Targeted Condition: Alcohol use disorders/misuse

Brain, Environment, and Alcohol Research (BEAR) Study

This project examines how brain responses to alcohol cues interact with everyday social contexts to shape drinking in young adult heavy drinkers. We pair multimodal neuroimaging (fMRI, EEG) with a 2-week ecological momentary assessment including transdermal alcohol monitoring and photo-based context capture. We test whether neural incentive salience predicts real-life intoxication, how social features (group size, familiarity, gender mix) influence drinking, and how perceived norms mediate these effects. We further assess whether incentive salience moderates context and norm influences. Findings will refine models of alcohol use disorder etiology and inform prevention and intervention strategies by linking precise brain markers with ecologically valid, context-rich assessments.

Developing a hospital-based treatment engagement program for Alcohol Use Disorder

Alcohol use disorder (AUD) frequently results in serious illness, injuries, and hospitalizations. Surviving illness or injuries related to alcohol use can motivate behavior change that could be harnessed through treatment engagement for AUD in the hospital; however, in general hospital settings, patients are rarely presented with more than a piece of paper with phone numbers to call for help with their drinking. This project is focused on designing and evaluating a shared decision making approach for AUD treatment in hospitalized patients. We are interviewing people who are hospitalized with complications of AUD to better understand their unique needs and preferences. We are using the knowledge gained from interviews with patients to adapt a paper-based decision aid that was originally designed to help clinic patients think about changing their drinking, and creating an interactive web-based interface, tailored to hospitalized patients. We will then evaluate the use and effectiveness of this new online decision aid for engaging hospitalized patients in AUD treatment. The overarching goal of this research is to more effectively use hospitalizations to bridge individuals to long-term, potentially lifesaving AUD care.

Validating changes in a primary-care based alcohol use screening instrument for predicting changes in risk for psychiatric acute care utilization

Approximately 20-25% of primary care patients have unhealthy alcohol use, which can have significant impacts on mental health. Screening for unhealthy alcohol use within primary care settings is increasingly used for point-in-time identification of people who could benefit from brief advice or brief interventions. My project will use a large, longitudinal, real-world dataset consisting of electronic health record (EHR) and insurance claims records to test whether longitudinal changes in alcohol screening scores completed by primary care patients as part of routine care are associated with changes in one-year risk for psychiatric acute care utilization (i.e., emergency department visit or hospital encounters primarily for a mental health condition).

Health Outcomes of Betting on Sports (Project HOBS)

Project HOBS is examining associations between sports betting, mental health, and substance use among young adults. Surveys are collected bi-weekly for one calendar year (25 follow-ups) and at a distal 15-month follow-up.

Using routine alcohol screening measures to identify 1-year risk of suicidal ideation, intent, and planning within a large primary care system in Washington

This study will use a large population-based primary care sample in Washington state to understand how heavy alcohol use and alcohol use disorder symptoms contribute to suicidal thoughts. This study will allow examination of how different levels of alcohol use can predict short term risk of suicidality and allow us to better identify and support patients at risk of suicide in the primary care setting.

A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents

People experiencing chronic homelessness comprise a small yet high-morbidity, high-cost subset of the larger homeless population and are disproportionately impacted by alcohol-related harm. This study proposes a cluster randomized controlled trial of an innovative, community-based, and client-driven program known as the LEAP to explore its impact on substance use and quality of life outcomes among individuals with lived experience of homelessness and alcohol use problems living in Housing First settings. Analyses will test LEAP effectiveness in increasing engagement in meaningful activities, decreasing alcohol use, ameliorating both first- and secondhand alcohol-related harm, and improving quality of life for this population.

Project Better

The co-occurrence of posttraumatic stress disorder (PTSD) and hazardous drinking (HD) can be particularly devastating; though evidence-based treatments exist, many individuals with this co-occurrence drop out from or do not or cannot access specialty care. Text-messaging is a mode of intervention delivery that is low-cost, low-burden, and accessible to most people; development and testing of self-directed text message interventions that use evidence- and theoretically-based strategies to reduce PTSD and HD symptom burden is highly needed. Such interventions have the potential for great clinical significance via providing additional, novel treatment options that are readily scalable and have wide reach and thus can have a large impact on individual and public health.

Project EQUIP

This is a subaward to an R34 awarded to Dr. Melissa Lewis at University of North Texas Health Science Center (UNTHSC). This project develops and tests an intervention for young adults that focuses on motivations for and quality of alcohol and marijuana protective behavior strategy use, including a daily-level examination of these processes.