There is little published information to guide evidence-based improvements in alcohol detoxification treatment that would lead to improved outcomes following hospitalization. As a result, inpatient detoxification clinical practices have changed little over the past 25 years. This application proposes a five-year period of support for the candidate, providing him with sufficient time and resources to develop as an independent researcher who will conduct trials of aftercare treatment initiation in alcohol detoxification settings. The candidate is an Addiction Medicine specialist who is currently an Associate Professor of Family Medicine at the University at Buffalo (UB). With an early background as a Family Medicine clinical educator at the University of Lousville (UofL), the candidate made a committed shift to a research career track in 1997 and completed a sabbatical in 1998. He then submitted an R01 proposal and a revision that were scored, but not funded. Following this, he resigned from a tenured, full-Professor position at UofL in 2003 and came to UB to seek sponsorship from UB's Research Institute on Addictions in preparation for this proposal. This career award will allow him to develop additional skills needed in treatment initiation theory and design, clinical trial methods, statistical analytic methods, and grantsmanship. A variety of formal and informal didactics during the early portion of the award period are planned to facilitate completion of career development objectives. However, the majority of the award period will be devoted to the supervised preparation for and completion of a pilot clinical trial, the submission of publications, and the submission of an R01 proposal. A novel Peer-delivered Twelve Step Facilitation (P-TSF) intervention will be developed for the pilot study based on the candidate's published preliminary work at UofL. The pilot clinical trial of this K23 will be conducted in the detoxification unit of a large hospital and will compare the treatment outcomes associated with two brief interventions (""""""""Motivational Enhancement Therapy"""""""" or a P-TSF) and a """"""""usual care"""""""" condition. The main outcome measures will be the initiation of aftercare (i.e. treatment/AA initiation) and percent days abstinent. ? ?
