1. Research Proposal John Miller Nicolette Edenburn Carolyn Cox

2.  This study believes that there is a multi-faceted problem regarding substance abuse. Recovery programs are costly, and relapse rates are still high. Therefore, this study would like to seek a cost-effective method for those in recovery to prevent relapse. We would like to prove that an effective exercise program could prevent relapse rates.  This study will implement exercise programs in a live-in, 30- day recovery treatment facility at a VA hospital.  There will be two groups of 25 recovering alcoholics who participate in the program with an added exercise program implemented and two groups of 25 who participate in the program without exercise involved over the course of a year.  After in-house treatment, monthly follow-up meetings will occur for six months to determine continued sobriety.  The dependent variable will be the relapse rate of patients within a 6-month period, and the independent variable will be implementation or lack of exercise.

3.  The importance of this study is to inform research and practice related to the use of exercise as a treatment intervention for veterans who suffer from alcohol disorders, a rapidly increasing population. Understanding how supervised exercise effects recovery may reveal an affordable and attainable alternative in alcohol abuse treatment for veterans.

4.  Possible limitations to this study may be the participants’ adherence to the exercise regime. Past studies cite participant attrition as problematic for study outcomes (Brown, et al., 2009; Brown, et al., 2008). In addition, participants may not remain steadfast to the daily log entries. As Gaye (2012) states, experimental studies involving humans are, at times, not easy.

5.  Very few studies done on this topic  Researchers hypothesize exercise would do the following for people in substance abuse recovery:  Provide an alternative use of time  Give a new social group  Endorphins would provide a positive “high” replacement from the substance abuse  Would give them a sense of accomplishment  May treat depression/channel emotional energies

6.  For implementation to be effective, those in charge of exercise element should be trained in that field  Brief bouts of treadmill exercise (10 minutes) reduced alcohol cravings during and directly after exercise  Some studies of outpatient implementation of exercise have shown a correlation between exercise and prolonged days without using, some have shown no relation

7.  Very small samples  Attrition  Reliance on log entries  High standards that get rid of potential participants  No control groups in many studies  Many studies have been used with outpatient care only

8.  The hypothesis of this study is that a structured exercise regimen will decrease the relapse rate among recovering alcoholic veterans more so than among recovering alcoholic veterans not exposed to a structured exercise regimen.  How can exercise programs integrated into an inpatient alcoholic recovery program?  What is the correlation between exercise and relapse rate?  What is the effect of structured group exercise on detoxification symptoms?

9.  Nonrandom, purposive sampling  Eligible for VA (Veterans Administration) benefits  Meets DSM-IV qualifications for alcohol dependence disorder  Willing and able to participate in an in-house detox, Motivational Enhancement Therapy, and Cognitive Therapy, and willing to follow up within a year  21-45 years old, either gender  Good health with lack of co-morbid mental disorders

10.  Timeline Followback to measure relapse events  Charts to assess duration and intensity of workouts  Attendance records at fitness facility  Subject interviews/logs  T-Test compares the mean ratio of the number of drinking days/drinks per drinking day of the control group and the treatment group to check for significant difference between the two groups

11.  12 month alcohol recovery program  3 components of treatment at VA hospital (experimental and control groups combined)  30-day in-house detox  Motivational Enhancement Therapy (MET) & Cognitive Therapy (CT)  Psycho educational module for instituting Relapse Prevention (RP).

12.  Intake interview with participants, participants chosen based on stated qualifications  25 randomly selected for control group, 25 randomly selected for treatment group  Modules conducted on aerobic exercise education (both groups combined to avoid cross-contamination of groups)  Control group told exercise portion is complete/canceled and continues recovery process  Treatment group gains access to exercise facility at VA hospital with participation from others in treatment group and access to personal trainer

13.  Treatment group given voucher incentives for participating in exercise program to reduce attrition (no added incentives for added intensity, only participation  After 12 months, follow-up interview with control and treatment groups  T-Test administered to compare the mean ratio of the number of drinking days/drinks per drinking day of the control group and the treatment group to check for significant difference between the two groups  Hypothesis proven if treatment group has a ratio with fewer numbers of drinking days and/or drinks per day than the control group