Notice of Special Interest on "development and dissemination of behavioral treatments for alcohol use disorder"

Notice Number: NOT-AA-19-010

Key Dates
Release Date : February 11, 2019

Related Announcements
None

Issued by
National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Purpose

This Notice signals NIAAA’s continuing interest in research on behavioral treatments for alcohol use disorder.  NIAAA invites applications for research that develop novel behavioral therapies, adapt existing treatments to new formats or populations, and enhance the broader dissemination of effective behavioral treatments for those with an AUD or significant drinking problems.  Such research considers behavioral treatments; developing, disseminating and implementing mechanisms of behavior change evidence-based processes; the organizational, cost-effectiveness, and environmental factors that facilitate or inhibit the delivery of evidence-based services for alcohol use disorders and enhancing clinical and supervision processes among clinical researchers and treatment providers.

NIAAA’s research interests in these areas are described in detail below. Investigators are strongly encouraged to speak with a program official before preparing an application.  Applicants should use the appropriate NIH Research Project Grant Parent Announcements when applying, and request assignment to NIAAA.

BACKGROUND:

(1) Behavioral Therapies

The alcohol treatment field has made enormous progress in the development and evaluation of behavioral treatments for heavy drinking and alcohol use disorders (AUDs). A primary limitation to our understanding and conceptualization of the effectiveness of behavioral treatments for AUD is that little is known about how to successfully disseminate and implement empirically-supported behavioral treatments for AUD within real-word addiction treatment settings and practice. Also, with the continued advancements in technology, NIH emphasis on personalized medicine, and continued development of novel research methods and statistics, continued strides can be made in understanding the efficacy and effectiveness of alcohol behavioral treatments as well as enhance the development of novel behavioral treatments for AUD. NIAAA encourages research that more broadly disseminates empirically-supported behavioral treatments for AUD into real world addiction practice settings as well as continue to develop and evaluate the efficacy of novel behavioral treatments.   

Examples of research in this domain include, but are not limited to:

  • Use dynamic and person-centered statistical modeling approaches to evaluate heterogeneity that impact alcohol use behavior within specific AUD treatments
  • Develop and evaluate adaptive clinical trial designs and statistical analyses that allow treatment       adjustments based on the changing disease status of the patient
  • Studies that test strategies to embed evidence-based treatments and/or evidence-based practices into standard clinical practice, and studies that examine the processes and contextual factors that hinder or facilitate the use of these treatments.
  • Enhance translational research methods by identifying potential neurobiological, cognitive or genetic processes that may act as potential mediators of therapeutic change and AUD behavioral treatment outcome
  • Develop strategies to enhance engagement, retention, and compliance of patients in treatment
  • Engage in research that harnesses technology (e.g., mobile phones) in disseminating empirically-supported behavioral treatments among harder to reach populations
  • Conduct research that adapts behavioral treatments with culturally diverse and special-emphasis populations

(2) Mechanisms of Behavior Change

Over the past 15 years, the Mechanisms of Behavior Change (MOBC) initiative in the Division of Treatment and Recovery Research at NIAAA has led to the identification of a number of potential empirically-supported mechanisms of treatment-related change (e.g., self-efficacy; therapeutic alliance) that underlie how specific behavioral treatments for AUD are purported to work. At present, we know little about how to teach clinical treatment providers to work with these empirically-supported mechanisms when they are not taught as one component of a specific, packaged therapy manual.  As a result, an important gap in MOBC science is the lack of a theoretical and translational framework that integrates MOBC and Dissemination and Implementation (D & I) scientific methodologies. NIAAA encourages research efforts to identify, evaluate and disseminate empirically-supported MOBC best practices as well as develop and disseminate common factor, or core principle, models of how behavioral treatments for AUD should exert specific MOBC to addiction clinicians, social workers and/or practitioners.

Examples of research in this domain include, but are not limited to:

  • Develop evidence-based MOBC “best practices” based on empirically-supported mechanisms of behavioral treatments and methods for disseminating these to key providers and stakeholders 
  • Engage in research that harnesses technology in dissemination and training of MOBC evidence-based practices
  • Engage in complex research designs (e.g., dismantling studies) that enhance support and evidence for established mechanisms of AUD behavioral treatments
  • Conduct pragmatic clinical trials that evaluate MOBC of evidence-based behavioral treatments in real-world treatment settings
  • Evaluate novel MOBC that underlie the effectiveness of adaptations of behavioral treatments within culturally diverse and special-emphasis populations
  • Conduct research that engages key stakeholders and treatment providers in understanding how to implement MOBC evidence-based best practices and processes

(3) Enhancing Supervision and Clinical Training Efforts

Clinical training and supervision for addiction treatment researchers and clinicians is critical for enhancing treatment effect sizes, adherence and ensuring effective dissemination and delivery of empirically-supported behavioral treatments for AUD.  At present, several theoretical models and guidelines set forth by the American Psychological Association (APA) of the supervisory process have been developed, but the evidence base underlying how this process works has been limited in the alcohol treatment field. In addition, given the strong empirical basis for specific behavioral treatments, there remains a significant gap in clinical research and practice, whereby less is understood how effective training modules and manualized treatments for AUD are adopted and implemented among addiction treatment clinicians. NIAAA seeks to address these pertinent gaps and prioritize research that enhances greater understanding of processes related to clinical training and supervision in the delivery of empirically-supported mechanisms of behavior change and behavioral treatments for AUD.  

Examples of research ideas in this domain include, but are not limited to:

  • Conduct research that enhances either or a combination of normative, restorative or formative functions of the clinical supervision process
  • Engage in research that
  • Develop stepped-care training models that dose training based on needs of the clinician
  • Develop and evaluate evidence-based MOBC training modules for clinicians and key treatment providers
  • Engage in research that establishes mechanisms and processes that enhance the supervisor-trainee alliance
  • Engage in qualitative mix-method designs that observes and evaluates in real-time processes that underlie the supervisor-trainee dyad
  • Conduct research that evaluates and enhances processes of supervisor competence
  • Conduct research that examines the influence of racial and ethnic differences in the supervisor-trainee dyad

Application and Submission Information:

Applications for this Notice must submit an application through NIH Parent Announcement PA-18-345;

NIH Research Project Grant (Parent R01 Clinical Trial Required) or PA 18 484; NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

All instructions for the Parent Announcement must be followed.

Submissions should indicate that they are in response to NOT-AA-19-011 in Field 4.b on the SF 424 form.

Inquiries

Please direct all inquiries to:

For general inquiries and those specific to the Behavioral Treatment Development/Mechanisms of Behavior Change portfolios contact:

Brett T. Hagman, Ph.D.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Division of Treatment and Recovery Research (DTRR)
Telephone: 301-443-0638
Email: brett.hagman@nih.gov

For inquires specific to Health Services/Implementation Science portfolios contact:

Name: Lori Ducharme, Ph.D.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Division of Treatment and Recovery Research (DTRR)
Telephone: 301-451-8507
Email: lori.ducharme@nih.gov

For inquires specific to Technology/Translational Research Methods portfolios contact:

Anita Bechtholt, Ph.D.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Division of Treatment and Recovery Research (DTRR)
Telephone : 301-443-9334
Email: anita.bechtholt@nih.gov

For inquires specific to Co-occurring Disorders/Special Emphasis Populations portfolios contact:

Deidra Roach, Ph.D.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Division of Treatment and Recovery Research (DTRR)
Telephone : 301-443-5820
Email: droach@mail.nih.gov