Reducing Alcohol Misuse and Promoting Treatment InitiationAmong Veterans Through a Brief Internet-Based Intervention:Protocol for a Randomized Controlled Trial

Background: Young adult veterans who served after the September 11 attacks on the United States in 2001 (ie, post-9/11) areat heightened risk for experiencing behavioral health distress and disorders including hazardous drinking, posttraumatic stressdisorder, and depression. These veterans often face significant barriers to behavioral health treatment, and reaching them throughbrief mobile phone-based interventions may help reduce drinking and promote treatment engagement.Objective: Following a successful pilot study, this randomized controlled trial (RCT) aims to further test the efficacy of a brief(ie, single session) mobile phone-delivered personalized normative feedback intervention enhanced with content to promotetreatment engagement.Methods: We will conduct an RCT with 800 post-9/11 young adult veterans (aged 18 to 40 years) with potentially hazardousdrinking and who have not recently received treatment for any behavioral health problems. Participants will be randomly assignedto the personalized intervention or a control condition with resources for seeking care. The personalized normative feedbackmodule in the intervention focuses on the correction of misperceived norms of peer alcohol use and uses empirically informedapproaches to increase motivation to address alcohol use and co-occurring behavioral health problems. Past 30-day drinking,alcohol-related consequences, and treatment-seeking behaviors will be assessed at baseline and 3, 6, 9, and 12 months postintervention. Sex, barriers to care, posttraumatic stress disorder, depression, and severity of alcohol use disorder symptoms willbe explored as potential moderators of outcomes.Results: We expect recruitment to be completed within 6 months, with data collection taking 12 months for each enrolledparticipant. Analyses will begin within 3 months of the final data collection point (ie, 12 months follow-up).Conclusions: This RCT will evaluate the efficacy of a novel intervention for non-treatment-seeking veterans who struggle withhazardous drinking and possible co-occurring behavioral health problems. This intervention has the potential to improve veteranhealth outcomes and overcome significant barriers to treatment.Trial Registration: ClinicalTrials.gov NCT04244461; https://clinicaltrials.gov/study/NCT04244461International Registered Report Identifier (IRRID): DERR1-10.2196/59993