The Social Context for AA-related Behavior Change (Tonigan, PI)

Alcoholics Anonymous (AA) is by far the most commonly sought source of help for alcoholism. Even among those receiving alcoholism treatment, a majority subsequently attend AA. Significant gains have been made in documenting the nature and magnitude of AA-related benefit, and incremental advances have occurred to better understand the mechanisms of change in AA that produce increased abstinence. Dr. Tonigan's K02 renewal application requests 5-years of funding to launch a new line of programmatic AA-research, one that integrates AA social dynamics with the more established study of behavior change mechanisms in AA to better understand short and long-term recovery from alcoholism. The achievement of this synthesis will provide practitioners with ecologically valid and clinically meaningful information to help clients initiate and sustain AA participation. Three career objectives are specified in the application, which are directly supported by and closely integrated with, the applicant's ongoing and planned AA-related research. Knowledge gains that are necessary to launch this new line of AA research include basic and advanced didactic training in social dynamic theory and practice, and intensive training in multilevel statistical analyses to investigate prospective hypotheses with nested, hierarchically arranged data structures. The career development plan also includes frequent and intensive consultations with Drs Moos and Stout, experts in social group dynamics and HLM-based statistics. While the general objective of mentoring AA investigators remains intact in the renewal application, proposed mentoring objectives reflect the evolving needs of the maturing field of mutual-help research. Dr. Tonigan thus proposes to secure an R13 mechanism to support 3-years of AA-specific conferences, each of which will generate a research monograph. The research plan is sequenced to consolidate knowledge gains and to provide pilot data for a new R01 application in year 3. Five research activities are described to achieve these goals, including organizing a consortium of four NIAAA funded studies to generate large data sets on perceptions of AA meeting social dynamics. A planned R01 is then described, one that includes recruitment from AA and treatment, 7 waves of assessments over 24 months, and testing of prospective hypotheses about the main and mediating effects of perceived AA meeting social dynamics on mobilizing AA-related behavior change.