Background: Contingency management (CM) is an intervention where incentives are provided in exchange for biochemically confirmed alcohol abstinence . CM is effective at initiating alcohol abstinence, but it is less effective at maintaining long-term abstinence . Phosphatidylethanol (PEth), collected via a finger-stick, can detect alcohol use for 14-28 days . PEth allows for the development of a CM model that includes increasingly less frequent monitoring of abstinence to assist high risk groups, such as formerly homeless individuals, maintain long-term abstinence . Aims: Investigate whether PEth-based CM intervention targeting alcohol abstinence in formerly homeless, currently housed individuals with alcohol use disorders is: (1) acceptable and feasible for housing program tenants and personnel; and is associated with increased (2) alcohol abstinence and (3) housing tenure .
Methods: Acceptability and feasibility will be assessed using a QUAL+quant mixed-methods design using qualitative interviews and quantitative measures of satisfaction and attrition . Effectiveness will be evaluated through a randomized pilot trial of 50 study participants who will receive 6 months of either treatment as usual (TAU) including incentives (e.g., gift cards) for providing blood samples (Control Condition) or TAU and incentives for negative PEth results (PEth-CM Condition). Outcomes will be assessed during the intervention and at a three-month follow-up visit . The trial will be conducted via telehealth as a result of COVID-19 .
Discussion: This protocol seeks to utilize a novel alcohol biomarker to evaluate the acceptability, feasibility, and initial effectiveness of a CM model that encourages long-term abstinence in a high-risk group.
Index: AUD, Alcohol use disorder, Contingency management, Homelessness, Housing programs, PEth, Phosphatidylethanol, alcohol treatment