# Improving Outcomes in Alcoholic Liver Disease: Integrating Behavioral Interventions into the Hepatology Clinic

> **NIH NIH K23** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $194,400

## Abstract

ABSTRACT
Alcoholic liver disease (ALD) causes nearly half of the liver-related deaths in the US, and with recent increases
in alcohol use disorders, ALD-related deaths are expected to rise. Unfortunately, medical treatments to arrest
liver dysfunction in ALD are of limited efficacy. Cessation of alcohol use, by contrast, is the only factor proven
to curb long-term mortality, even in the most advanced stages of ALD. Yet many patients with ALD never
cease alcohol use. Widely studied in the addiction literature, behavioral interventions for alcohol cessation
have not been a major focus of research in hepatology, and we know little about why such severely ill patients
continue to drink. Motivational interviewing may have benefit, but alone, may not be enough for these complex
patients. Creating patient-specific interventions by finding and correcting errors in how patients view the risks
of alcohol use and liver disease and understanding how these views impact alcohol treatment engagement
(the “mental models” method) combined with tailored alcohol intervention engagement may be a more effective
way of helping patients stop drinking. ALD patients often seek medical treatment for their liver disease while
avoiding formal treatment to stop alcohol use. The hepatology visit is therefore a unique opportunity to
transform existing liver health and alcohol use discussions into effective behavioral interventions to help ALD
patients stop drinking. The goal of this project is to improve outcomes in ALD patents by developing a novel
multimodal behavioral intervention, to be deployed in the hepatology clinic, to help patients stop drinking. We
will accomplish this by 1) eliciting patient mental models of the liver-related risk of ongoing alcohol use and
exploring how those beliefs are related to engagement in alcohol interventions, 2) developing a behavioral
intervention combining tailored risk education with motivational enhancement and preference-sensitive alcohol
treatment engagement, and 3) pilot testing this multimodal behavioral intervention in ALD patients. To
accomplish these aims, Dr. Mellinger will receive mentorship and focused didactic coursework and training in
alcohol misuse/use disorder treatment and research, behavioral intervention design and implementation, and
advanced mixed-methods research techniques. Dr. Mellinger's long-term goal is to become a leading
independent clinical investigator and expert in both hepatology and behavioral science in order to design
behavioral interventions to improve outcomes for patients with alcoholic liver disease (ALD) by helping them
stop drinking. An NIAAA K23 award will provide Dr. Mellinger with the protected time and needed training to
achieve her career goals and improve outcomes for patients with ALD by helping them stop drinking.

## Key facts

- **NIH application ID:** 9966835
- **Project number:** 5K23AA026333-03
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Jessica Leigh Mellinger
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $194,400
- **Award type:** 5
- **Project period:** 2018-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9966835

## Citation

> US National Institutes of Health, RePORTER application 9966835, Improving Outcomes in Alcoholic Liver Disease: Integrating Behavioral Interventions into the Hepatology Clinic (5K23AA026333-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9966835. Licensed CC0.

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