Project Abstract Each year in the U.S., millions of Spanish-speaking Hispanics experience negative consequences from harmful alcohol use. Hispanics suffer from alcohol use disorder (AUD) and alcohol-related liver disease at rates similar to non-Hispanic Whites. However, Hispanics with AUD are less likely to receive treatment than non- Hispanic Whites. Hispanics also face greater socioeconomic, cultural, and linguistic barriers to treatment for AUD than non-Hispanic Whites. These barriers include limited access to Spanish-speaking providers and culturally adapted evidence-based treatments. Computerized treatments and mobile technology have significant potential to increase access to evidence-based treatments in a cost-effective manner for Spanish speakers. A culturally adapted computerized treatment for Spanish-speaking Hispanics with substance use disorders has demonstrated efficacy at reducing rates of alcohol and drug use in a randomized clinical trial (Computer-Based Training for Cognitive Behavioral Therapy; Spanish CBT4CBT). Several other clinical trials have supported the efficacy and cost-effectiveness of English versions of CBT4CBT. Rapid, mobile delivery of CBT skills would facilitate treatment feasibility during risky periods for drinking in daily life (e.g. weekend evenings). But, CBT4CBT modules each require 35-40 minutes of sustained attention to complete and cannot be used quickly during high- risk drinking periods. This project proposes to develop a concentrated mobile version of Spanish CBT4CBT to rapidly deliver treatment content on high-risk drinking days: Aim 1) Identify Spanish CBT4CBT module topics associated with greater reductions in daily alcohol use and psychiatric symptoms. Aim 2) Develop a concentrated version of Spanish CBT4CBT consisting of a subset of content from the current modules. Aim 3) Test the feasibility and acceptability of using smartphones to deliver a concentrated version of Spanish CBT4CBT on high-risk drinking days. To complete these aims, my career development plan includes mentored training in the following domains: 1) conducting clinical trials of treatments for AUD; 2) designing culturally adapted treatments for Hispanics; 3) delivering treatment components through smartphones; 4) using mixed methods to explore stakeholders’ perspectives on treatments for AUD; 5) fostering professional development through grant writing, publishing, leadership, and networking. This award will provide me with hands-on experience in ongoing clinical trials of computerized treatments for Spanish speakers with AUD. I will participate in NIH training programs on digital technologies, minority health, and professional development, including the MOSAIC UE5 leadership forums. I will complete Yale University courses on clinical trial methods, qualitative research, and grant writing. These activities will build on my prior expertise with using mobile technology and advanced statistics to study the temporal dynamics of motivation for drinking and social processes. This award will support my transition to an independent research career developing mobile treatments for Hispanics to target drinking in real-time.

Project Narrative Many Hispanics who have an alcohol use disorder face much greater difficulties getting treatment than non- Hispanic Whites. This disparity exists partially because there are not enough Spanish-speaking treatment providers who can deliver culturally adapted treatments. This research will develop a brief culturally adapted mobile treatment for alcohol use disorder that Spanish-speaking Hispanics can use through their smartphones on days when they are at high risk for drinking (e.g. weekends, holidays).