# Mechanisms of Behavior Change in Alcohol Use Disorder Treatment

> **NIH NIH R01** · UNIVERSITY OF NEW MEXICO · 2020 · $428,721

## Abstract

Project Summary/Abstract
Numerous evidence-based behavioral and pharmacological interventions have been developed and some
have been adopted by alcohol treatment providers, however very little is known why specific treatments are
effective (i.e., what are the mechanisms of behavior change in treatment) and which treatments are most
effective for specific individuals. Despite an increased focus on mechanisms of behavior change among
alcohol researchers over the past 15 years, many findings have not been replicated and an evidence-based
understanding of why and for whom individual treatments for alcohol use disorder (AUD) are effective remains
elusive. First, it is clear that AUD is heterogeneous in both etiology and outcomes following treatment, yet
heterogeneity in mediators of AUD treatment has not been considered, mostly because of methodological
limitations. In general, the mechanisms of behavior change following alcohol treatment are not well
understood. Second, AUD treatment studies investigate multiple mechanisms of behavior change. One issue is
a lack of understanding and methodological techniques to test which mechanism of behavior change is robust
if it were to be replicated under a different set of conditions (e.g., different participants with different
mechanisms of behavior change). To address these gaps in understanding, this study will build an empirical
knowledge base by identifying robust mechanisms of behavior change (i.e., do mechanisms replicate across
different participants?) and by modeling heterogeneity in alcohol treatment (i.e., for whom it works/fails to work)
through development and application of the state-of-the-art methodological techniques, extensive analyses of
eleven existing randomized clinical trials for AUD, as well as simulation studies based on AUD clinical trial
data. Candidate mechanisms of behavior change, based on prior studies and the dynamic model of relapse as
a guiding theoretical model, will include self-efficacy, craving or urges to drink, mutual help involvement, social
support, therapeutic alliance, client language, and coping responses. Results from the proposed study will
inform an individualized approach to formulating treatment recommendations, clarify which treatment
mechanisms (mediators) are most robust across studies, and directly inform clinical decision making. In
addition, the proposed study will provide an extensive suite of data analytic tools that will be designed
specifically to answer questions regarding (a) testing robustness of candidate mediators, and (b) testing
mediation in the presence of heterogeneity. The analytic tools will accommodate features of data commonly
observed in AUD clinical trials and will be accessible to substantive researchers with knowledge of regression
and mediation. The ultimate goal of this study is to yield a better understanding of mechanisms of AUD
treatment outcomes in order to inform precision medicine initiatives.

## Key facts

- **NIH application ID:** 9900689
- **Project number:** 5R01AA025539-04
- **Recipient organization:** UNIVERSITY OF NEW MEXICO
- **Principal Investigator:** Davood Tofighi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $428,721
- **Award type:** 5
- **Project period:** 2017-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9900689

## Citation

> US National Institutes of Health, RePORTER application 9900689, Mechanisms of Behavior Change in Alcohol Use Disorder Treatment (5R01AA025539-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9900689. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*