Couple-Based Motivational Interviewing With Mobile Breathalyzers to Reduce Alcohol Use in South Africa
Study Details
Study Description
Brief Summary
This project aims to develop and pilot test an intervention using couple-based motivational interviewing (MI) and mobile breathalyzers to reduce heavy alcohol use with couples living with HIV in South Africa.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
This project aims to develop and test an alcohol intervention using couple-based motivational interviewing (MI) and mobile breathalyzers to build dyadic support around drinking in HIV-affected couples in South Africa. Specifically, the study aims to: 1) To develop a couple-based MI intervention with mobile breathalyzer technology to deliver real-time feedback on BAC levels. We will target heavy alcohol users with HIV and enroll their primary partner; 2) to develop and pilot test the study procedures for a future randomized controlled trial (RCT) of the couple-based intervention; and 3) to determine the feasibility and acceptability (F&A) of couple-based MI as a standalone intervention and when combined with mobile breathalyzers to provide real-time feedback and support to couples. We will also conduct qualitative interviews with a subset of 15 couples to contextualize F&A data and refine our procedures. Our goal is to demonstrate a proof-of-concept for the proposed intervention, which if shown to be feasible and acceptable, may provide a scalable intervention to reduce heavy alcohol consumption and improve HIV treatment outcomes for couples in South Africa.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Enhanced Usual Care Couples in this condition will receive the standard of care for alcohol use in addition to a brief alcohol counseling session modeled after WHO guidelines and Dr. Conroy's intervention in Malawi, which uses participants' baseline AUDIT scores for messaging around alcohol reduction and lasts 5-10 minutes. |
|
| Experimental: Motivational Interviewing (MI) Couples will have three MI sessions over a 60-day period. These sessions will focus on communication between the couple, alcohol consumption patterns, and setting goals for alcohol-use reduction. |
Behavioral: Motivational Interviewing
Counseling
|
| Experimental: Motivational Interviewing Plus Breathalyzer (MI Plus) In addition to three MI sessions, drinkers in this condition will be prompted via SMS message twice per day to use a mobile app and a breathalyzer to test their blood alcohol levels (BAC). Both the drinker and their partner will receive real-time feedback about alcohol use. |
Behavioral: Motivational Interviewing
Counseling
Behavioral: Motivational Interviewing plus Breathalyzer
Counseling plus mobile breathalyzer/ app
|
Outcome Measures
Primary Outcome Measures
- Enrollment Rate [Baseline (Time 0)]
proportion of eligible couples who enroll in the study
- Retention Rate [6 months]
proportion of enrolled couples who remain at the end
Secondary Outcome Measures
- Satisfaction with Intervention [2 months]
proportion of participants who report being "satisfied" or "very satisfied" with the intervention at the two-month follow-up
- Mid-point survey completion [2 months]
proportion of couples who complete the two-month survey
- Final survey completion [6 months]
proportion of couples who complete the six-month survey
- MI sessions completed [2 months]
proportion of participants who attend all three intervention sessions
- 70% breathalyzer completion [2 months]
proportion of participants who complete 70% of breathalyzer tests
Other Outcome Measures
- Exploratory: Alcohol Use [2 months and 6 months]
Number of drinking days in the past 30 days (self-report)
- Exploratory: Alcohol Use [2 months]
Non-heavy drinking determined by self-report (Alcohol Use Disorders Identification Test - Consumption [AUDIT-C], prior 3 months, negative) and phosphatidylethanol (PEth) <35 ng/mL (composite measure)
- Exploratory: ART adherence [2 months and 6 months]
Proportion of pills taken by HIV-infected participants in the past 30 days, using the bean count method (self-report) adapted from VAS
- Exploratory: HIV viral load [2 months]
Proportion of HIV-infected participants who are virally suppressed by local lab normal ranges, as measured by dried blood spots (DBS)
Eligibility Criteria
Criteria
Inclusion Criteria:
-
in a primary relationship for at least 6 months
-
aged 18-49
-
have at least one partner (the "index patient") with a positive AUDIT-C screen score
-
has been on antiretroviral therapy (ART) for at least 6 months
-
has disclosed HIV status to their partner
Exclusion Criteria:
- Report severe intimate partner violence in the past 3 months and/or fear that their safety would be at risk (reported during screening)
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Human Sciences Research Council | Pietermaritzburg | South Africa |
Sponsors and Collaborators
- University of California, San Francisco
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- Human Sciences Research Council
- City University of New York, School of Public Health
Investigators
- Principal Investigator: Amy Conroy, Ph.D., University of California, San Francisco
Study Documents (Full-Text)
None provided.More Information
Publications
- Aharonovich E, Stohl M, Cannizzaro D, Hasin D. HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial. J Subst Abuse Treat. 2017 Dec;83:15-26. doi: 10.1016/j.jsat.2017.09.013. Epub 2017 Sep 29.
- Conroy AA, McKenna SA, Ruark A. Couple Interdependence Impacts Alcohol Use and Adherence to Antiretroviral Therapy in Malawi. AIDS Behav. 2019 Jan;23(1):201-210. doi: 10.1007/s10461-018-2275-2.
- Hahn JA, Emenyonu NI, Fatch R, Muyindike WR, Kekiibina A, Carrico AW, Woolf-King S, Shiboski S. Declining and rebounding unhealthy alcohol consumption during the first year of HIV care in rural Uganda, using phosphatidylethanol to augment self-report. Addiction. 2016 Feb;111(2):272-9. doi: 10.1111/add.13173. Epub 2015 Nov 5.
- Lauckner C, Taylor E, Patel D, Whitmire A. The feasibility of using smartphones and mobile breathalyzers to monitor alcohol consumption among people living with HIV/AIDS. Addict Sci Clin Pract. 2019 Nov 26;14(1):43. doi: 10.1186/s13722-019-0174-0.
- Starks TJ, Millar BM, Doyle KM, Bertone P, Ohadi J, Parsons JT. Motivational interviewing with couples: A theoretical framework for clinical practice illustrated in substance use and HIV prevention intervention with gay male couples. Psychol Sex Orientat Gend Divers. 2018 Dec;5(4):490-502. doi: 10.1037/sgd0000297. Epub 2018 Jun 25.
- Woolf-King SE, Conroy AA, Fritz K, Johnson MO, Hosegood V, van Rooyen H, Darbes L, McGrath N. Alcohol use and relationship quality among South African couples. Subst Use Misuse. 2019;54(4):651-660. doi: 10.1080/10826084.2018.1531428. Epub 2018 Nov 8.
- P0551145
- R34AA029649