Project Summary / Abstract Alcohol misuse, which includes alcohol use disorder (AUD), is present in up to 2 million patients admitted to an intensive care unit (ICU) each year. The ICU admission may be a “teachable moment” and many ICU survivors are motivated to change their drinking. Unfortunately, the current paradigm for linking ICU survivors to alcohol treatment is ineffective. The unique challenge in harnessing an ICU patient’s motivation is that alcohol treatment programs are separated from the acute care environment. This proposal describes a 2-year research fellowship program that will iteratively develop and pilot a peer-narrated virtual tour regarding treatment for ICU survivors with AUD and will allow Dr. Kelsey Hills-Dunlap to develop an academic career in Critical Care Medicine. The proposed research program will develop the first and only virtual intervention for ICU survivors with AUD aimed at increasing entry to alcohol treatment and will provide the research skills necessary to further Dr. Hills- Dunlap toward her goal of becoming an independent investigator in alcohol health services and critical care research. The program will consist of direct mentoring from a multidisciplinary team of nationally renowned local experts in alcohol and critical illness, health behavior change, decision aids, and qualitative methodology. In addition, a formalized research advisory committee will ensure that the goals and benchmarks of this proposal are met. The program will also include coursework in clinical sciences, addiction medicine and medical decision making. This cohesive program will help Dr. Hills-Dunlap learn and apply multiple research methods, acquire foundational knowledge of addiction medicine focusing on AUD, and gain expertise in the development and implementation of decision aids for ICU survivors with AUD. The overall research goal of this proposal is to optimize the way in which alcohol treatment options are delivered to ICU survivors with AUD through the creation of a peer-narrated virtual tour prototype. Presenting treatment options in the form of a peer-narrated virtual tour may help overcome the separation between the acute care environment and alcohol treatment programs. Dr. Hills-Dunlap will build this prototype by first conducting semi- structured interviews in ICU survivors with AUD to determine the content of the tour. Subsequently, she will use a rigorous process of development and feedback to create a video prototype of a peer-narrated virtual tour of the Center for Dependency, Addiction and Rehabilitation (CeDAR), a nationally recognized addiction treatment center at the University of Colorado Anschutz Medical Campus, and will pilot the prototype for acceptability. This will pave the way for a NIAAA K23 submission to complete peer-narrated virtual tours for the remaining treatment options in the Denver area and conduct a pragmatic effectiveness study. A peer-narrated virtual tour for ICU survivors with AUD would help to close the treatment gap for a large population of patients at a time when they are uniquely motivated to change.

Project Narrative Alcohol use disorder (AUD) is common among patients in the intensive care unit (ICU) but very few ICU survivors with AUD are effectively connected to alcohol treatment programs. The goal of this project is to facilitate the entry of ICU survivors with AUD into alcohol treatment by creating, refining, and piloting a peer-narrated virtual tour of an alcohol treatment program which would immediately and virtually transport a patient to a treatment facility while hearing the narrative of a peer in recovery. After rigorous development and testing, the end result will be a video patient decision aid for ICU survivors with AUD that can be expanded to various treatment options in the Denver area for a larger pragmatic effectiveness trial.