Currently accepted at: JMIR Research Protocols
Date Submitted: May 25, 2026
Date Accepted: Oct 12, 2026
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/102363
The final accepted version (not copyedited yet) is in this tab.
Automatic Reinforcement Management System (ARMS): A randomized controlled trial of an app-based Contingency Management intervention for Alcohol use Disorders.
ABSTRACT
Background:
Background:
Alcohol Use Disorder (AUD) is associated with substantial morbidity and low treatment engagement. Contingency Management (CM) is an effective behavioral intervention, but its implementation has been limited by the need for frequent in-person monitoring. The Automatic Reinforcement Management System (ARMS) is a fully digital platform designed to deliver CM remotely using real-time biochemical verification.
Objective:
Objective:
This study aims to evaluate the efficacy of the ARMS, a fully automated digital Contingency Management intervention for AUD, in promoting alcohol abstinence, reducing heavy drinking days, and improving treatment adherence. A secondary aim is to investigate whether Addiction Neuroclinical Assessment (ANA) domains—namely incentive salience, negative emotionality, and executive function—mediate treatment response.
Methods:
Methods:
This two-arm randomized controlled trial will enroll 120 adults with AUD, assigned to either CM or a non-contingent (NC) control condition over 12 weeks. Participants will submit three daily breath alcohol concentration (BrAC) samples using Bluetooth-enabled devices integrated with the ARMS app. In the CM condition, incentives are contingent on alcohol-negative samples, whereas in the NC condition, incentives are provided for timely submissions regardless of alcohol status. Ecological momentary assessments targeting Addiction Neuroclinical Assessment (ANA) domains—namely incentive salience, negative emotionality, and executive function—will be collected repeatedly during treatment to examine potential mechanisms of change. Primary outcomes include biochemically verified days of abstinence, heavy drinking days, and treatment adherence.
Results:
Results:
Outcomes will be evaluated using longitudinal models of repeated BrAC measurements, and mediation analyses will examine whether early-treatment ANA domain functioning accounts for differences in alcohol outcomes between groups.
Conclusions:
Conclusions:
This study will evaluate the efficacy of a fully automated CM intervention for AUD and investigate underlying neurobehavioral mechanisms of treatment response. If effective, ARMS may represent a scalable and accessible approach to delivering evidence-based care for AUD. Clinical Trial: NCT06456905
Citation
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