Development of a Personalized Feedback Intervention Targeting Pain-Related Anxiety for Adults Reporting Hazardous Drinking and Chronic Pain: A Randomized Controlled Trial.

OBJECTIVE:Among individuals with chronic pain, the rate of hazardous alcohol use is elevated compared to the general population. Yet, hazardous drinkers with chronic pain remain an underserved group. There is a need to develop and test alternative and complementary interventions to reduce hazardous alcohol use among this high-risk segment of the general population; targeting pain-related anxiety, a candidate mechanism, is one theoretically-informed route. METHOD:Our approach followed a staged model (1a/1b) to develop and test a novel personalized feedback intervention (PFI). Phase 1A collected qualitative feedback from (N = 9; 77.8% female, Mage = 33.86, SD = 8.75) participants to refine intervention content and evaluate treatment acceptability and feasibility. For phase 1B, individuals (N=118; 57.3% male, Mage = 35.24, SD = 11.90) participated in a pilot randomized clinical trial for our novel PFI compared to a health information control condition on alcohol use, intention/motivation to reduce drinking, pain-related anxiety, and expectancies for alcohol analgesia/pain coping for hazardous drinkers with chronic pain. RESULTS:Phase 1a results provided support for the feasibility of using a PFI to target pain-related anxiety, and results from Phase 1b indicated that participants reduced drinking and primary outcomes changed in the expected directions, but there were no differential effects of the intervention. CONCLUSIONS:The current data provide preliminary evidence for the utility of computer-based brief interventions to encourage behavior change. However, further refinement of the intervention to target pain-related anxiety is warranted.