Candidate: Dr. Coughlin?s goal is to establish herself as an independent clinical researcher with a systematic line of research focused on reducing health disparities by developing well-specified, highly effective behavioral economic mobile health interventions for risky alcohol users. The applicant has a multifaceted and productive background in behavioral economics and clinical psychology, with F31 and T32 funding from NIAAA since 2014. The overall goal of this K23 is to support Dr. Coughlin in pursuing training and research experiences to integrate mobile intervention development methods with behavioral economics to address risky alcohol use in underserved populations. Career Development Plan: Dr. Coughlin?s career development plan builds on her clinical psychology training and addiction research experience, filling gaps in her professional development to establish the knowledge base, skills, and professional collaborations to become a leader in the field of mobile alcohol use interventions for rural populations. Her comprehensive training plan involves participation in scientific conferences, methods workshops, coursework, and mentorship from leaders in the field, Drs. Frederic Blow and Inbal Nahum-Shani, along with a team of contributors. These activities will develop her expertise in: 1) early alcohol use interventions for rural risky drinkers, 2) mobile collection and analysis of intensive longitudinal daily-level data to inform interventions, and 3) preparation, optimization, and evaluation of mobile multicomponent interventions. These training experiences interface with the proposed research aims with the overall goal of improving the effectiveness, efficiency, and equity of behavioral interventions for alcohol misuse, consistent with the NIAAA?s mission and strategic plans. Research Plan: Dr. Coughlin will use skills gained through training activities in her complementary research plan, guided by the Multiphase Optimization Strategy (MOST) framework, to develop a mobile multicomponent behavioral intervention to reduce alcohol use in rural risky drinkers. She will refine two promising intervention components based on behavioral economic theories of addiction for remote, text message-based delivery prior to 3-waves of field testing of the intervention components and focus testing interviews to incorporate iterative end-user feedback from rural risky drinkers (N=15) recruited from primary care (Aim 1). In the same population and using a randomized factorial trial, Aim 2 will ensure intervention preparation through assessment of acceptability and technical feasibility of the intervention components alone and in combination (N=75), along with preliminary evaluation of candidate behavioral economic mechanisms of change. Consistent with the MOST framework, Aim 2 outcomes will inform a subsequent R01 submission to optimize the mobile behavioral economically informed (mBE) intervention in rural risky drinkers. Over the long-term, data from this study will strategically inform behavior change interventions that directly target behavioral economic constructs and alcohol use outcomes in a population with significant health disparities in access to care.
Excessive alcohol use is the 3rd leading preventable cause of death in the U.S., and is associated with significant economic burden and negative health-related consequences that are undertreated in rural regions. This K23 involves evaluating two remotely-delivered behavioral economic intervention components using remote text message delivery that will lead to the development of a well-specified, novel mobile health intervention for rural risky drinkers. Given the high rates of mobile phone ownership, if the efficacy is established, this intervention will have great promise for increasing access to alcohol intervention services for rural individuals, thereby benefiting public health.
