Computerized Alcohol Misuse Intervention System for Health Care



Status:Not yet recruiting
Conditions:Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - Any
Updated:4/21/2016
Start Date:April 2016
End Date:August 2016
Contact:Diana H Caldwell, PhD
Email:dcaldwell@researchcircle.org
Phone:410-435-7455

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Micro-targeted Computerized Alcohol Misuse Intervention System for Health Care

This project expands upon the proof-of-concept work done under the pilot project in order to
get Interventionaire© poised for more widespread use. Interventionaire© is designed to
deploy a computerized interactive questionnaire to patients in a physician waiting room. The
information gathered is intended to be a conversation starter for primary care providers and
patients (who may feel more at ease with the computer in revealing health risk behaviors,
like alcohol abuse). Widespread use of Interventionaire© could result in a substantial cost
savings by delivering a wide reaching and highly acceptable prevention strategy for
integrating risky health behavior screening and brief intervention into mainstream medical
practice.The investigators overall hypothesis is that participants receiving the
computerized intervention will have greater improvement than those receiving the attention
control condition.

Alcohol misuse continues to pose a major burden for public health. Screening and brief
intervention for alcohol misuse in primary care settings has been recommended for decades,
and the evidence base supporting it in primary care is robust. However, many primary care
providers do not intervene in alcohol misuse, and those that do often fail to do so
systematically or in accordance with best-evidence standards. Computerization of screening
and brief intervention for alcohol misuse holds the promise of alleviating many of the
barriers that have prevented its adoption into routine care, and also offers new
opportunities for optimizing the effectiveness of brief interventions. This Phase 2 Small
Business Technology Transfer (STTR) project follows up on Research Circle Associates' (RCA)
successful proof-of-concept work done under Phase 1, which led to the development of a
versatile software platform (Interventionaire©) to support computerized alcohol misuse
screening and brief intervention using evidence based strategies including motivational
interviewing and normative feedback. The investigators' computerized alcohol misuse
intervention includes a normative feedback component that is unique in its micro-targeting
of alcohol use feedback based on participant demographic characteristics (race/ethnicity,
gender, and age), drawing population normative data from the National Surveys on Drug Use
and Health. This represents a novel use of epidemiological data to inform clinical services.
The Phase 2 project is designed to answer a number of important research questions and
prepare the product for successful commercialization. Specifically, during Phase 2 the
investigators intend to implement several refinements into the Interventionaire© platform
that will increase its usability and streamline the creation of complex content with
tailored feedback. The investigators will also upgrade the software to make it compatible
with a major electronic health record system used by the investigators' clinical partner
site. This will increase the reach of the product and ensure maximum readiness for
deployment into the modern healthcare marketplace, a dynamic and rapidly evolving industry.
The investigators will also conduct a study at the investigators' clinical partner site
using qualitative key informant, focus group, and survey methodologies to investigate
barriers to adopting computerized alcohol screening and brief intervention systems. A
critical question is whether the computerized alcohol misuse intervention is effective in
changing drinking behavior. To answer this question, the investigators will conduct a
cross-over randomized controlled trial examining the short-term impact of the computerized
alcohol misuse intervention with micro-targeted normative feedback and motivational
messaging compared to an "attention-control" (placebo) generic health promotion message.
This trial will help to establish the short-term efficacy of the intervention and set the
stage for larger trials and adoption of the product in healthcare settings. Finally, the
investigators will conduct a projection analysis of the economic and health impacts of the
intervention under a variety of assumptions regarding intervention effect size, target
population, and product penetration. Satisfying these Phase 2 objectives will leave RCA
well-poised to deploy the product commercially, which will leverage the power of the market
to improve clinical service delivery and promote public health.

Inclusion Criteria:

- Adult age 18 and older;

- Positive AUDIT screening score; and

- Willing to provide contact information for themselves and two friends or family
members (to assist with tracking for follow-up).

Exclusion Criteria:

- Inability to give informed consent (e.g., due to cognitive impairment);

- Acute medical or psychiatric problem that precludes ability to complete the study
interview or intervention;

- Inability to comprehend or read English.
We found this trial at
1
site
Baltimore, Maryland 21225
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from
Baltimore, MD
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