A Peer Recovery Coaching Intervention for Hospitalized Alcohol Use Disorder Patients
NCT Number: NCT06479681
Acronym: RC-Link
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Alcohol Use Disorder
Interventions: BEHAVIORAL: Peer recovery coaching (PRC)|BEHAVIORAL: Brief Intervention (SBIRT)
Sponsor: Clemson University
Collaborators: Prisma Health-Upstate|National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 750
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (OUTCOMES_ASSESSOR)|Primary Purpose: TREATMENT
Start Date: 2024-04-25
Completion Date: 2028-06-02
Locations: Greenville Memorial Hospital, Greenville, South Carolina, 29605, United States|Oconee Memorial Hospital, Seneca, South Carolina, 29672, United States

Summary:
The project objective is to rigorously evaluate the effectiveness of a peer recovery coaching intervention (called RC-Link) in patients hospitalized with medical complications from alcohol use on recovery outcomes guided by the new NIAAA definition of recovery, examine mechanisms of heavy drinking using daily ecological momentary assessment (EMA), and determine the program's cost-effectiveness using an randomized controlled trial (RCT) design. The primary outcomes are frequency of heavy drinking, biopsychosocial functioning, and remission from AUD.

Primary Outcome Measures: Change in Percentage of Heavy Drinking Days Per Month, This outcome will be measured using the Alcohol Timeline Follow Back (TLFB), a calendar-based, self-report survey. The TLFB is the most widely used measure of alcohol use frequency in treatment trials for AUD and has strong reliability and validity in diverse populations., one-month, 3-months, 6-months|Remission from Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) AUD Diagnosis, The DSM-5 checklist for AUD will be used to assess AUD diagnosis. Remission is defined as meeting 0 of the 11 criteria for AUD diagnosis, excluding craving. According to the NIAAA recovery definition, cessation of heavy drinking and AUD remission are classified as the following durations: initial (0-3 months), early (3-12 months), sustained (1-5 years), and stable (\>5 years). Using this definition, primary study endpoints will be 1-month post-baseline (initial recovery; past 1 month symptoms), 3-month post-baseline (early recovery; past 3-month symptoms), 6-month post-baseline (end of intervention period), and 1-year post-baseline (sustained recovery; past 12-month symptoms), one-month, 3-months, 6-months, 12-months|Change in Biopsychosocial Functioning, The self-report World Health Organization (WHO) Quality of Life brief version (WHOQoL-BREF) will measure biopsychosocial functioning. There are subscales for physical functioning, psychological functioning, level of independence, social relationships, environment, and spirituality. Items are scored on a 1 - 5 scale with higher scores reflecting higher levels of that subscale domain. These items are them transformed so that the raw scale score for each domain is converted to a 0-100 scale with higher scores reflecting greater quality of life on that domain., one-month, 3-months, 6-months|Cost Effectiveness, The intervention cost will be determined by gauging recovery coach salaries and additional medical provider and support staff time required, and applying this cost to each interaction. We will examine the cost of hospital services (hospital charges), including emergency department visits, hospitalizations, psychiatric inpatient stay, medical outpatient costs, and physician professional fee costs., 6-months
Secondary Outcome Measures: Change in Coping, The self-reported Brief Coping Orientation to Problems Experienced (COPE) Inventory 28-item scale will be used and administered. Items on this scale range from 1 (I haven't been doing this at all) to 4 (I have been doing this a lot). There are two items for 14 coping strategies, such as self-distraction, emotional support, humor, self-blame, and denial. Higher scores reflect a higher degree of engaging in a particular coping strategies., one-month, 3-months, 6-months, 12-months|Change in linkage to and engagement in Evidence-Based Practices, Percentage of participants linked and percentage of participants engaged: Participants will indicate the types of evidence-based practices (EBPs) for AUD that they have been engaged in and the number of days they engaged in EBPs in the past month. EBPs for AUD are defined by the NIAAA as FDA-approved pharmacology for AUD (disulfiram, acamprosate \& naltrexone), inpatient/outpatient rehabilitation, therapy/counseling, and mutual aid programs (e.g., 12-step programs, SMART recovery, etc.)., one-month, 3-months, 6-months, 12-months|Change in linkage to and engagement in Social Determinants of Health (SDoH) resources, Percentage of participants linked and percentage of participants utilizing resources: Participants will be asked if anyone (family/friend, recovery coach, social worker, etc.) helped provide them with housing, employment, education, food security, or transportation assistance in the past month, and if so, what services and who helped them., one-month, 3-months, 6-months, 12-months|Hospital Utilization, Hospital utilization refers to the number of overall and alcohol-specific inpatient admission and emergency visits., 6-months|EMA: Heavy Drinking, Two-items from the Daily Drinking Questionnaire will be used: one queries whether participants drank alcohol that day (yes/no) and the other assesses amount consumed, 6-months|EMA: Breath Alcohol Content (BrAC) Levels, Breath alcohol content levels will be measured using a breathalyzer (BACtrack) as an objective measure of alcohol consumption, which controls for the possibility that differences in self-reported consumption are due to inaccurate reporting., 6-months|EMA: Change in Craving, This will be measured using a single-item questionnaire administered via EMA, 6-months