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Cucciare MA, Marchant K, Benton C, Hildebrand D, Ghaus S, Han X, Thompson RG, Timko C. Connect To Care (C2C): protocol for two-site randomized controlled pilot trial to improve outcomes for patients with hazardous drinking and PTSD and/or depression symptoms. Addict Sci Clin Pract 2023; 18:50. [PMID: 37592359 PMCID: PMC10433540 DOI: 10.1186/s13722-023-00403-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/31/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND In studies of the general population and of military veterans, many primary care patients with hazardous drinking and PTSD and/or depression (abbreviated here as HD +) do not initiate or engage with alcohol-related care. To address this gap in care, we identified and will pilot test a promising evidence-based intervention, Connect To Care (C2C). C2C is a strengths-based approach, delivered by a Care Coach by telephone and/or video, with four components: (1) identifying and leveraging patient strengths to facilitate care initiation, (2) collaborative decision-making around a menu of care options, (3) identifying and resolving barriers to care, and (4) monitoring and facilitating progress toward care initiation by, for example, checking on barriers, identifying solutions, and revisiting care options. METHODS/DESIGN Aim 1 will involve adapting C2C for use in Veterans Affairs' (VA) primary care. We will use an iterative process that includes focus groups and semi-structured interviews with key stakeholders (patients, primary care providers, and VA national policy leaders). In Aim 2, we will conduct a two-site, pilot randomized controlled trial to determine the feasibility of conducting a larger scale trial to test C2C's effectiveness, ascertain the acceptability of C2C among primary care patients with HD + , and explore the efficacy of C2C to improve veteran patients' initiation of and engagement in alcohol care, and their alcohol and mental health (PTSD, depression) outcomes, at 3-month follow-up. We will explore explanatory mechanisms by which C2C is effective. DISCUSSION Study findings are likely to have implications for clinical practice to enhance current approaches to linking patients with HD + to alcohol care by applying a practical intervention such as C2C. The results may improve treatment outcomes for people with HD + by drawing on patients' strengths to problem-solve barriers to care following a process of shared decision-making with a coach. In addition to possibly accelerating the translation of C2C into practice, study findings will also support additional research in terms of a planned effectiveness-implementation hybrid trial, adding to this study's potential for high impact. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05023317.
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Affiliation(s)
- Michael A Cucciare
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Education and Clinical Center, Veterans Affairs South Central Mental Illness Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Kathy Marchant
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Cristy Benton
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Deanna Hildebrand
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Sharfun Ghaus
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA
| | - Xiaotong Han
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Education and Clinical Center, Veterans Affairs South Central Mental Illness Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Ronald G Thompson
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA.
- Center for Innovation to Implementation, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA.
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Schumm J, Wong C, Okrant E, Tharp JA, Embree J, Lester N. Factor Structure of the Brief Addiction Monitor in a Non-Veteran Substance Use Disorder Outpatient Treatment Sample. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100125. [PMID: 36844173 PMCID: PMC9948935 DOI: 10.1016/j.dadr.2022.100125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/04/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
Background The Brief Addiction Monitor (BAM) was developed as a comprehensive substance use disorder (SUD) outcome metric to fill a gap in quality measurement. Research to date has only examined the psychometric performance of this measure in veteran SUD populations. The purpose of the current research is to examine the factor structure and validity in a non-veteran SUD population. Methods Non-veteran patients admitted to a SUD treatment program (N = 2,227) completed BAM at intake. After confirmatory factor analysis (CFA) was performed to evaluate the measurement model validity of previously defined latent structures, exploratory factor analysis (EFA) was used to assess the factor structure and psychometric properties of the BAM within the full sample and within subgroups, specifically racial, referral source (mandated vs. not), and primary SUD diagnosis. Results Exploratory factor analyses in the full sample supported a 4-factor model (representing Stressors, Alcohol Use, Risk Factors, and Protective Factors) derived from 13 items. Subsequent EFAs conducted separately in each subgroup revealed variability in the number of resulting factors and pattern matrices. The internal consistency also varied among factors and between subgroups; in general, reliability was greatest for the Alcohol Use scale and either poor or questionable for pattern matrices resulting in scales reflecting Risk or Protective Factors. Conclusion Findings from our study suggest that the BAM might not be a reliable and valid instrument for all populations. More research is needed to develop and validate tools that are clinically meaningful and allow clinicians to track recovery progress over time.
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Affiliation(s)
- Jeremiah Schumm
- School of Professional Psychology, College of Health, Education, and Human Services, Wright State University, 3640 Colonel Glenn Hwy, Dayton, OH, 45435,Samaritan Behavioral Health, Inc./OneFifteen, Inc., 707 S Edwin C Moses Blvd, Dayton, OH, 45417,Correspondence should be addressed to Jeremiah A. Schumm, Wright State University, School of Professional Psychology, 3640 Colonel Glenn Highway, Dayton, OH, 45435-0001
| | - Celeste Wong
- Verily, LLC, 269 E Grand Ave, South San Francisco, CA, 94080
| | | | - Jordan A. Tharp
- Verily, LLC, 269 E Grand Ave, South San Francisco, CA, 94080
| | - Jared Embree
- OneFifteen, Inc., 6636 Longshore St Suite 200, Dublin, OH, 43017
| | - Natalie Lester
- Verily, LLC, 269 E Grand Ave, South San Francisco, CA, 94080,OneFifteen, Inc., 6636 Longshore St Suite 200, Dublin, OH, 43017
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Hasin DS, Saxon AJ, Malte C, Olfson M, Keyes KM, Gradus JL, Cerdá M, Maynard CC, Keyhani S, Martins SS, Fink DS, Livne O, Mannes Z, Wall MM. Trends in Cannabis Use Disorder Diagnoses in the U.S. Veterans Health Administration, 2005-2019. Am J Psychiatry 2022; 179:748-757. [PMID: 35899381 PMCID: PMC9529770 DOI: 10.1176/appi.ajp.22010034] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE In the United States, adult cannabis use has increased over time, but less information is available on time trends in cannabis use disorder. The authors used Veterans Health Administration (VHA) data to examine change over time in cannabis use disorder diagnoses among veterans, an important population subgroup, and whether such trends differ by age group (<35 years, 35-64 years, ≥65 years), sex, or race/ethnicity. METHODS VHA electronic health records from 2005 to 2019 (range of Ns per year, 4,403,027-5,797,240) were used to identify the percentage of VHA patients seen each year with a cannabis use disorder diagnosis (ICD-9-CM, January 1, 2005-September 30, 2015; ICD-10-CM, October 1, 2015-December 31, 2019). Trends in cannabis use disorder diagnoses were examined by age and by race/ethnicity and sex within age groups. Given the transition in ICD coding, differences in trends were tested within two periods: 2005-2014 (ICD-9-CM) and 2016-2019 (ICD-10-CM). RESULTS In 2005, the percentages of VHA patients diagnosed with cannabis use disorder in the <35, 35-64, and ≥65 year age groups were 1.70%, 1.59%, and 0.03%, respectively; by 2019, the percentages had increased to 4.84%, 2.86%, and 0.74%, respectively. Although the prevalence of cannabis use disorder was consistently higher among males than females, between 2016 and 2019, the prevalence increased more among females than males in the <35 year group. Black patients had a consistently higher prevalence of cannabis use disorder than other racial/ethnic groups, and increases were greater among Black than White patients in the <35 year group in both periods. CONCLUSIONS Since 2005, diagnoses of cannabis use disorder have increased substantially among VHA patients, as they have in the general population and other patient populations. Possible explanations warranting investigation include decreasing perception of risk, changing laws, increasing cannabis potency, stressors related to growing socioeconomic inequality, and use of cannabis to self-treat pain. Clinicians and the public should be educated about the increases in cannabis use disorder in general in the United States, including among patients treated at the VHA.
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Affiliation(s)
- Deborah S Hasin
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Andrew J Saxon
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Carol Malte
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Mark Olfson
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Katherine M Keyes
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Jaimie L Gradus
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Magdalena Cerdá
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Charles C Maynard
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Salomeh Keyhani
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Silvia S Martins
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - David S Fink
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Ofir Livne
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Zachary Mannes
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
| | - Melanie M Wall
- Department of Epidemiology (in Psychiatry) (Hasin), Department of Epidemiology (Olfson, Keyes, Martins, Livne, Mannes), and Department of Psychiatry (Olfson), Columbia University, New York; New York State Psychiatric Institute, New York (Hasin, Olfson, Fink, Wall); VA Puget Sound Health Care System, Seattle (Saxon, Malte, Maynard); Department of Psychiatry and Behavioral Sciences (Saxon) and Department of Health Systems and Population Health (Maynard), University of Washington, Seattle; Department of Epidemiology, Boston University, Boston (Gradus); Department of Population Health, New York University, New York (Cerdá); San Francisco VA Health System and Division of General Internal Medicine, University of California at San Francisco (Keyhani); Department of Biostatistics (in Psychiatry), Columbia University Medical Center, New York (Wall)
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Miller MB, Metrik J, McGeary JE, Borsari B, McCrae CS, Maddoux J, Arnedt JT, Merrill JE, Carey KB. Protocol for the Project SAVE randomised controlled trial examining CBT for insomnia among veterans in treatment for alcohol use disorder. BMJ Open 2021; 11:e045667. [PMID: 34103317 PMCID: PMC8190049 DOI: 10.1136/bmjopen-2020-045667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION As many as 74% of veterans with alcohol use disorders (AUDS) report symptoms of insomnia. Insomnia represents a barrier to alcohol treatment because insomnia symptoms (1) may lead to relapse among those who use alcohol to help them sleep and may negatively impact (2) executive functions and (3) emotion regulation skills. Cognitive-behavioural therapy for insomnia (CBT-I) is an efficacious first-line treatment for insomnia; however, no research has examined the impact of CBT-I on individuals' response to alcohol treatment. In the Sleep and Alcohol for Veterans (Project SAVE) randomised controlled trial, we hypothesise that CBT-I will enhance the efficacy of alcohol treatment among Veterans with insomnia by enhancing their abilities to attend to treatment, regulate emotions and initiate sleep without alcohol. METHODS AND ANALYSIS Eighty Veterans enrolled in alcohol treatment at the Veterans Administration (VA) hospital will be randomly assigned to receive either CBT-I or single-session sleep hygiene (SH) education. Individuals will be eligible to participate if they meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for moderate to severe AUD and Insomnia Disorder of at least 1-month duration. Participants will complete assessments at baseline, post-treatment and 6-week follow-up. Preliminary process outcomes include retention/recruitment rates and treatment satisfaction (feasibility and acceptability, respectively). Primary outcomes are insomnia severity, percentage of heavy-drinking days and alcohol-related problems. We will assess a variety of secondary clinical and mechanistic outcomes (eg, post-traumatic stress disorder (PTSD) symptoms, attention and working memory). ETHICS AND DISSEMINATION Ethics approval was obtained in October 2018. Data collection began in July 2019 and is planned for completion by July 2021. Trial results will be disseminated at local and national conferences, in peer-reviewed publications and through media outlets, as available. Results will also be shared with interested participants and clinical collaborators at the end of the trial. TRIAL REGISTRATION NUMBER clinicaltrials.gov identifier NCT03806491 (pre-results).
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Affiliation(s)
- Mary Beth Miller
- Department of Psychiatry, University of Missouri, Columbia, MO, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
- Mental Health & Behavioral Sciences Service, Providence VA Medical Center, Providence, RI, USA
| | - John E McGeary
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
- Mental Health & Behavioral Sciences Service, Providence VA Medical Center, Providence, RI, USA
| | - Brian Borsari
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Services, University of California San Francisco, San Francisco, CA, USA
| | | | - John Maddoux
- Harry S Truman Memorial Veterans' Hospital, Columbia, Missouri, USA
| | - J Todd Arnedt
- Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer E Merrill
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
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