| 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. |
Targeted Condition: Alcohol use disorders/misuse
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.
Alcohol and addiction Research Domain Criteria (AARDoC) and alcohol use disorder recovery
This project will integrate and analyze datasets from multisite clinical trials of alcohol use disorder treatments to understand alcohol addiction research domain criteria (AARDoC) phenotypes and biopsychosocial predictors of alcohol use disorder recovery up to three and ten years following treatment.
Young Adult Education on Alcohol & Health (YEAH Study)
This study aims to develop and test a web-based intervention to reduce alcohol and sexual risk behaviors among young women.
Project THRIVE pilot
This study involved developing and preliminarily testing a new app to prevent PTSD and alcohol misuse following recent sexual assault.
Staying in Touch and Engaged Project (STEP)
The “Staying in Touch and Engaged Project” (STEP) aimed to support Housing First residents in staying in touch with researchers and in engaging in meaningful activities during the COVID-19 outbreak and social distancing directives. A 16-week, two-group randomized controlled pilot trial compared remote assessment of substance-use and health-related quality of life assessment paired with immediate versus delayed provision of remotely delivered meaningful activities. The aim of this project was to test whether the meaningful activities package (MAP) engages residents and improves their mood, substance-use outcomes, and physical and mental health-related quality of life.
The project team mailed study invitations to residents in five housing programs (estimated mailed N=538). To date, 32 Housing First residents reached out to consent to participate, responding via mailed consent forms, phone, video conferencing or online survey completion. Of those who consented, 26 have completed baseline assessments, and 11 have completed one-month follow-ups. The study highlighted the difficulties in reaching residents, partly due to the lack of communication technologies.
The team found that the technological divide has grown deeper and more consequential during the pandemic and must be bridged to facilitate social connection, physical and mental health, and basic communication for people marginalized by the lived experience of homelessness and psychiatric, medical and substance use disorder. The team is working to locate additional funds through the UW and WSU to continue participant recruitment and evaluation efforts, achieve the originally proposed sample size and further improve follow-up rates.
Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment
Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.
Project SARAH (Sexual Assault, Recovery & Hope)
Project SARAH is a randomized clinical trial providing treatment for PTSD and alcohol use in the first year following sexual assault for individuals who identify as female. The study aims to test 1) the role of fear and reward in recovery following sexual assault; 2) the efficacy of a PTSD vs an alcohol intervention for promoting recovery; and 3) the type and amount of intervention needed to best promote recovery (e.g., whether individuals need both PTSD and alcohol interventions and whether recovery is improved by intervening on PTSD or alcohol use first).
