Integrated Digital Health Approach to Reduce Hazardous Alcohol Use and Chronic Pain Among Rural Populations

The current proposal seeks to test the benefit of a brief intervention combined with a digital program delivered though a smartphone app for reducing chronic pain and hazardous drinking among those in rural settings. Participants are recruited through social media and complete an online pre-screener and telephone screener to determine eligibility. All subsequent study assessment procedures are conducted through videoconferencing online. Participants complete 3 assessments over the course of 8 months. Following the first (baseline assessment) participants are randomized to either the INTERVENTION (INTV) or a treatment-as-usual CONTROL (CTL) condition. Those in the INTV condition meet with a health counselor for up to 50 minutes and then complete an 8-week smartphone-based intervention with weekly SMS based brief coaching. This in the CTL group meet with the health counselor only. Participants complete additional assessments at 3-months and 8-months post -baseline. Measures of alcohol use and pain are assessed after the intervention at 3 months and at the final outcome period at 8-months post-baseline.

Inclusion Criteria: * Reside in a US rural area (non-metropolitan country) as defined by the Rural-Urban Commuting Codes from US Dept. of Agriculture * At least 18 years of age * Engage in hazardous drinking (either by exceeding weekly NIAAA guidelines of 7 standard drinks for women \[\>7\] and those \> 65 and older or 14 for men \[\>14\] \3 drinks for women and those \> 65 and \>4 drinks for men \< 65), - - Experience chronic pain (at least 3 months in duration) of at least moderate severity (4 or greater on the Numerical Pain Rating Scale) * Fluent in English * Use of a personal smartphone * Able to provide the name and contact information for one or more individuals who may be contacted in case the participant cannot be reached at follow-up. Exclusion Criteria: * History of bipolar disorder, schizophrenia, or other psychotic disorders * Prior history of serious alcohol-related withdrawal symptoms (i.e., withdrawal-related seizures or delirium tremens) * Current psychological/behavioral treatment for alcohol use disorder * Current psychological/behavioral treatment for chronic pain * Cancer-related pain * Intent to have surgery for a pain-related condition in the next 8-months * If using psychoactive medications for pain management or alcohol use must be using a stable medication dose (same dose for at least 2 months).