An interventional study of Contingency management for alcohol abstinence and Contingency management for completing job related activities in Unemployment and Hazardous Drinking, sponsored by UConn Health. Completed at 1 site in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2024-04-23.
Sponsored by UConn Health · Not applicable, Interventional, and Treatment
Despite recent improvements in the US economy, unemployment remains a significant concern, and estimates indicate that one-third of unemployed persons drink at hazardous levels, adversely impacting their health and abilities to find jobs. Reinforcement interventions are highly efficacious in reducing substance use, and they can be applied to increase job-seeking activities as well. In partnership with CT United Labor Agency, this project is designed to reduce hazardous drinking and enhance active participation in job-seeking activities among those with job loss. It will evaluate the independent and combined effects of reinforcing negative breathalyzer samples and job-seeking activities to ascertain the simplest and most cost-effective approach to improving outcomes in this population. Unemployed individuals with hazardous drinking (N = 280) will be randomly assigned to one of four conditions using a 2 x 2 design: standard care, standard care with reinforcement for submitting negative breathalyzer samples, standard care with reinforcement for job-seeking activities, or standard care plus reinforcement for both negative breathalyzer samples and job-seeking activities. Participants in all conditions will receive usual services part of CT United Labor Agency, along with a novel remote breath alcohol monitoring procedure. The study interventions will be in effect for three months, and participants will be followed for one year. Alcohol and other drug use, employment, psychiatric symptoms, and global measures of health will be assessed throughout treatment and follow-up. Reinforcing negative breathalyzer samples is expected to significantly reduce drinking, and reinforcing job-seeking activities is expected to increase re-employment rates and reduce time until job attainment. Reinforcing both negative breathalyzer samples and job-seeking activities is hypothesized to improve outcomes along both domains. The reinforcement interventions may also decrease psychiatric distress and slow progression of physical decline, common among the unemployed. If efficacious and cost-effective, results from this study may stimulate adoption of reinforcement interventions in the context of unemployment services. Reducing the adverse consequences of hazardous drinking and improving job re-entry may have pronounced benefits in a highly vulnerable segment of the US population.
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Exclusion Criteria:
Standard services plus job activity contracting and alcohol monitoring
Behavioral: Job relelated activity contracting
Standard services plus job activity contracting and alcohol monitoring plus reinforcement for negative breath alcohol recordings
Behavioral: Contingency management for alcohol abstinence · Behavioral: Job relelated activity contracting
Standard services plus job activity contracting and alcohol monitoring plus reinforcement for completing job-related activities
Behavioral: Contingency management for completing job related activities · Behavioral: Job relelated activity contracting
Standard services plus job activity contracting and alcohol monitoring plus reinforcement for negative breath alcohol recordings and for completing job-related activities
Behavioral: Contingency management for alcohol abstinence · Behavioral: Contingency management for completing job related activities · Behavioral: Job relelated activity contracting
Participants will earn reinforcement (incentives) for each alcohol negative breath test provided (when prompted to submit a test) during the 12-week intervention period.
Participants will earn reinforcement (incentives) for completing specific job-related activities during the 12-week intervention period.
Participants will complete job-related activity contracts each week with the goal of obtaining employment.
Longest Duration of Alcohol Abstinence (Samples) (Physiological Measure)
Greatest number of consecutive breath tests submitted on-time (within 1 hour of prompt) and reading alcohol negative (BAL \< 0.02)
Time frame: 12 weeks
Percent Alcohol Negative Breath Tests
Of alcohol breath tests requested, the percentage submitted on-time (within 1-hour of prompt) and reading alcohol-negative (BAL \< .02)
Time frame: 12 weeks
Percent of Days Worked for Pay (Missing Data Treated as Missing)
The percentage of days of work for pay (in the formal or informal economy), with the number of days of data in the denominator (missing data considered missing)
Time frame: 12 weeks
Time to First Worked
From study day 1, the number of days until first worked in the formal or informal economy during the 12-week intervention, censored at day 85.
Time frame: 12 weeks
Percent of Days Worked for Pay (84 Day Intervention Period in the Denominator)
The percent of days worked for pay (in the formal or informal economy), with 84 days (intervention period duration; missing treated as not working) in the denominator
Time frame: 12 weeks
Longest Duration of Alcohol Abstinence (Days) (Physiological Measure)
Greatest number of consecutive days of submitting all breath tests requested on-time and reading alcohol negative
Time frame: 12 weeks
| Milestone | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Started | 50 | 65 | 58 | 67 |
| Completed | 50 | 64 | 58 | 67 |
| Not completed | 0 | 1 | 0 | 0 |
Greatest number of consecutive breath tests submitted on-time (within 1 hour of prompt) and reading alcohol negative (BAL \< 0.02)
| number of alcohol negative breath tests | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Longest Duration of Alcohol Abstinence (Samples) (Physiological Measure) | 6.0 (3.0 to 14.0) | 11.0 (5.0 to 26.0) | 7.0 (4.0 to 17.3) | 7.5 (5.0 to 18.3) |
Of alcohol breath tests requested, the percentage submitted on-time (within 1-hour of prompt) and reading alcohol-negative (BAL \< .02)
| percentage of alcohol negative tests | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Percent Alcohol Negative Breath Tests | 90.8 (48.9 to 100.0) | 98.1 (78.9 to 100.00) | 91.2 (66.6 to 100.0) | 97.1 (67.0 to 100.0) |
The percentage of days of work for pay (in the formal or informal economy), with the number of days of data in the denominator (missing data considered missing)
| percentage of days work occurred | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Percent of Days Worked for Pay (Missing Data Treated as Missing) | 1.79 (0.00 to 22.99) | 4.76 (0.00 to 24.40) | 6.25 (0.00 to 25.77) | 1.33 (0.00 to 26.19) |
From study day 1, the number of days until first worked in the formal or informal economy during the 12-week intervention, censored at day 85.
| days | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Time to First Worked | 79.50 (15.00 to 85.0) | 57.00 (24.00 to 85.0) | 63.00 (16.50 to 85.0) | 63.00 (16.00 to 85.0) |
The percent of days worked for pay (in the formal or informal economy), with 84 days (intervention period duration; missing treated as not working) in the denominator
| percentage of days work occurred | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Percent of Days Worked for Pay (84 Day Intervention Period in the Denominator) | 1.19 (0.00 to 18.15) | 4.17 (0.00 to 22.02) | 4.76 (0.00 to 23.81) | 1.19 (0.00 to 22.62) |
Greatest number of consecutive days of submitting all breath tests requested on-time and reading alcohol negative
| days | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Longest Duration of Alcohol Abstinence (Days) (Physiological Measure) | 4.0 (2.0 to 10.0) | 9.0 (3.0 to 19.0) | 5.0 (3.0 to 12.3) | 6.0 (3.0 to 13.5) |
Collected over 12 months. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Group A - Standard Job Activity Contracting and Alcohol Monitoring | 0/50 (0%) | 6/50 (12%) | 5/50 (10%) |
| Group B - Reinforcement for Negative Alcohol Samples | 0/65 (0%) | 8/65 (12.3%) | 5/65 (7.7%) |
| Group C - Reinforcement for Completing Job Activities | 1/58 (1.7%) | 9/58 (15.5%) | 1/58 (1.7%) |
| Group D - Reinforcement for Negative Alcohol Samples & Job Activities | 0/67 (0%) | 9/67 (13.4%) | 6/67 (9%) |
| Event | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Inpatient substance use treatmentGeneral disorders | 3/50 | 3/65 | 5/58 | 6/67 |
| Inpatient medical treatmentGeneral disorders | 2/50 | 4/65 | 4/58 | 4/67 |
| Inpatient psychiatric treatmentPsychiatric disorders | 1/50 | 1/65 | 2/58 | 1/67 |
| Event | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities |
|---|---|---|---|---|
| Emergency Room VisitGeneral disorders | 5/50 | 5/65 | 1/58 | 6/67 |
| Age, Categorical(Participants) | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities | Total |
|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 50 | 65 | 58 | 67 | 240 |
| >=65 years | 0 | 0 | 0 | 0 | 0 |
| Age, Continuous(years) | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities | Total |
|---|---|---|---|---|---|
| Mean | 46.10 ± 9.77 | 45.94 ± 11.34 | 42.38 ± 10.89 | 46.37 ± 10.06 | 45.23 ± 10.63 |
| Sex: Female, Male(Participants) | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities | Total |
|---|---|---|---|---|---|
| Female | 17 | 34 | 30 | 35 | 116 |
| Male | 33 | 31 | 28 | 32 | 124 |
| Ethnicity (NIH/OMB)(Participants) | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities | Total |
|---|---|---|---|---|---|
| Hispanic or Latino | 4 | 7 | 8 | 10 | 29 |
| Not Hispanic or Latino | 46 | 58 | 50 | 57 | 211 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities | Total |
|---|---|---|---|---|---|
| American Indian or Alaska Native | 1 | 1 | 0 | 0 | 2 |
| Asian | 0 | 0 | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 1 | 0 | 0 | 0 | 1 |
| Black or African American | 29 | 37 | 25 | 36 | 127 |
| White | 19 | 24 | 31 | 28 | 102 |
| More than one race | 0 | 2 | 0 | 0 | 2 |
| Unknown or Not Reported | 0 | 1 | 2 | 3 | 6 |
| Region of Enrollment(participants) | Group A - Standard Job Activity Contracting and Alcohol Monitoring | Group B - Reinforcement for Negative Alcohol Samples | Group C - Reinforcement for Completing Job Activities | Group D - Reinforcement for Negative Alcohol Samples & Job Activities | Total |
|---|---|---|---|---|---|
| United States | 50 | 65 | 58 | 67 | 240 |
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