The combination of COVID-19 and alcohol/substance use disorders exacerbated a wide range of existing problems, including the likelihood of contracting COVID and the severity of its consequences, pandemic-related stresses that triggered alcohol and substance use, loss of jobs and healthcare access, increased interpersonal violence, and overarching systemic inequities. Interventions were needed to address these serious problems, which were likely to persist. In response to PAR 20-243, this R01 project was a Hybrid II RCT/implementation study that modified and tested two alcohol smartphone interventions to address the fallout from COVID.

The study performed a 3-arm RCT comparing a control group, a drinker-focused intervention, and a family-focused intervention. The drinker-focused intervention (ACHESS-C) was an extension of the evidence-based Addiction–Comprehensive Health Enhancement Support system (ACHESS), augmented with COVID resources. The family-focused intervention (FamCHESS-C) combined ACHESS-C services with evidence-based Alcohol Behavioral Couple Therapy services to help both the drinker and the partner with behavior change, relationship problems, and general well-being.

In the 8-month trial plus 4-month follow-up, 198 dyads (drinker + family member) were randomly assigned to:

• Smartphone control: Both received a smartphone with standard support and crisis numbers;
• ACHESS-C: The drinker received a phone with ACHESS-C, and the partner received a phone with support and crisis numbers;
• Fam-CHESS-C: Both received a phone with FamCHESS-C.