# Reducing Alcohol use among Elective Surgical Patients using Adaptive Interventions

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $650,389

## Abstract

Project Summary/Abstract
Surgery is a pivotal life event during which the acuity and imminence of surgical risk can motivate patients to
make major changes to behaviors and lifestyle factors to optimize surgical health. Preoperative alcohol
consumption (>2 drinks a day) is a common surgical risk factor linked to increased postoperative
complications. Appropriately timed interventions could promote short- and long-term alcohol use reduction and
prevent excess surgical morbidity and mortality. However, the dearth of research in this area limits our ability to
intervene effectively or leverage motivation at critical time points. This study uses a sequential, multiple
assignment, randomized trial (SMART) to test the efficacy of adaptive interventions for elective surgical
patients reporting high-risk alcohol use. These adaptive interventions use decision rules at critical points during
the surgical episode of care to modify treatment type and intensity based on early treatment response. The
specific aims are: 1) Test the efficacy of adaptive interventions that begin with preoperative ‘Virtual Coaching’
relative to Enhanced Usual Care on reducing alcohol use, surgical complications, and hospital length of stay;
and 2) Identify the most efficacious second-stage intervention to sustained alcohol use reduction after surgery
among early treatment responders and non-responders. Elective surgical patients (N = 440) will be
randomized before surgery to either Virtual Coaching or Enhanced Usual Care. Initial treatment response will
be assessed at the 2-month follow up for the perioperative period. Early responders (i.e., abstinence or low-risk
alcohol use) will be re-randomized to postoperative strategies, either continued Virtual Coaching or stepped
down to Usual Care. Early non-responders (i.e., not abstinent or low risk drinking), will be re-randomized to
alternative postoperative strategies, either ‘On-track,’ a mobile health intervention that incorporates self-
monitoring and progress feedback, or a combined intervention (Virtual Coaching + On-Track). Outcomes will
be measured at 2-, 6-, and 12-month follow-ups and via electronic health records. Secondary aims are: 1)
Identify the best performing adaptive interventions; and 2) Identify baseline and time varying moderators of
intervention efficacy. Results of this study will have wide-ranging implications for innovating and moving
beyond static alcohol interventions in healthcare settings and will advance surgical health optimization
research. This study is consistent with the priorities of the National Institute of Alcohol Abuse and Alcoholism
which seeks to advance addiction health services by integrating alcohol treatment into mainstream healthcare,
thereby improving access and decreasing stigma. The adaptive interventions developed in this study enables
real-time treatment tailoring based on individual’s response to first stage interventions, a critical advance in
care consistent with national precisi...

## Key facts

- **NIH application ID:** 10791910
- **Project number:** 5R01AA029666-03
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Anne Christie Fernandez
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $650,389
- **Award type:** 5
- **Project period:** 2022-05-05 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10791910

## Citation

> US National Institutes of Health, RePORTER application 10791910, Reducing Alcohol use among Elective Surgical Patients using Adaptive Interventions (5R01AA029666-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10791910. Licensed CC0.

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