NCT06821295

Brief Summary

Approximately 1 out of every 3 adults experiencing homelessness has a current alcohol use disorder (AUD). Alcohol use plays a central role in increased morbidity and mortality in this population, with some studies suggesting it plays a direct role in as many as 17% of deaths. Alcohol is also a leading cause of homelessness and contributes to its chronicity by inhibiting progress toward obtaining employment and a stable living environment. Shelter-based treatments are common, but compliance is often poor. There are many documented challenges to effectively implementing traditional evidence-based interventions in shelter settings. In the current project, we will conduct a randomized controlled trial. Adults currently experiencing homelessness who report hazardous alcohol use (N = 600) will be recruited from five shelters across the Dallas, TX and Oklahoma City, OK metropolitan areas. Individuals will attend screening and training visits, then complete one week of self-monitoring (via smartphone app) before being randomized to receive either standard shelter-based treatment (Usual Care; UC), or the Smart-T Alcohol intervention + UC. The Smart-T Alcohol intervention offers on-demand content and automated contextually tailored messages to reduce alcohol consumption. The intervention period will span eight-weeks (i.e., weeks 2-9), with follow-up assessments occurring at weeks 9, 13, and 26. All participants will complete brief daily smartphone-based surveys for 13 weeks. Aims of the project will be to assess the effects of the Smart-T Alcohol intervention on alcohol use and alcohol-related problems (Aim 1), intervention effects on key drinking risk indicators and their mediation of use outcomes (Aim 2), and identify specific subpopulations (e.g., women, racial/ethnic minorities, younger adults; Exploratory Aim 3) for which the intervention is most effective. Findings will provide a rigorous evaluation of the efficacy of the Smart-T Alcohol intervention and guide future smartphone-based interventions for this population.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
600

participants targeted

Target at P75+ for phase_2

Timeline
37mo left

Started Mar 2025

Typical duration for phase_2

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress28%
Mar 2025Apr 2029

First Submitted

Initial submission to the registry

February 6, 2025

Completed
5 days until next milestone

First Posted

Study publicly available on registry

February 11, 2025

Completed
22 days until next milestone

Study Start

First participant enrolled

March 5, 2025

Completed
4.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 30, 2029

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2029

Last Updated

May 1, 2026

Status Verified

April 1, 2026

Enrollment Period

4.2 years

First QC Date

February 6, 2025

Last Update Submit

April 27, 2026

Conditions

Keywords

Just In Time Adaptive InterventionMobile Healthhomelessecological momentary assessment

Outcome Measures

Primary Outcomes (4)

  • Number of drinks per week

    The number of drinks per week reported during daily EMAs.

    13 weeks

  • Number of heavy drinking days

    Number of heavy drinking days reported in daily EMAs (defined in alignment with NIAAA guidelines as ≥ 5 drinks/day for men and ≥ 4 drinks/day for women).

    13 weeks

  • Total number of drinking days

    The total number of drinking days will be calculated using EMA data.

    13 weeks

  • Slopes of key drinking factors over time(e.g., urge, mood, alcohol availability, motivation)

    Analyses will determine the effects of tailored intervention messages (Smart-T app group) versus no intervention messages (Usual Care) on key drinking risk factors over time.

    13 weeks

Secondary Outcomes (4)

  • Number of drinks per week

    13 weeks

  • Number of heavy drinking days

    13 weeks

  • Total number of drinking days

    13 weeks

  • Alcohol-related problems

    End of treatment and each follow-up assessment (i.e., 9, 13, and 26 weeks).

Study Arms (2)

Usual Care (UC)

ACTIVE COMPARATOR

All participants at the recruitment sites have access to 12-step support groups, intensive or supportive outpatient services, and/or medical and/or psychiatric care. All participants that report heavy drinking episode(s) during daily smartphone-based surveys will be referred for additional treatment services via a designated shelter referral/contact.

Other: Usual Care

Usual Care + Smart-T Alcohol

EXPERIMENTAL

The Smart-T Alcohol arm will receive Usual Care plus the Smart-T Alcohol smartphone-based intervention which includes two core components: 1) an on-demand "Tips" function/button; and 2) an algorithm that uses daily survey responses to assess current risk for alcohol use and automatically delivers tailored messages to help participants achieve their daily drinking goal.

Other: Smart-T AlcoholOther: Usual Care

Interventions

The Smart-T Alcohol intervention offers on-demand content and automated contextually tailored messages to reduce alcohol consumption. The intervention period will span eight-weeks (i.e., weeks 2-9), with follow-up assessments occurring at weeks 9, 13, and 26. All participants will complete brief daily smartphone-based surveys for 13 weeks.

Usual Care + Smart-T Alcohol

Participants will receive standard shelter-based treatment (Usual Care) along with completing surveys and assessments.

Usual Care (UC)Usual Care + Smart-T Alcohol

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • At least 18 years old
  • or above on the AUDIT
  • Receiving shelter-based services
  • Consuming 1 or more standard drink of alcohol in the past week
  • Score of 4 or higher on the REALM-SF
  • Score under 8 on the 6CIT

You may not qualify if:

  • Under 18 years old

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, 73104, United States

RECRUITING

MeSH Terms

Interventions

Ethanol

Intervention Hierarchy (Ancestors)

AlcoholsOrganic Chemicals

Central Study Contacts

Michael Businelle, PhD

CONTACT

Krista Kezbers, PhD

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 6, 2025

First Posted

February 11, 2025

Study Start

March 5, 2025

Primary Completion (Estimated)

April 30, 2029

Study Completion (Estimated)

April 30, 2029

Last Updated

May 1, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will share

De-identified data will be shared via the NIMH Data Archive (NDA) and/or other repositories.

Locations