Renewed Recovery: a Pilot Test of a Web-Based Mindfulness-Based Relapse Prevention Continuing Care Intervention for Alcohol Use Disorder

Substance use will be assessed using the Timeline Followback (TLFB), a validated self-report instrument used to collect retrospective estimates of daily drinking.

The Patient-Reported Outcomes Measurement Information System (PROMIS) Depression (Short form 6a) item bank assesses self-reported negative mood, views of self, and social cognition, as well as decreased positive affect and engagement. Higher scores indicate higher levels of depression. Minimum score = 38.4, maximum score = 80.3.

The Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety (Short Form 8a) item bank assesses self-reported fear, anxious misery, hyperarousal, and somatic symptoms related to arousal. Higher scores indicate higher levels of anxiety. Minimum score = 37.1, maximum score = 83.1.

The Coping Strategies Inventory- Short Form (CSI-SF) is a self-reported instrument that assesses the prevalence of problem-focused and emotion-focused coping mechanisms. The measurement is broken down into 4 sub-scales: problem-focused engagement, problem-focused disengagement, emotion-focused engagement, and emotion-focused disengagement. Each sub-scale has a possible score range from 5 to 20. Higher scores on a sub-scale indicate greater use of that specific coping strategy by the participant.

The Penn Alcohol Craving Scale (PACS) is a self-reported instrument that measures an individual's craving to drink alcohol. Scores range from 0 to 30. Higher scores indicate greater overall severity of alcohol craving.

The 5 Facet Mindfulness Questionnaire (FFMQ) is a self-rated measurement on the five aspects of mindfulness namely: observation, description, aware actions, non-judgmental inner experience, and non-reactivity. Each facet is scored separately, with higher scores indicating greater levels of that particular mindfulness trait. Sub-scale scores can be analyzed individually or combined to reflect overall mindfulness, with higher total scores indicating greater overall mindfulness. For all facets except for non-reactivity, the score ranges from 8-40. For non-reactivity, the score ranges from 7-35.

The Acceptance and Action Questionnaire II (AAQII) measures psychological flexibility, defined as the ability to fully contact the present moment including all negative private events (which is thoughts, feelings, and physiological sensations) it contains, without needless defenses and depending on the situation engaging or changing behaviors in line with goals and values. Scores range from 7 to 49. Higher scores indicate less flexibility and acceptance, while lower total scores mean more flexibility.

The Alcohol Abstinence Self-Efficacy Scale (AASE) is a self-reported instrument that assesses an individual's confidence in their ability to abstain from alcohol across a variety of high-risk situations. The scale consists of 20 items divided into four sub-scales representing different types of high-risk contexts: negative affect, social pressure, physical and other concerns, and withdrawal and urges. Higher scores on each sub-scale and the total score indicate greater self-efficacy in resisting the urge to drink alcohol in corresponding situations. The total score ranges from 20 to 100, while each sub-scale ranges from 5 to 25.

The Transaddiction Craving Triggers Questionnaire (TCT) measures what kinds of things trigger the responder to have a craving for alcohol and/or substances. The questionnaire assesses various domains such as emotional states, environmental cues, social interactions, and physical sensations. There are three sub-scales: unpleasant affect (scores ranging from 14- 84), pleasant affect (scores ranging from 7-42), and cues and associated thoughts (scores ranging from 4-24). The total score ranges from 25-150. Higher total and sub-scale scores indicate a greater frequency of experiencing craving in response to specific types of triggers, reflecting higher craving vulnerability across those domains.

The Social Provisions scale (SPS) is a measure of the provision of social support from current relationships. The scale is based on six provisions theorized to be critical to social support, making up the six sub-scales: guidance, reliable alliance, reassurance of worth, attachment, social integration, and opportunity for nurturance. The total score ranges from 24 to 96. Each sub-scale ranges from 4 to 16. Higher scores on the SPS indicate a greater perceived availability of social support across various domains. Higher sub-scale scores reflect stronger perceived support in that specific social domain.

The Client Satisfaction Questionnaire (CSQ) is a self-rated instrument that asks participants to rate different aspects of the program to indicate their satisfaction with it. Participants rate various aspects of the program, such as quality of service, whether their needs were met, and their willingness to return or recommend the program. Scores range from 8 to 32. Higher total scores indicate greater overall satisfaction with the program.

The System Usability Scale (SUS) is a 10-item self-reported questionnaire designed to assess the usability of a system, product, or digital platform. It measures overall user experience, including perceptions of ease of use, effectiveness, efficiency, and satisfaction. Scores range from 0 to 100. Higher scores indicate greater perceived usability of the system.