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NCT Number: NCT07735585

TRIS: Contingency Management App for Alcohol Use Disorder

Alcohol Use Disorder (AUD) is a major public health concern associated with substantial morbidity, mortality, and impaired social and occupational functioning. Contingency Management (CM) is an evidence-based behavioral intervention that provides incentives contingent on abstinence and has demonstrated effectiveness in the treatment of substance use disorders. This study will evaluate the efficacy of Tratamento Remoto com Incentivos à Sobriedade (TRIS), a Brazilian mobile health application that integrates a smartphone app with a Bluetooth-enabled breathalyzer (BACtrack) to deliver remote CM for AUD. Participants will be randomized to receive either standard outpatient treatment plus TRIS-based CM or standard outpatient treatment with remote alcohol monitoring only. The primary objective is to determine whether TRIS-based CM increases biochemically verified alcohol abstinence compared with standard outpatient treatment alone.

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Key information

Conditions

Alcohol Use Disorder (AUD) Alcohol-Related Disorders Alcoholism Chemically-Induced Disorders Mental Disorders Substance-Related Disorders

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

IPER Research Center

São Paulo, 05021-001, Brazil

Location status: Recruiting

About this study

A total of 130 adults with Alcohol Use Disorder (AUD) from two public outpatient clinics in São Paulo, Brazil, will be randomized (1:1) to the experimental or control group. The experimental group will receive standard outpatient treatment plus 12 weeks of remote Contingency Management (CM) delivered through the TRIS mobile application. Participants will submit three daily breath alcohol concentration (BrAC) samples at 1:00 p.m., 5:00 p.m., and 9:00 p.m. using a BACtrack Bluetooth breathalyzer connected to the app. Financial incentives will be provided when all three daily samples are submitted on time and are alcohol-negative (BrAC = 0.00). Incentives begin at R$5.00 per day and increase by R$2.00 for each consecutive day of verified abstinence, up to a maximum of R$15.00 per day. Missed or alcohol-positive samples reset the incentive value to R$5.00 on the next eligible day. Incentives will be redeemed via PIX transfer. The control group will receive standard outpatient treatment and will also use the TRIS application and BACtrack breathalyzer to submit three daily BrAC samples but will not receive contingency management incentives. The primary outcome is the number of biochemically verified days of alcohol abstinence during the 12-week intervention. Secondary outcomes include days without heavy alcohol use, treatment adherence, usability and acceptability of the TRIS application, alcohol withdrawal severity, obsessive-compulsive drinking symptoms, alcohol craving, alcohol use severity, quality of life, psychiatric symptoms, disability, and healthcare service utilization. Assessments will be conducted at baseline, weekly during the 12-week intervention, and at follow-up visits scheduled at Weeks 16, 20, and 24.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Able to read and speak Portuguese.
  • Provide signed informed consent.
  • Age 18 to 70 years.
  • Alcohol consumption within the past month.
  • Current diagnosis of Alcohol Use Disorder (AUD).
  • Seeking treatment for AUD at AME Vila Maria or Instituto Perdizes.
  • Breath alcohol concentration (BrAC) of 0.00 at the time of consent.
  • Own and be able to operate a smartphone with an active mobile service plan.
  • Smartphone compatible with the Bluetooth frequency required for the BACtrack breathalyzer.

Exclusion criteria

  • Crack cocaine use within the past 90 days.
  • Any seizure episode within the past 12 months.
  • Diagnosis of a psychotic disorder (DSM-5).
  • Suicide attempt within the past two years.
  • Any medical or psychiatric condition that may compromise safe participation, as determined by the study medical director.

Treatment and study plan

Remote Contingency Management (CM)

Behavioral

Remote contingency management delivered through the TRIS mobile application. Participants submit three daily breath alcohol concentration (BrAC) samples using a Bluetooth-enabled BACtrack breathalyzer. Monetary incentives ranging from R$5.00 to R$15.00 per day are provided contingent on verified alcohol abstinence.

Treatment as Usual (TAU)

Behavioral

Standard outpatient treatment for Alcohol Use Disorder provided at the participating outpatient clinics. Participants also use the TRIS mobile application and a Bluetooth-enabled BACtrack breathalyzer for remote alcohol monitoring but do not receive contingency management incentives.

Primary outcomes

  1. Days of Alcohol Abstinence

    Time frame: Up to 12 weeks

    Number of days with verified abstinence based on three daily BrAC samples submitted via the BACtrack remote breathalyzer over the 12-week intervention period.

Secondary outcomes

  1. Days without Heavy Alcohol Consumption

    Time frame: Up to 12 weeks

    Description: Number of days in which all three daily BrAC samples are below 0.06 during the 12-week intervention period.

  2. App Usability

    Time frame: Week 12 (end of intervention)

    Usability and acceptability of the TRIS mobile application assessed at the end of the intervention using a study-specific questionnaire.

  3. Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar)

    Time frame: Baseline (Week 0), weekly during Weeks 1-12, and follow-up at Weeks 16, 20, and 24.

    The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is a 10-item clinician-administered scale assessing alcohol withdrawal severity. Scores range from 0 to 67, with higher scores indicating more severe alcohol withdrawal symptoms.

  4. Obsessive-Compulsive Drinking Scale (OCDS)

    Time frame: Baseline (Week 0), weekly during Weeks 1-12, and follow-up at Weeks 16, 20, and 24.

    The Obsessive-Compulsive Drinking Scale (OCDS) is a 14-item self-report measure assessing obsessive thoughts and compulsive behaviors related to alcohol use. Scores range from 0 to 56, with higher scores indicating greater alcohol craving and obsessive-compulsive drinking symptoms.

  5. Treatment Adherence

    Time frame: Up to 12 weeks

    Number of days the participant remains engaged in the 12-week intervention, based on attendance and study procedures.

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Sponsors and collaborators

Lead sponsor

University of Sao Paulo General Hospital

Other

Collaborators

  • Medical school of the University of São Paulo (FMUSP)
  • University of Sao Paulo

Registry information

Official study title

Remote Treatment With Incentives for Sobriety (TRIS): A Randomized Controlled Trial of a Contingency Management App for Alcohol Use Disorder

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jul 30, 2026
Registry last updated
Jul 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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