U.S. military service members engaged in alcohol misuse are a vulnerable population with high unmet need. Alcohol misuse is a stage of problem drinking that occurs before abuse and dependence, placing service members'partners and families at risk for serious consequences. Unfortunately, existing military reporting policies may discourage service members from seeking help for fear of negative career consequences. Service members report encouragement from their partners as the most prevalent facilitator of seeking care and individuals who change their drinking patterns most often cite partner support as the most helpful mechanism in supporting change. Thus, targeting service members'partners using preventive interventions can be an important vehicle for preventing the progression to abuse and dependence. We propose a 3-year study to adapt and pilot-test a web-based intervention (WBI) intended to help concerned partners (CPs) provide support to service members with alcohol misuse and to begin development of a service member module based on service member's input. We will first adapt an evidence-based intervention known as Community Reinforcement and Family Training (CRAFT) intervention to the web to help overcome barriers related to confidentiality concerns and access. Our proposal has three specific aims.
Aim 1 : Develop a 4-session web- based intervention (WBI) prototype and make iterative revisions based on feedback from 15-20 CPs.
Aim 2 : Conduct a randomized controlled pilot-test of the finalized WBI (n=50) compared to delayed WBI (n=50), and evaluate the impact of the WBI on CP's reports of service member help-seeking (e.g., counseling, self-help, primary care, treatment) and drinking, and CP well-being and relationship satisfaction three months after the intervention.
Aim 3 : Begin development of a follow-on WBI module for service members based on service member input and content evaluation. We will explore the service member's intervention preferences and obtain their feedback on a proposed WBI for them. Our project is significant because it has the potential to benefit a large population of military service members who may be disproportionately affected by the current OEF/OIF/OND conflicts and whose drinking misuse would otherwise go undetected and untreated. It also develops a new prevention model that does not rely on service members or partners attending a hospital or clinical facility to access care. The proposed study is innovative because there are no CP-based preventive interventions addressing misuse. This pilot study will inform the development of an R01 trial that evaluates a larger randomized study of a WBI for CPs with a follow-on intervention for service members.
The current study addresses an important public health problem: alcohol misuse among military service members. This is an innovative preventive intervention because it targets CPs, is web-based, and exists outside the traditional health care system as a stand-alone health promotion intervention. If this intervention is found to increase engagement in alcohol abuse services, reduce alcohol consumption in service members, and improve relationship functioning, the DoD will have a low-stigma, readily accessible tool that will enhance overall force health and readiness and could also be effective in the general population for preventing the progression of alcohol use disorders and for reducing the overall prevalence of alcohol use disorders.
|Osilla, Karen Chan; Pedersen, Eric R; Gore, Kristie et al. (2014) Study design to develop and pilot-test a web intervention for partners of military service members with alcohol misuse. Addict Sci Clin Pract 9:18|