Interventions for Unemployed Hazardous Drinkers

NCT02559609 | Completed Results DMC

• 2 other identifiers: 15-041-2R01AA023502
• Study Type: interventional
• Target: 240
• Locations: 1 country
• Sites: 1

Brief Summary

Despite recent improvements in the US economy, unemployment remains a significant concern, and estimates indicate that one-third of unemployed persons drink at hazardous levels, adversely impacting their health and abilities to find jobs. Reinforcement interventions are highly efficacious in reducing substance use, and they can be applied to increase job-seeking activities as well. In partnership with CT United Labor Agency, this project is designed to reduce hazardous drinking and enhance active participation in job-seeking activities among those with job loss. It will evaluate the independent and combined effects of reinforcing negative breathalyzer samples and job-seeking activities to ascertain the simplest and most cost-effective approach to improving outcomes in this population. Unemployed individuals with hazardous drinking (N = 280) will be randomly assigned to one of four conditions using a 2 x 2 design: standard care, standard care with reinforcement for submitting negative breathalyzer samples, standard care with reinforcement for job-seeking activities, or standard care plus reinforcement for both negative breathalyzer samples and job-seeking activities. Participants in all conditions will receive usual services part of CT United Labor Agency, along with a novel remote breath alcohol monitoring procedure. The study interventions will be in effect for three months, and participants will be followed for one year. Alcohol and other drug use, employment, psychiatric symptoms, and global measures of health will be assessed throughout treatment and follow-up. Reinforcing negative breathalyzer samples is expected to significantly reduce drinking, and reinforcing job-seeking activities is expected to increase re-employment rates and reduce time until job attainment. Reinforcing both negative breathalyzer samples and job-seeking activities is hypothesized to improve outcomes along both domains. The reinforcement interventions may also decrease psychiatric distress and slow progression of physical decline, common among the unemployed. If efficacious and cost-effective, results from this study may stimulate adoption of reinforcement interventions in the context of unemployment services. Reducing the adverse consequences of hazardous drinking and improving job re-entry may have pronounced benefits in a highly vulnerable segment of the US population.

Conditions

Unemployment; Hazardous Drinking

Outcome Measures

Primary Outcomes (4)

• Longest Duration of Alcohol Abstinence (Samples) (Physiological Measure)

  Greatest number of consecutive breath tests submitted on-time (within 1 hour of prompt) and reading alcohol negative (BAL \< 0.02)

  12 weeks

• Percent Alcohol Negative Breath Tests

  Of alcohol breath tests requested, the percentage submitted on-time (within 1-hour of prompt) and reading alcohol-negative (BAL \< .02)

  12 weeks

• Percent of Days Worked for Pay (Missing Data Treated as Missing)

  The percentage of days of work for pay (in the formal or informal economy), with the number of days of data in the denominator (missing data considered missing)

  12 weeks

• Time to First Worked

  From study day 1, the number of days until first worked in the formal or informal economy during the 12-week intervention, censored at day 85.

  12 weeks

Secondary Outcomes (2)

• Percent of Days Worked for Pay (84 Day Intervention Period in the Denominator)

  12 weeks

• Longest Duration of Alcohol Abstinence (Days) (Physiological Measure)

  12 weeks

Study Arms (4)

job activity contracting

ACTIVE COMPARATOR

Standard services plus job activity contracting and alcohol monitoring

Behavioral: Job relelated activity contracting

reinforcement for negative alcohol samples

EXPERIMENTAL

Standard services plus job activity contracting and alcohol monitoring plus reinforcement for negative breath alcohol recordings

Behavioral: Contingency management for alcohol abstinence; Behavioral: Job relelated activity contracting

reinforcement for completing activities

EXPERIMENTAL

Standard services plus job activity contracting and alcohol monitoring plus reinforcement for completing job-related activities

Behavioral: Contingency management for completing job related activities; Behavioral: Job relelated activity contracting

reinforcement for negative alcohol samples & activities

EXPERIMENTAL

Standard services plus job activity contracting and alcohol monitoring plus reinforcement for negative breath alcohol recordings and for completing job-related activities

Behavioral: Contingency management for alcohol abstinence; Behavioral: Contingency management for completing job related activities; Behavioral: Job relelated activity contracting

Interventions

Contingency management for alcohol abstinence BEHAVIORAL

Participants will earn reinforcement (incentives) for each alcohol negative breath test provided (when prompted to submit a test) during the 12-week intervention period.

reinforcement for negative alcohol samples; reinforcement for negative alcohol samples & activities

Contingency management for completing job related activities BEHAVIORAL

Participants will earn reinforcement (incentives) for completing specific job-related activities during the 12-week intervention period.

reinforcement for completing activities; reinforcement for negative alcohol samples & activities

Job relelated activity contracting BEHAVIORAL

Participants will complete job-related activity contracts each week with the goal of obtaining employment.

job activity contracting; reinforcement for completing activities; reinforcement for negative alcohol samples; reinforcement for negative alcohol samples & activities

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age 18-65 years
• not worked for pay in the formal economy for \>4 weeks
• willing to participate in a workforce training program and willing to accept either part-time or full-time work
• hazardous alcohol use defined by AUDIT scores \>8, a mean of \>2 drinks/drinking day or \>14 drinks/week in men (\>1 drink/drinking day or \>7 drinks/week in women) in the past 2 months, or submission of an alcohol positive breathalyzer (\>0.02 g/dl) or EtG positive urine sample
• English or Spanish speaking and able to read at 5th grade level
• have a valid photo ID
• willing and able to use study equipment and sign an off-campus property transfer form

You may not qualify if:

• have begun receiving unemployment benefits within the past 4 weeks
• worked full- or part-time \<3 months in the past 3 years in the formal or informal economy
• physiological alcohol withdrawal symptoms (score \>10 on Clinical Institute Withdrawal Assessment for Alcohol-revised)
• physiological withdrawal symptoms from an illicit drug use disorder
• serious untreated psychiatric illness
• in recovery from gambling disorder

Sponsors & Collaborators

• UConn Health: lead
• National Institute on Alcohol Abuse and Alcoholism (NIAAA): collaborator

Study Sites (1)

United Labor Agency

Middletown, Connecticut, 06457, United States

Location

MeSH Terms

Interventions

Ethanol

Intervention Hierarchy (Ancestors)

Alcohols; Organic Chemicals

Results Point of Contact

• Title: Sheia Alessi
• Organization: UConn Health

salessi@uchc.edu

860-679-1849

Study Officials

• Carla J Rash, Ph.D.

  UConn Health

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: August 24, 2015
• First Posted: September 24, 2015
• Study Start: April 19, 2016
• Primary Completion: June 1, 2022
• Study Completion: June 1, 2022
• Last Updated: April 23, 2024
• Results First Posted: June 22, 2023

Record last verified: 2024-04

Locations

US (1)