Telehealth-Delivered Mindfulness-Based Intervention: Protocol for a Randomized Clinical Trial for Individuals With Alcohol Use Disorder.

Background: Globally, approximately 8.6% of people will meet criteria for alcohol use disorder (AUD) in their lifetimes, with 2.2% meeting criteria for AUD in the past 12 months. In the United States, AUD prevalence is even greater, with 13.9% meeting criteria in the past 12 months. Effective treatments for AUD exist, although most people receive help through mutual support groups (ie, Alcoholics Anonymous [AA]). However, AA and other mutual support programs may not be desirable for all individuals, particularly those who do not seek abstinence-based approaches. Treatments that support reductions in drinking have been shown to be as effective as abstinence-based treatments in reducing alcohol-related harms, and may be more appealing to a broader range of people. Mindfulness-based interventions may be particularly effective in supporting long-term recovery, whole-person health, and functioning for those with abstinent and nonabstinent recovery goals.

Objective: This study is designed to test a novel rolling group-based mindfulness-based relapse prevention (MBRP) delivered via videoconferencing, focused on drinking reduction goals and whole-person functioning.

Methods: This study is a hybrid type 1 effectiveness-implementation design to prospectively test the effectiveness of MBRP and to identify barriers and facilitators of group participation to inform future implementation of MBRP as continuing care. Individuals with AUD (n=470) interested in stopping or reducing their drinking, meet criteria for AUD based on a symptom checklist, report heavy drinking at least once in the past 6 months, consent and understand study procedures in English, and provide a valid US mailing address are recruited nationwide via online sources in the United States. Participants are randomized to either MBRP groups via Zoom (Zoom Video Communications, Inc) or referral to online mutual support (eg, AA). All participants receive an individual orientation session delivered via Zoom that includes brief motivational interviewing and an overview of their assigned condition and next steps (MBRP condition: overview of the MBRP groups and instructions on participating in MBRP via Zoom; referral condition: referral to online mutual support groups). Participants provide blood samples for phosphatidylethanol testing at baseline and 3-year follow-up and complete self-report measures of psychosocial functioning, alcohol and other drug use, addiction cycle domains, and previously established predictors of recovery every 6 months for 3 years.

Results: Recruitment began on September 13, 2023, and the last recruited participant was randomized on March 20, 2025. Follow-up data collection is ongoing with all 6-month follow-ups completed (86% retention).

Conclusions: This study evaluates the effectiveness and mechanisms of MBRP delivered via videoconferencing, compared with referral to online mutual support groups, in supporting recovery among individuals with AUD. It also examines the reach, effectiveness, adoption, implementation, and maintenance of MBRP as an accessible, freely available continuing care option to support long-term recovery from AUD.