# Using Wearable Technology to Develop Biomarker-Driven Intervention for Alcohol-Facilitated Intimate Partner Violence

> **NIH NIH R21** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2022 · $226,783

## Abstract

ABSTRACT
Alcohol use disorder (AUD) and acute intoxication have a salient precipitous effect on intimate partner violence
(IPV). Conversely, IPV negatively impacts AUD treatment and increases risk for relapse. Despite intense
scientific inquiry regarding behavioral mechanisms underlying this link, there remains a critical unmet need to
identify complex multimodal mechanisms and develop effective treatments to reduce alcohol-facilitated IPV.
Mitigating maladaptive physiological reactivity in the form of respiratory sinus arrhythmia measure of heart rate
variability (HRV) is one promising pathway to achieve this goal. HRV is an autonomic biomarker of sympathetic
dominance and emotional over-arousal relevant to AUD pathophysiology. Our team’s promising laboratory
research also suggests that HRV is an emerging mechanism underlying alcohol-facilitated IPV. However, a
critical step to achieve clinical translation is to extend these findings to naturalistic settings. The primary
objective of the proposed project is to use wearable technology to develop proof-of-concept of HRV as a
biomarker of alcohol-facilitated IPV in vivo. Our secondary objective is to examine the preliminary usability,
feasibility, and acceptability of a remote, self-administered HRV biofeedback (HRV-B) intervention. To
accomplish this, we will utilize discreet, low cost wearable technology in an innovative 28-day
micro-longitudinal design. Participants (N=50 couples, 100 total participants) will complete ecological
momentary assessment (EMA; 4 times daily plus optional event-triggered reports) of alcohol use, couple
conflict including IPV, and affect via smartphone. Both partners within each dyad will be assigned to the
same assessment schedule, and we will use geolocation to further contextualize our primary outcomes.
During days 21-28, participants will also receive once-daily prompts to complete 10 minutes of HRV-B in a
non-randomized, open-label approach. This study will also leverage our team’s established remote
participation procedures from ongoing AUD trials. Participants will have the option to complete the study
remotely using electronic informed consent, mailing of study materials, and interviews, surveys, and direct
observation of biologic sample data using HIPAA-compliant platforms. These findings will be used to
refine and optimize our methodology, statistical power, and HRV-B dose and timing in preparation for a
collaborative R01 application proposing a randomized controlled trial of the efficacy of HRV-B delivered
remotely in a “just-in-time” fashion. The proposed study directly addresses the mission of the National Institute
on Alcohol Abuse and Alcoholism (NIAAA) in that will identify real-time physiological and behavioral
antecedents and sequelae of alcohol-facilitated IPV in naturalistic settings. Our findings will provide
critical new information to advance the mechanistic science and accelerate clinical prevention and
intervention efforts in the area of alcoho...

## Key facts

- **NIH application ID:** 10373267
- **Project number:** 1R21AA029235-01A1
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** JULIANNE Christina Flanagan
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $226,783
- **Award type:** 1
- **Project period:** 2022-03-01 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10373267

## Citation

> US National Institutes of Health, RePORTER application 10373267, Using Wearable Technology to Develop Biomarker-Driven Intervention for Alcohol-Facilitated Intimate Partner Violence (1R21AA029235-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10373267. Licensed CC0.

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