Using EMA Data to Inform a Web-intervention for Couples Concerned About Drinking

Alcohol; Use, Problem

Alcohol misuse is a prevalent and serious problem with significant harms to society, individuals, and their relationships. Romantic partners have a strong influence on their partner's behavior, uniquely positioning them as a motivator and supportive factor in changing their partner's alcohol use, but little evidence exists on the specific ways they can influence their partner. The impact this has on the quality of their relationship, communication, and overall well-being has yet to be explored. Thus, this study utilizes qualitative, quantitative, and ecological momentary assessment (EMA) data from both partners to develop a web-based intervention that applies communication-based personalized feedback to support the concerned partner (CP) in motivating their drinking partner (DP) to reduce drinking and other adverse relationship outcomes.

Previous research by our team and others has shown that certain CP responses to their DP's drinking (e.g., using punishment such as expressing anger or sarcasm, or threatening to leave) lead to increased DP drinking and poorer relationship functioning. Effective CP communication may affect fluctuations in DP drinking, but its mechanism is poorly understood. Limitations of prior research include long intervals between data collection points and lack of real-time dyadic data.The proposed project will use EMA and dyadic data to identify specific CP behaviors that elicit and/or inhibit DP drinking which will directly inform a CP-focused intervention. CP-focused interventions, such as Community Reinforcement and Family Therapy (CRAFT), encourage CP positive communication and reinforcement as important tools in promoting the DP's treatment entry. The DPs of CPs receiving CRAFT are 2-3 times more likely to enter alcohol treatment compared with Al-Anon or Johnson interventions and CRAFT is also effective in improving CP mental health and relationship functioning. However, CRAFT is time- and resource-intensive (i.e., 12 in-person sessions), limiting access for CPs who lack time or are hesitant to seek help. The proposed study aims to adapt CRAFT as a new WBI developed for a community sample of CPs. In contrast to the goals of CRAFT that focus on DP treatment entry, our WBI goals focus on outcomes that may be more proximal to treatment initiation and more attainable with a WBI including improved DP drinking, CP mental health and relationship functioning. In doing so, we also target DPs with a continuum of drinking severity including those who may not need treatment. Using EMA findings that elucidate communication strategies that influence DP drinking, the WBI will include psychoeducation on interaction patterns commonly associated with DP drinking and personalized feedback based on CP baseline data to support changes in CP communication strategies. This research addresses an important problem of mitigating the adverse impact of alcohol misuse on individuals and their families. The expected outcome of this research is to leverage CP influence into an accessible, theoretically-informed intervention that will help CPs more effectively communicate with their DP for improvements to their DP's drinking behavior, their own well-being, and their relationship functioning.

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