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| ID | Type | Description | Link |
|---|---|---|---|
| 1R01AA028776-01A1 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute on Alcohol Abuse and Alcoholism (NIAAA) | NIH |
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The research study seeks to refine and test a brief, self-directed, intervention for individuals from the general public with PTSD and co-occurring HD that can be delivered via text-messaging. This application seeks to refine the intervention further by testing whether theoretically-driven, evidence-based strategies from basic cognitive psychology (message framing) and social psychology (facilitating growth mindsets) result in better outcomes for PTSD symptoms and HD by addressing pilot participant feedback related to avoidance and motivation.
This study will refine a previously piloted text message intervention by integrating and testing the efficacy of behavioral nudge and psychologically-wise intervention techniques when added to CBT text messages for reducing hazardous drinking (HD) and PTSD symptoms.The enhancements will be tested in a fully crossed 3 (message framing: avoid losses vs. maximize gains vs. no framing) x 2 (mindsets: facilitate growth mindset reminder vs. simple reminder to use skills) factorial design to identify the most effective combination of text messages. A sample of 500 participants with DSM-5 Criterion A trauma exposure, PTSD symptoms, and HD will be enrolled and randomized to condition. Baseline, immediate post-, 1-, and 3-month assessments will capture change in primary outcomes (PTSD, hazardous drinking).
Trauma exposure and PTSD symptoms will be assessed using the Posttraumatic Stress Disorder Checklist, Civilian Version DSM-5 with the Life Events Checklist (PCL-5 and LEC).
HD will be assessed via a set of measures that provide a detailed picture of drinking patterns. First, two questions will ask about heavy episodic drinking (HED: 4/5 or more drinks per single occasion for men/women) episodes, assessing both frequency over the lifetime and frequency over the last month. Typical weekly alcohol consumption will also be assessed using the Daily Drinking Questionnaire (DDQ). Negative alcohol-related consequences will be assessed via the Short Index of Problems (SIP).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Loss Framing + Growth Mindset | Experimental | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward preventing future losses from trauma exposure, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. |
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| Loss Framing + Simple Reminder | Experimental | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward prevent future losses from trauma exposure, and day 3 will have a simple reminder to use the skill. |
|
| Gain Framing + Growth Mindset | Experimental | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. |
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| Gain Framing + Simple Reminder | Experimental | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a simple reminder to use the skill. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CBT Text Messages | Behavioral | CBT skills based text messages delivered 3x per week for four weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Heavy Episodic Drinking | Heavy Episodic Drinking (HED) assesses the quantity of heavy drinking episodes (i.e., >4/5 drinks per occasion for women/men, based on the National Institute of Alcohol Abuse and Alcoholism's definition) over the last month. It is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16). The range of the scale is 0-10 (count of the number of heavy drinking episodes in the last month); 10 is described as 10 or more heavy drinking episodes. Higher scores represent a greater number of heavy drinking episodes. | Baseline, 4 weeks, 8 weeks, 16 weeks |
| Posttraumatic Stress Disorder (PTSD) | The Posttraumatic Stress Disorder Checklist for the 5th Edition of Diagnostic and Statistical Manual of Mental Disorders (PCL-5) assesses the severity of symptoms of posttraumatic stress disorder (PTSD) as defined by the 5th Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16) to assess change in PTSD symptoms. The range of the scale is 0-80. Higher scores represent more severe PTSD symptoms. | Baseline, 4 weeks, 8 weeks, and 16 weeks |
| Typical Weekly Alcohol Consumption | The Daily Drinking Questionnaire (DDQ) assesses the number of standard drinks consumed each day of a typical week over the last month and is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16). The range for the scale to report drinks consumed each day is 0-25. Each day's score for the week is summed to created a total number of drinks consumed per week; the count of drinks consumed per week ranges from 0 to 175. Higher scores representing greater number of drinks consumed during a typical week. | Baseline, 4 weeks, 8 weeks, 16 weeks |
| Alcohol Use Consequences | The Short Index of Problems (SIP) assesses the negative consequences from alcohol consumption over the last month and is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16). The range for the scale is 0-15 and higher scores represent a greater number of alcohol-related consequences. |
| Measure | Description | Time Frame |
|---|---|---|
| Risk of Alcohol Use Disorder (AUD) | The Alcohol Use Disorders Identification Test (AUDIT) assesses problem drinking and likely diagnosis of an alcohol use disorder over the last 12 months and is administered at pre-intervention (baseline) and 3 month follow up (week 16). The total range of scores is 0-40 and higher scores represent greater risks of having an alcohol use disorder. | Baseline,16 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kristen Lindgren, PhD | University of Washington | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Washington | Seattle | Washington | 98105 | United States |
2,751 completed the screening survey, and 1,397 of them were not eligible. Among 1,354 participants who were eligible for the verification call, 628 were excluded prior to verification call due to suspected fraud, missing contact information, etc. and 162 did not show up/declined participation. Among 564 participants who were sent baseline survey, 45 never completed baseline and 14 were identified as fraudulent upon review. 505 completed baseline/enrolled and were randomized.
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| ID | Title | Description |
|---|---|---|
| FG000 | Loss Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward preventing future losses from trauma exposure, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| FG001 | Loss Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward prevent future losses from trauma exposure, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| FG002 | Gain Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| FG003 | Gain Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| FG004 | No Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| FG005 | No Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Post Intervention |
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| 1-Month Follow Up |
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| 3-Month Follow Up |
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| ID | Title | Description |
|---|---|---|
| BG000 | Loss Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward preventing future losses from trauma exposure, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Heavy Episodic Drinking | Heavy Episodic Drinking (HED) assesses the quantity of heavy drinking episodes (i.e., >4/5 drinks per occasion for women/men, based on the National Institute of Alcohol Abuse and Alcoholism's definition) over the last month. It is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16). The range of the scale is 0-10 (count of the number of heavy drinking episodes in the last month); 10 is described as 10 or more heavy drinking episodes. Higher scores represent a greater number of heavy drinking episodes. | Posted | Mean | Standard Deviation | number of heavy drinking episodes | Baseline, 4 weeks, 8 weeks, 16 weeks |
|
The study collected adverse event data for participants for 4 month (16 weeks) following baseline. Adverse event event information was collected through study completion.
This is study is a brief text message psychosocial intervention for individuals with PTSD symptoms and co-occurring hazardous drinking. Risks for participation were expected to be potential discomfort with answering questions about mental health and substance use. No serious adverse events were anticipated, and the study was judged to be minimal risk by the IRB.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Loss Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward preventing future losses from trauma exposure, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Kristen Lindgren | University of Washington | 206-658-8083 | kpl9716@uw.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 12, 2024 | Mar 12, 2024 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D013313 | Stress Disorders, Post-Traumatic |
| D000428 | Alcohol Drinking |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
| D004327 | Drinking Behavior |
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Participants will receive text messages 3 days a week for a 4 week period. To keep text messages within the length of standard SMS limits (160 characters), each day's message will be sent in the form of two brief texts (each will be 160 characters or less). The content of the text messages will vary as a function of condition. Participants will be assigned to CBT text messages plus one of six combinations of framing (3: loss vs. gain vs. no framing) and mindsets (2: growth vs reminder) texts. The combination that consists of no framing and simple reminder is an active comparator as it is the version of CBT text messages closest to what has been tested previously.
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| No Framing + Growth Mindset | Experimental | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. |
|
| No Framing + Simple Reminder | Active Comparator | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a simple reminder to use the skill. |
|
| Baseline, 4 weeks, 8 weeks, 16 weeks |
| Depression, Anxiety, and Stress Scale | The Depression Anxiety Stress Scale (DASS-21) assesses the general psychopathology symptoms over the last month and is administered at pre-intervention (baseline), 1 month follow up (week 8), and 3 month follow up (week 16). It has 3 subscales; two of which (anxiety and depression subscales) are outcomes for this study. The total range of scores of the anxiety subscale of the DASS-21 is 0-21 and higher scores indicate more severe symptoms. The total range of scores of the depression subscale of the DASS-21 is 0-21 and higher scores indicate more severe symptoms. | Baseline, 8 weeks, 16 weeks |
| Treatment Seeking | The Treatment Services Received (TSR) assesses the types of mental health and addictions treatments that individuals (e.g., inpatient, outpatient, 12-step, etc) received since enrolling in the study and is administered at 3 month follow up (week 16). Twelve types of treatment are listed and counted to calculate the number of types of treatment that individuals received over the 16-week study period. The minimum possible score is 0 (no services received) and the maximum is 12 types of treatment. Higher numbers indicate receiving more types of treatment. | 16 weeks |
| Drug Use | The Customary Drinking and Drug Use Record (CDDR) assesses comprehensive substance use, other than alcohol, over the last 3 months and is administered at pre-intervention (baseline) and 3 month follow up (week 16). The total range of scores is 0-12 and higher scores indicate more drug use. | Baseline,16 weeks |
| Drug Use Problems | The Drug Abuse Screening Test (DAST-10) assesses the problems related to other substance use and likely drug use disorder diagnosis over the last 12 months and is administered at pre-intervention (baseline) and 3 month follow up (week 16). The total range of scores is 0-10 and higher scores indicate more substance use-related problems and likely drug use disorder diagnosis. | Baseline, 16 weeks |
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| NOT COMPLETED |
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| COMPLETED |
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| NOT COMPLETED |
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| BG001 | Loss Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward prevent future losses from trauma exposure, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| BG002 | Gain Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| BG003 | Gain Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| BG004 | No Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| BG005 | No Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| BG006 | Total | Total of all reporting groups |
| years |
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| Sex/Gender, Customized | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| OG001 | Loss Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward prevent future losses from trauma exposure, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| OG002 | Gain Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| OG003 | Gain Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| OG004 | No Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
| OG005 | No Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks |
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| Primary | Posttraumatic Stress Disorder (PTSD) | The Posttraumatic Stress Disorder Checklist for the 5th Edition of Diagnostic and Statistical Manual of Mental Disorders (PCL-5) assesses the severity of symptoms of posttraumatic stress disorder (PTSD) as defined by the 5th Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16) to assess change in PTSD symptoms. The range of the scale is 0-80. Higher scores represent more severe PTSD symptoms. | Posted | Mean | Standard Deviation | score on a scale | Baseline, 4 weeks, 8 weeks, and 16 weeks |
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| Primary | Typical Weekly Alcohol Consumption | The Daily Drinking Questionnaire (DDQ) assesses the number of standard drinks consumed each day of a typical week over the last month and is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16). The range for the scale to report drinks consumed each day is 0-25. Each day's score for the week is summed to created a total number of drinks consumed per week; the count of drinks consumed per week ranges from 0 to 175. Higher scores representing greater number of drinks consumed during a typical week. | Posted | Mean | Standard Deviation | number of standard drinks per week | Baseline, 4 weeks, 8 weeks, 16 weeks |
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| Primary | Alcohol Use Consequences | The Short Index of Problems (SIP) assesses the negative consequences from alcohol consumption over the last month and is administered at pre-intervention (baseline), post-intervention (week 4), 1 month follow up (week 8), and 3 month follow up (week 16). The range for the scale is 0-15 and higher scores represent a greater number of alcohol-related consequences. | Posted | Mean | Standard Deviation | score on a scale | Baseline, 4 weeks, 8 weeks, 16 weeks |
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| Secondary | Risk of Alcohol Use Disorder (AUD) | The Alcohol Use Disorders Identification Test (AUDIT) assesses problem drinking and likely diagnosis of an alcohol use disorder over the last 12 months and is administered at pre-intervention (baseline) and 3 month follow up (week 16). The total range of scores is 0-40 and higher scores represent greater risks of having an alcohol use disorder. | Posted | Mean | Standard Deviation | score on a scale | Baseline,16 weeks |
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| Secondary | Depression, Anxiety, and Stress Scale | The Depression Anxiety Stress Scale (DASS-21) assesses the general psychopathology symptoms over the last month and is administered at pre-intervention (baseline), 1 month follow up (week 8), and 3 month follow up (week 16). It has 3 subscales; two of which (anxiety and depression subscales) are outcomes for this study. The total range of scores of the anxiety subscale of the DASS-21 is 0-21 and higher scores indicate more severe symptoms. The total range of scores of the depression subscale of the DASS-21 is 0-21 and higher scores indicate more severe symptoms. | Posted | Mean | Standard Deviation | score on a scale | Baseline, 8 weeks, 16 weeks |
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| Secondary | Treatment Seeking | The Treatment Services Received (TSR) assesses the types of mental health and addictions treatments that individuals (e.g., inpatient, outpatient, 12-step, etc) received since enrolling in the study and is administered at 3 month follow up (week 16). Twelve types of treatment are listed and counted to calculate the number of types of treatment that individuals received over the 16-week study period. The minimum possible score is 0 (no services received) and the maximum is 12 types of treatment. Higher numbers indicate receiving more types of treatment. | Posted | Mean | Standard Deviation | unique mental health treatments | 16 weeks |
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| Secondary | Drug Use | The Customary Drinking and Drug Use Record (CDDR) assesses comprehensive substance use, other than alcohol, over the last 3 months and is administered at pre-intervention (baseline) and 3 month follow up (week 16). The total range of scores is 0-12 and higher scores indicate more drug use. | Posted | Mean | Standard Deviation | score on a scale | Baseline,16 weeks |
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| Secondary | Drug Use Problems | The Drug Abuse Screening Test (DAST-10) assesses the problems related to other substance use and likely drug use disorder diagnosis over the last 12 months and is administered at pre-intervention (baseline) and 3 month follow up (week 16). The total range of scores is 0-10 and higher scores indicate more substance use-related problems and likely drug use disorder diagnosis. | Posted | Mean | Standard Deviation | score on a scale | Baseline, 16 weeks |
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| 0 |
| 84 |
| 0 |
| 84 |
| 0 |
| 84 |
| EG001 | Loss Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward prevent future losses from trauma exposure, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks | 0 | 83 | 0 | 83 | 0 | 83 |
| EG002 | Gain Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks | 0 | 86 | 0 | 86 | 0 | 86 |
| EG003 | Gain Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that is framed with toward future benefits from doing so, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks | 0 | 85 | 0 | 85 | 0 | 85 |
| EG004 | No Framing + Growth Mindset | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a reminder that aims to instill a growth mindset about using the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks | 0 | 85 | 0 | 85 | 0 | 85 |
| EG005 | No Framing + Simple Reminder | Participants in this condition will receive 3 days of text messages for 4 weeks. Day 1 will consist of psychoeducation about CBT skill, day 2 will be a remainder to use the skill that has no framing, and day 3 will have a simple reminder to use the skill. CBT Text Messages: CBT skills based text messages delivered 3x per week for four weeks | 0 | 82 | 0 | 82 | 0 | 82 |
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| D001519 | Behavior |
| Timepoint: Post-intervention (Week 4) |
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| Timepoint: Month 1 follow-up (Week 8) |
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| Timepoint: Month 3 follow-up (Week 16) |
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| Timepoint: Post-intervention (Week 4) |
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| Timepoint: Month 1 follow-up (Week 8) |
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| Timepoint: Month 3 follow-up (Week 16) |
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| Timepoint: Post-intervention (Week 4) |
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| Timepoint: Month 1 follow-up (Week 8) |
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| Timepoint: Month 3 follow-up (Week 16) |
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| Timepoint: Month 3 follow-up (Week 16) |
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| Timepoint: Month 1 follow-up (Week 8), Depression |
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| Timepoint: Month 3 follow-up (Week 16), Depression |
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| Timepoint: Pre-intervention (Baseline), Anxiety |
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| Timepoint: Month 1 follow-up (Week 8), Anxiety |
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| Timepoint: Month 3 follow-up (Week 16), Anxiety |
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| Timepoint: Month 3 follow-up (Week 16) |
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| Timepoint: Month 3 follow-up (Week 16) |
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