PROJECT SUMMARY/ABSTRACT Despite being one of the largest and fastest-growing demographics in the United States (US), Latinx persons experience striking health disparities, particularly in terms of hazardous drinking and co-occurring elevated anxiety. The co-occurrence of these risk factors contributes to worse physical/mental health outcomes among Latinx individuals. Few interventions to date have targeted hazardous drinking in the context of high anxiety among Latinx persons. The current Phase I STTR project directly aligns with the published NIAAA SBIR/STTR Research Interests1, including developing “Mobile device applications … to improve the effectiveness, accessibility, and use of behavioral interventions for AUD and co-occurring disorders” and “Solutions for minority health and health disparities with capabilities of reaching persons in rural, remote, and under- resourced/under-served communities.” The current proposal has the end goal of improving strategies to prevent alcohol misuse, alcohol use disorder, and alcohol-related consequences among an ‘at-risk’ population for these conditions. In addition, it enhances the public health impact of NIAAA-supported research by focusing on one of the fastest-growing and largest demographics in the US who demonstrate disparities in hazardous drinking. We aim to remove barriers of treatment access and cost and increase treatment appeal by offering a digital therapeutic product in the form of a smartphone-delivered, personalized, brief intervention named Aliento, designed to address hazardous drinking and associated elevated anxiety. We will utilize and iterative approach using expert input and focus groups (N = 21) of Latinx hazardous drinkers with elevated anxiety to inform the design and functionality of the prototype. We will then assess program navigation and conduct usability testing of Aliento among Latinx hazardous drinkers with elevated anxiety (N = 5) and prepare the final prototype. With the final prototype we will evaluate the feasibility, acceptability, and effects of Aliento among Latinx hazardous drinkers with elevated anxiety symptoms (N = 50) recruited from a Federally Qualified Health Center (FQHC). The low-cost app will address infrastructure barriers that prevent delivery of such interventions in point-of-care settings (i.e., community health centers) and will be delivered in Spanish to reduce language barriers. This study represents an important and pivotal step in the larger landscape of translating basic research to more efficacious strategies for reducing hazardous drinking in underserved populations with biobehavioral comorbidities. We anticipate robust evidence for the feasibility, acceptability, and clinical utility of the Aliento mobile app that will support proceeding to Phase II development and evaluation. Aliento fills a crucial niche as evidenced by requests from local community health center administrators and clinicians, is based on a theoretically rich and empirically derived intervention and is practical enough to lend itself to mobile delivery in community health centers. We strongly believe this intervention will offer a promising and profitable approach to address alcohol/anxiety-related disparities among an underserved population.

PROJECT NARRATIVE There is a public health need to develop novel, culturally adapted interventions to reduce alcohol consumption among Latinx hazardous drinkers with comorbid elevated anxiety. We propose to conduct an open trial to develop and examine a culturally adapted, brief, integrated, Spanish language mobile health application for the Android platform, named Aliento, optimized to deliver our Anxiety-Alcohol Personalized Feedback Intervention (PFI) and designed to reduce hazardous alcohol consumption and anxiety symptoms, alcohol-related negative consequences, and anxiety-related impairment. Aliento fills a crucial niche as evidenced by requests from local community health center administrators and clinicians, is based on a theoretically rich and empirically derived intervention and is practical enough to lend itself to mobile delivery in community health centers.