Title: Advancing mHealth Interventions for Understanding and Preventing Alcohol-Related Domestic Violence

Contact: Robert Freeman, Ph.D., Division of Epidemiology and Prevention Research

Purpose

In light of the documented increases in both alcohol misuse (among some individuals) and domestic violence (DV) as a result of the global COVID-19 pandemic and array of mandated restrictions enacted to mitigate COVID spread, the purpose of this grant application solicitation is to announce NIAAA’s interest in addressing  alcohol and DV. A critical need for research includes development of testing and interventions proximal to drinking occasions when risk of DV is elevated. The results would be hypothesized to include interventions sufficient  to decrease the likelihood of alcohol consumption at levels sufficient to trigger DV and to provide skills that would reduce the risk of DV perpetration and victimization.

Background

Several decades of methodologically rigorous research has demonstrated that alcohol use is an important contributing factor in many instances of DV/IPV. Unfortunately, evidence for the effectiveness of preventive interventions for IPV is underwhelming. Development of effective interventions—e.g., traditional batterer intervention programs—has been limited by high dropout rates, treatment resistance, and poor working alliance, while the United States Preventive Services Task Force has found only limited evidence for the efficacy of IPV screening instruments for men.

The NIAAA’s release of this solicitation at this time reflects a number of recent developments. Clearly, the evidence of increased rates of heavy drinking and DV during the COVID-19 pandemic lockdown period signals an urgent need for efficacious interventions that can reduce alcohol-involved DV. Moreover, the global pandemic, in general, has highlighted the utility of mHealth approaches for reaching DV survivors who may remain dangerously sequestered with an abusive partner while likely enduring adverse physical, psychological, social, and economic conditions.  Indeed, remote intervention delivery possesses a number of attractive features, including enhanced reproducibility; greater engagement (i.e., can be made available 24/7); enhanced reach (increased treatment options for those who live in, e.g., rural areas); greater privacy and lower cost. Importantly, too, wireless and remotely delivered interventions—which have shown efficacy in changing various health behaviors—can be delivered in real time, at the critical moment of greatest need. Growing evidence suggests that many DV survivors prefer the practicality and confidentiality of technology-enabled interventions and guided online support to in-person face-to-face services such as group counseling and individual therapy.

Research Scope

NIAAA encourages the submission of applications that include, but are not limited to, the following areas:

• basic behavioral and etiological research, including experimental research, that informs and test theoretical models of the association between individual and contextual factors, drinking patterns, and IPV/DV perpetration daily and over time 
• studies that advance ecological momentary assessment (EMA) research methodology that assesses individuals in their own environment in near real-time, providing insights in understanding in-the-moment Establishing the feasibility of EMA techniques to capture proximal moderators of the alcohol-IPV relationship (e.g., negative affect, emotion dysregulation) figures to enhance understanding of IPV/DV episodes and provide crucial information for the development of preventive interventions. The contextual and situational factors surrounding DV/IPV episodes (e.g., where and with whom one is drinking; motives for use; feelings of craving, stress) can be probed using EMA methods and illuminated by continuously collected data from mobile phone sensors indicating date, time and movement (suggestive of change in activities; etc) that may signal initiation of alcohol use.
• studies to assess the feasibility, acceptability, and efficacy of Just-In-Time interventions for alcohol-related IPV/DV that can be deployed before or during the drinking episode with the aim of reducing the amount consumed and/or preventing adverse consequences.
• research that advances dissemination and implementation of preventive interventions for alcohol-related DV. Such research can provide an important next step in moving promising preventive interventions out into the field. Current interventions for IPV tend to be resource intensive. The NIAAA encourages the development of scalable, sustainable interventions that can be readily integrated into community practice; delivered using existing service platforms, personnel, and resources; and that incorporate features that ease implementation fidelity. For instance, an effective online platform eventually might be incorporated into primary care or women’s wellness clinics, urgent care facilities, community or school-based health clinics, mobile clinics, HIV clinics, VA facilities, and substance use treatment providers to provide access to information, motivation building, and skills training to reduce risk for violence victimization.
• studies that advance basic behavioral and intervention development research with populations that are at elevated risk for alcohol-related IPV/DV but which remain relatively understudied (e.g., sexual/gender minority students; community college students; military populations).

Outcome

This solicitation seeks to advance the development, feasibility, acceptability, pilot testing, potential efficacy, and implementation of scalable, low resource, and remotely delivered interventions via mobile devices that rely on communication technologies for reducing and preventing alcohol-triggered DV.