Homeless adults are 8 times as likely to be alcohol dependent compared with adults in the general population, yet few studies have examined the precipitants of alcohol use in this vulnerable population. This lack of information is a barrier to developing effective alcohol treatments for homeless adults, a population that is often excluded from clinical trials. R34 AA024584-01A1 is developing and testing a ?just-in-time? adaptive smartphone intervention to reduce alcohol use in homeless men and women. We have completed Phase 1 (identification of ?in-the-moment? risk factors that predict imminent drinking) and are nearly finished with Phase 2 (development of the prediction algorithm, treatment messages, and an app to deliver messages based on the risk of ?imminent drinking? within four hours). In Phase 3, we will test the feasibility, acceptability, and preliminary efficacy of the app in a new sample of homeless adults. Following public health recommendations around COVID-19, we began to curtail our human subjects activities in late February, 2020. To comply with university directives, we ceased human subjects activities on 3/17/20. We expect to resume human subjects research in July, 2020. Disruptions from COVID-19 have resulted in an estimated 4 months of delay from a human subjects perspective; the current supplement request is necessary to complete Phase 3 (Aim 3) of the project.
Homeless adults have higher rates of disease, shorter life expectancies, and disproportionately higher health care utilization and costs compared to housed individuals. Using a three-phase design, this study is identifying real-time antecedents of drinking among homeless adults, developing risk algorithms and tailored treatment messages, and testing the feasibility, acceptability and preliminary efficacy of a ?just in time? adaptive smartphone app. The supplement request is necessary to complete the final phase of the project, which has been delayed due to COVID-19.
