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

Trial Summary

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 data supports the effectiveness of the treatment CRAFT Web-Based Intervention for alcoholism in military families?

Research shows that the Community Reinforcement and Family Training (CRAFT) program helps family members encourage their loved ones with alcohol problems to seek treatment. Studies have found that CRAFT can improve the well-being of family members and increase the likelihood that the person with alcohol issues will enter treatment. ^{1 2 3 4 5}

Is the CRAFT Web-Based Intervention safe for humans?

The available research on the CRAFT Web-Based Intervention focuses on its effectiveness and experiences of participants, but does not specifically address safety concerns. However, as a behavioral support program, it is generally considered safe for human use. ^{1 2 3 4 6}

How is the CRAFT Web-Based Intervention treatment for alcoholism in military families different from other treatments?

The CRAFT Web-Based Intervention is unique because it focuses on helping family members of those with alcohol problems to encourage their loved ones to seek treatment, and it is delivered online, making it accessible and convenient for military families who may face barriers to traditional in-person therapy. ^{1 3 4 7 8}

What is the purpose of this trial?

The purpose of this study is to evaluate the efficacy of an adaptive web intervention (Partners Connect) on military spouse drinking behaviors (CPs) and service member help-seeking (SMs). The investigators want to identify for whom this intervention is most efficacious and on what drinking behaviors and mechanisms. The investigators hypothesize that the intervention will reduce concerned partner drinking and increase service member help-seeking, compared to website resources, and that phone-based CRAFT will increase help-seeking behaviors, compared to those who are guided via a CRAFT workbook.

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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 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]

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]

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 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]

References

1. England 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. [2023]

2. Ireland 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. [2019]

3. England 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. [2020]

4. England 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. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

The Community Reinforcement Approach. [2019]

6. England pubmed.ncbi.nlm.nih.gov

How concerned significant others experience Community Reinforcement and Family Training (CRAFT) - a qualitative study. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Study design to develop and pilot-test a web intervention for partners of military service members with alcohol misuse. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Evaluation of two web-based alcohol interventions in the U.S. military. [2019]