reduce their alcohol use are willing to wear a transdermal alcohol monitor own a smartphone are willing and able to deposit $200

Ages Eligible for Study
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Minimum Age: 21 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: Monitoring Group Only<br>Individuals in the Monitoring only group will be required to put down a 200$ deposit but will earn it back non-contingently by attending the weekly study meetings. They will be monitored using the Transdermal Alcohol Monitoring device, but will not be required to meet any Alcohol reduction goals to earn their deposit back. | Other: Transdermal Alcohol Monitoring<br>* Using a SCRAM-Cam device participants will be monitored for their alcohol use.<br>|
| Experimental: Deposit Contract Group<br>Individuals in the Deposit COntract group will be required to put down a 200$ deposit but will earn it back, as well as a bonus, contingently for meeting alcohol reduction requirements. For this study, this is counted as having a Transdermal Alcohol COntent below equal to .02 g/dl. They will be monitored using the Transdermal Alcohol Monitoring device. | Behavioral: Deposit Contract<br>* A deposit contract requires individuals to put down money that is earned back contingently upon meeting their goals.<br>Other: Transdermal Alcohol Monitoring<br>* Using a SCRAM-Cam device participants will be monitored for their alcohol use.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Transdermal Alcohol Content | Measurement produced while wearing Transdermal Alcohol Monitor | 4 weeks continuously |