Web-Based Intervention for Alcoholism in Military Families

Overseen By Kat Nameth, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Substance use treatment, Unsafe relationship, Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

744 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test a web-based program called Partners Connect, designed to help reduce drinking in military spouses and encourage service members to seek help. The study will compare the effectiveness of the web program against other resources, such as a CRAFT (Community Reinforcement and Family Training) workbook or phone support. It suits military spouses living with their partners, who feel safe in their relationship, and are open to trying online help for risky drinking. As an unphased trial, it provides a unique opportunity for participants to explore innovative online support tailored to their needs.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that this web-based intervention is safe for military families?

Research shows that the CRAFT programs, available online and by phone, are generally easy to use. Studies have found that CRAFT helps families of those with alcohol problems, and no serious side effects have been reported, indicating the programs are safe.

For the phone-based CRAFT, research indicates it is practical and safe for families dealing with substance use issues. Again, no major negative effects have been reported, reassuring users of its safety.

Overall, both the online and phone-based CRAFT programs have been used safely in past studies. The absence of serious side effects in these studies suggests participants can trust the safety of these treatments. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these interventions for alcoholism in military families because they leverage technology to offer more accessible and flexible treatment options. Unlike traditional face-to-face therapy sessions, the CRAFT Web-Based Intervention allows participants to engage with the program at their own pace and from any location, which can be particularly beneficial for military families who may face frequent relocations. The Phone-Based CRAFT option provides a convenient alternative for those who may not have reliable internet access, ensuring that more people can receive support. Additionally, the use of self-guided resources, like the Gottman Self-Guided Resources and CRAFT Workbook, empowers individuals to take control of their treatment journey, offering a customized approach that can complement existing therapies.

What evidence suggests that this trial's treatments could be effective for alcoholism in military families?

Studies have shown that the Community Reinforcement and Family Training (CRAFT) approach can assist families dealing with addiction. In this trial, participants may receive the CRAFT Web-Based Intervention, adapted into an online format called Partners Connect, which provides support and strategies to military families to help reduce drinking. Research indicates that CRAFT can effectively encourage individuals with substance issues to seek treatment, even if initially hesitant. Another arm of this trial involves a phone-based version of CRAFT, which users found effective and meeting a need for military families. Overall, these programs offer practical tools and support to help families manage and improve drinking behaviors. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for partners of service members who live together, speak English fluently, and are not in the military themselves. They should be willing to try an online program for risky drinking (with scores indicating concern on a screening test) and feel safe in their relationship. Both must be over 18 and not currently receiving mental health or alcohol treatment.

Inclusion Criteria

Scoring ≥4 on the AUDIT-C for females or ≥5 for males/other

Willing to try an online program to address risky drinking

Not in the military themselves (to reduce concerns about mandated reporting of alcohol use)

Exclusion Criteria

Does not feel safe in the current relationship

I have difficulties with thinking, seeing, or hearing.

I am not fluent in English.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive an adaptive web intervention (Partners Connect) or a control intervention to evaluate efficacy on drinking behaviors and help-seeking

6 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• CRAFT Web-Based Intervention
• CRAFT Workbook
• Gottman Self-Guided Resources
• Phone-Based CRAFT

Trial Overview The study tests 'Partners Connect,' a web intervention aimed at reducing drinking in military spouses and encouraging service members to seek help. It compares different support methods: phone-based CRAFT, a web-based CRAFT intervention, self-guided resources, and a CRAFT workbook.

How Is the Trial Designed?

Group I: Phone Based CRAFT Experimental Treatment 2 Interventions

If a member of the recruited dyad does not respond, then participants will be randomized to receive phone-based CRAFT

Group II: Intervention Experimental Treatment 3 Interventions

Those randomized to the CRAFT intervention will receive a web-based intervention

Group III: Control Active Control 1 Intervention

Those randomized to CONTROL will complete a self-guided intervention

Group IV: CRAFT Workbook Active Control 2 Interventions

If a member of the recruited dyad does not respond, then participants will be randomized to receive a CRAFT workbook

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials

865

Recruited

1,091,000+

University of Southern California

Collaborator

Trials

956

Recruited

1,609,000+

RAND

Collaborator

Trials

145

Recruited

617,000+

Northern California Institute of Research and Education

Collaborator

Trials

30

Recruited

10,400+

Published Research Related to This Trial

The study evaluated two web-based alcohol interventions among 3,070 active-duty military personnel, finding that the Drinker's Check-Up significantly reduced alcohol use measures at both 1-month and 6-month follow-ups.

In contrast, the Alcohol Savvy intervention did not show any significant changes in alcohol use, highlighting the effectiveness of the Drinker's Check-Up for military personnel struggling with alcohol misuse.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of two web-based alcohol interventions in the U.S. military. Pemberton, MR., Williams, J., Herman-Stahl, M., et al.[2019]

A pilot study is evaluating a 4-session web-based intervention designed for concerned partners of military service members with alcohol misuse, aiming to improve their perceptions of help-seeking and relationship satisfaction.

The intervention is based on the Community Reinforcement and Family Training (CRAFT) model and could provide a new way for military families to access support without needing to visit clinical facilities, potentially addressing a significant issue in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study design to develop and pilot-test a web intervention for partners of military service members with alcohol misuse. Osilla, KC., Pedersen, ER., Gore, K., et al.[2021]

The internet-based Community Reinforcement Approach and Family Training (iCRAFT) program did not significantly increase the likelihood of individuals with alcohol use disorders seeking treatment compared to a wait-list group, with only 10 out of 94 participants initiating treatment during the study.

However, participants in the iCRAFT program experienced short-term improvements in depressive symptoms, quality of life, and relational happiness, suggesting some benefits for concerned significant others despite the lack of impact on treatment-seeking behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of an Internet-Based Community Reinforcement and Family Training Program to Increase Treatment Engagement for AUD and to Improve Psychiatric Health for CSOs: A Randomized Controlled Trial. EÉk, N., Romberg, K., Siljeholm, O., et al.[2020]

In a study involving 249 concerned significant others (CSOs) of individuals with alcohol problems, the Community Reinforcement and Family Training (CRAFT) intervention showed that 29% of those receiving group or individual sessions reported their loved ones engaged in treatment after three months, compared to 15% for those using self-administered materials.

While the results suggested that group or individual formats may be more effective than self-administered CRAFT, the differences were not statistically significant, indicating that all formats may have potential benefits for encouraging treatment engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary Outcome from a cluster-randomized trial of three formats for delivering Community Reinforcement and Family Training (CRAFT) to the significant others of problem drinkers. Hellum, R., Bilberg, R., Andersen, K., et al.[2022]

The study aims to implement and evaluate the effectiveness of Community Reinforcement and Family Training (CRAFT) for concerned significant others (CSOs) of individuals with alcohol use disorder, involving 405 participants from 24 outpatient clinics in Denmark.

The trial will compare three CRAFT interventions (individual, group, and self-help) over 6 weeks to determine which is most effective in motivating problem drinkers to seek treatment, with outcomes assessed at baseline, 3 months, and 6 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community reinforcement and family training (CRAFT) - design of a cluster randomized controlled trial comparing individual, group and self-help interventions. Hellum, R., Nielsen, AS., Bischof, G., et al.[2023]

The Community Reinforcement and Family Training (CRAFT) approach significantly increased treatment engagement rates for alcohol-dependent individuals (40.5% in the immediate intervention group compared to 13.9% in the waitlist group) at the 3-month follow-up.

Both groups of concerned significant others (CSOs) reported improvements in mental health and family cohesion after receiving the CRAFT intervention, indicating its effectiveness in enhancing the well-being of CSOs regardless of the timing of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of the Community Reinforcement and Family Training for concerned significant others of treatment-refusing individuals with alcohol dependence: A randomized controlled trial. Bischof, G., Iwen, J., Freyer-Adam, J., et al.[2019]

Community Reinforcement and Family Training (CRAFT) was found to be beneficial for concerned significant others (CSOs) of individuals with alcohol problems, regardless of whether it was delivered in individual or group sessions, based on interviews with 11 female participants.

Key components of CRAFT, such as the 'Communication Element' that focuses on positive reinforcement and understanding alcohol use disorder (AUD), were particularly helpful, along with the acceptance and non-judgmental attitudes from facilitators.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How concerned significant others experience Community Reinforcement and Family Training (CRAFT) - a qualitative study. Hellum, R., Bilberg, R., Bischof, G., et al.[2022]

The Community Reinforcement Approach (CRA) is designed to help individuals with substance abuse issues by modifying their environment to make sobriety more rewarding than substance use, focusing on community support from family, friends, and social activities.

The Community Reinforcement and Family Training (CRAFT) program targets individuals who resist treatment by involving their family and friends to encourage them to seek help, demonstrating a unique approach to engaging treatment-refusing individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Community Reinforcement Approach. Meyers, RJ., Smith, JE., Lash, DN.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5493506/

The Feasibility of a Web-Intervention for Military and Veteran ... We adapted the Community Reinforcement and Family Training (CRAFT) intervention into a 4-session web-based intervention (WBI) called Partners Connect.

2. link.springer.com link.springer.com/chapter/10.1007/978-3-031-82583-5_19

Community Reinforcement Approach and Family Training ... CRAFT is aimed at offering addiction-affected family members (AFMs) both support and strategies to increase the likelihood that the person with addictive ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT02112396

Community Reinforcement and Family Training (CRAFT ... The present study examines the efficacy of the Community Reinforcement and Family Training (CRAFT) for Concerned Significant Others (CSOs) of individuals with ...

4. withpower.com withpower.com/trial/phase-alcohol-abuse-1-2023-595c1

Web-Based Intervention for Alcoholism in Military Families The study aims to implement and evaluate the effectiveness of Community Reinforcement and Family Training (CRAFT) for concerned significant others (CSOs) of ...

5. researchgate.net researchgate.net/publication/276077118_Community_Reinforcement_and_Family_Training_CRAFT_An_effectiveness_study

Community Reinforcement and Family Training (CRAFT) Community Reinforcement and Family Training (CRAFT) is a cognitive-behavioral program designed to get treatment-refusing substance-abusing ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5690811/

Analyzing Components of Community Reinforcement and ... We replicated the results of previous trials demonstrating that CRAFT produces greater treatment entry rates than ANF and found similar treatment entry rates ...

7. bmcpublichealth.biomedcentral.com bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6632-5

Community reinforcement and family training (CRAFT) | Full Text The aim of this study is to implement CRAFT interventions into the daily routine of Danish community alcohol treatment centers, and investigate ...

8. apa.org apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement

Community Reinforcement and Family Training (CRAFT) Results indicated that CRAFT was considerably more successful in getting the persons with substance abuse into treatment and reducing their alcohol consumption ...

9. drugfree.org drugfree.org/article/craft-community-reinforcement-family-training/

The CRAFT Approach CRAFT is an approach for families who have a loved one struggling with substances, but who is not really interested in making changes or getting help.