4 - (SYM 25) Using Wearable Technology to Develop Biomarker-driven Intervention for Alcohol-related Intimate Partner Violence

Abstract Body

Background: There is a persistent and unmet need to develop effective and accessible treatments to reduce alcohol-related intimate partner violence (IPV). Mitigating maladaptive physiological reactivity in the form of heart rate variability (HRV) is one promising pathway to achieve this goal. HRV is biomarker of autonomic balance that is inversely related to emotional over-arousal relevant to AUD pathophysiology and aggression including IPV.

Method: Participants were N=46 couples with current AUD and recent physical IPV. Participants completed 28 days of ecological momentary assessment (EMA; 4 times daily plus optional event-driven reports) of alcohol use, couple conflict including IPV, and affect via smartphone. Participants wore a Garmin Vivosmart device for continuous HRV monitoring. During days 21-28, participants also received once-daily prompts to complete 10 minutes of HRV-Biofeedback (HRV-B) using a smartphone application. Generalized linear mixed models were used to test hypotheses.

Results: Participants were 56.5% women, 47.8% identified race other than white, and reported an average age of 36.8 years and relationship length of 8.4 years. 79.3% of the sample met diagnostic criteria for AUD, with an average of 48.7% drinking days including 28.3% heavy drinking days at baseline. Alcohol use was reported in 19.7% of EMA reports and relationship conflict was reported in 9.1% of EMA reports. Results of lagged generalized linear mixed models did not reveal any significant associations between HRV at Time i and either alcohol use, relationship conflict, or their combination at Time i+1. With regard to HRV-B, 84.8% completed at least one prompted session, however only 22.8% completed all seven prompted HRV-B sessions. The mean Client Satisfaction Questionnaire (CSQ) score was 3.1 (our of 4), and the mean Post Study System Usability Questionnaire (PSSUQ) score was 51.6, where lower scores indicate greater usability (range =18-126). There was a marginally significant association between magnitude of HRV change during days 21-18 with CSQ (r = 0.27, p=0.06).

Conclusions: Although the hypothesized associations between HRV and primary outcomes were not supported, this study yielded preliminary evidence of feasibility and acceptability of HRV-B in this complex, high risk population. Qualitative analyses to understand user experiences, as well as post hoc analyses to identify those more likely to use and benefit from HRV-B, and to examine HRV and relationship conflict relations at a more granular level are needed.