Contingency Management to Reduce Alcohol Use in a Soup Kitchen Sample

Alcohol use and alcohol-related disorders are highly prevalent in soup kitchen users, and
this population is overrepresented by minorities and disproportionately affected by
alcohol-related morbidity and mortality. Contingency management is a behavioral intervention
effective in reducing substance use, but few studies have evaluated the efficacy of
contingency management in the context of soup kitchens or homeless programs. The
investigators found that contingency management, using a twice weekly testing and
reinforcement schedule, had benefits for decreasing drinking in individuals receiving
services at a homeless shelter. This study will replicate and extend these earlier findings
to a soup kitchen population using more sophisticated alcohol monitoring procedures to
better assess the extent of drinking in this group and in response to a contingency
management intervention reinforcing submission of negative breath samples. Specifically, 40
hazardous drinkers recruited from a soup kitchen will be randomly assigned to one of two
conditions: alcohol monitoring or the same plus reinforcement for provision of daily
negative breath alcohol samples. The interventions will be in effect for 3 weeks, and all
participants will also wear transdermal continuous alcohol monitors during the intervention
period. Objective and subjective indices of alcohol consumption will be evaluated and
compared between and within the treatment conditions. This pilot project will provide
information regarding the effect size of contingency management reinforcing negative breath
samples in an important health disparities group, and results from this study will guide
subsequent grant applications focusing on methods to decrease drinking in this underserved
population.