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Randomized Controlled Trial
. 2016 Mar:47:93-100.
doi: 10.1016/j.cct.2015.12.010. Epub 2015 Dec 17.

A culturally-tailored behavioral intervention trial for alcohol use disorders in three American Indian communities: Rationale, design, and methods

Michael G McDonell  1 , Jenny R Nepom  2 , Emily Leickly  2 , Astrid Suchy-Dicey  2 , Kait Hirchak  3 , Abigail Echo-Hawk  2 , Stephen M Schwartz  4 , Darren Calhoun  5 , Dennis Donovan  6 , John Roll  7 , Richard Ries  6 , Dedra Buchwald  1
Affiliations
Randomized Controlled Trial

A culturally-tailored behavioral intervention trial for alcohol use disorders in three American Indian communities: Rationale, design, and methods

Michael G McDonell et al. Contemp Clin Trials. 2016 Mar.

Abstract

Background: Disproportionately high rates of alcohol use disorders are present in many American Indian/Alaska Native (AI/AN) communities, yet little information exists regarding the effectiveness of alcohol treatments in AI/AN populations. Contingency management is an intervention for illicit drug use in which tangible reinforcers (rewards) are provided when patients demonstrate abstinence as assessed by urine drug tests. Contingency management has not been widely studied as an intervention for alcohol problems because until recently, no alcohol biomarker has been available to adequately verify abstinence.

Aims: The HONOR Study is designed to determine whether a culturally-tailored contingency management intervention is an effective intervention for AI/AN adults who suffer from alcohol use disorders.

Methods: Participants include 400 AI/AN alcohol-dependent adults residing in one rural reservation, one urban community, as well as a third site to be decided, in the Western U.S. Participants complete a 4-week lead-in phase prior to randomization, then 12 weeks of either a contingency management intervention for alcohol abstinence, or a control condition where participants receive reinforcers for attending study visits regardless of alcohol use. Participants are then followed for 3-more months post-intervention. The primary study outcome is urinary ethyl glucuronide-confirmed alcohol abstinence; secondary outcomes include self-reported alcohol and drug use, HIV risk behaviors, and self-reported cigarette smoking.

Discussion: This will be the largest randomized, controlled trial of any alcohol for AI/ANs and the largest contingency management study targeting alcohol use disorders, thus providing important information to AI/AN communities and the alcohol treatment field in general.

Keywords: Alaska Natives; Alcohol; Alcohol biomarker; American Indians; Contingency management; Ethyl glucuronide; Treatment.

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Figures

Fig. 1
Fig. 1
Overview of HONOR Study procedures.
Fig. 2
Fig. 2
HONOR Study contingency management prize draw schedule.
See this image and copyright information in PMC

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