The overall objective of this program of research is to utilize phosphatidylethanol (PEth), a blood-based biomarker that can detect alcohol use for up to 28 days to deliver a feasible telehealth-based 26-week CM intervention. This study will test a telehealth PEth-based CM model in a sample of adults with AUD (n=200), recruited via online platforms by randomizing individuals to six months of 1) an online cognitive behavioral therapy for AUD (CBT4CBT) and telehealth PEth-based CM (CM condition) or 2) CBT4CBT and reinforcers for submitting blood samples (no abstinence required) (control condition). Investigators will assess group differences in PEth-defined abstinence and regular excessive drinking (PEth \>= 200 ng/mL), and alcohol-related harms (e.g., smoking, drug use). This study will address important gaps in CM research by assessing outcomes during a 12-month follow-up, which is much longer than most previous CM studies; using a conceptual model to identify predictors of post-treatment abstinence. Investigators will conduct an economic analysis to place the cost of this model in the context of downstream CM-associated cost-offsets and improvements in personal and public health.
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Aim 1) Alcohol Abstinence & Aim 3) Predictors: PEth-Defined Alcohol Abstinence During CM (Aim 1) and Follow-Up (Aim 3)
Timeframe: Every study visit, up to 18 months
Aim 2) Alcohol-Related Harms: Addiction Severity Index (ASI) Lite
Timeframe: Once a month during the intervention, Follow Up, up to 18 months
Aim 2) Alcohol-Related Harms: Patient Health Questionnaire-9 (PHQ-9)
Timeframe: Once a month during the intervention, Follow Up, up to 18 months
Aim 2) Alcohol-Related Harms: Generalized Anxiety Disorder-7 (GAD-7)
Timeframe: Once a month during the intervention, Follow Up, up to 18 months
Aim 2) Alcohol-Related Harms: Short Form Health Survey-12 (SF-12)
Timeframe: Once a month during the intervention, Follow Up, up to 18 months
Aim 2) Alcohol-Related Harms & Aim 4) Cost Analysis: Non-study Medical and Other Services (NMOS) form
Timeframe: Once a month during the intervention, Follow Up, up to 18 months
Aim 2) Alcohol Related Harms: Fagerstrom
Timeframe: Once a month during the intervention, Follow Up, up to 18 months
Aim 2) Alcohol Related Harms: Urine Drug Tests
Timeframe: Every study visit, up to 18 months
Aim 2) Alcohol Related Harms: Perceived Stress Scale (PSS-10)
Timeframe: Every study visit, up to 18 months
Aim 3) Predictors: Demographics
Timeframe: Baseline
Aim 3) Predictors: Addictions Neuroclinical Assessment (ANA) Questionnaire
Timeframe: Every study visit, up to 18 months
Aim 3) Predictors: TestMyBrain
Timeframe: Baseline
Aim 3) Predictors: Positive Negative Affect Schedule (PANAS)
Timeframe: Every study visit, up to 18 months
Aim 3) Predictors: Situational Confidence Questionnaire-8 (SCQ-8)
Timeframe: Every study visit, up to 18 months
Aim 3) Predictors: Alcohol Craving VAS
Timeframe: Every study visit, up to 18 months
Aim 4) Cost Analysis: Drug Abuse Treatment Cost Analysis Program (DATCAP)
Timeframe: Baseline
Aim 4) Cost Analysis: PROPr
Timeframe: Once a month during the intervention, Follow Up, up to 18 months