Center for Addiction & Prevention Research

The Center for Addiction and Prevention Research (CAPR) includes a dedicated group of multidisciplinary faculty and staff who aim to assess health risk behaviors, develop effective interventions and policies, and translate these into communities to reduce the associated health burdens.

CAPR research targets vulnerable populations throughout the United States, specifically military personnel and rural Appalachians. Our faculty, staff, and collaborators are located in multiple locations across the country. CAPR research focuses primarily on the three health behaviors that contribute the most to daily-adjusted life years lost in the United States: tobacco use, alcohol abuse, and overweight/obesity. A secondary focus is to develop effective interventions to curtail the growing opiate abuse epidemic in this country.

The CAPR team develops, translates and evaluates evidence-based health promotion and disease prevention interventions. Emphasis is placed on validated treatments that are affordable, and can be easily adopted and disseminated in community settings.

CAPR research is funded through the National Institutes of Health and the Department of Defense.

Co-Directors: G. Wayne Talcott, Ph.D., ABPP, Col USAF (ret) & Robert C. Klesges, Ph.D.

A Population Health Research Team

The Center for Addiction and Prevention Research is a member of the Readiness and Performance Lab (RPL).  RPL is comprised of a team of researchers who are dedicated to the development and implementation of interventions designed to reduce health risk behaviors for Airmen and TRICARE beneficiaries.

The Institute of Medicine called binge drinking in the military a public health crisis. Military personnel have an increased prevalence of tobacco use and surprisingly, well over half of military members are overweight or obese. Over half of sampled military personnel report 6 or fewer hours of sleep.  Tobacco use is the single most preventable cause of premature death and yet the prevalence of tobacco use in the military remains higher than the civilian population.  Our group of researchers identifies health risk behaviors among active-duty members and develops tailored interventions across communities in the Air Force.  The goal is a healthier Airman who is fit and ready to serve. These military members are often underserved, and enhancing military health contributes to our national security.

Currently our research team is comprised of professionals in behavioral economics, health psychology, social work, nursing, public health, statistics, and epidemiology.  The team includes both active duty and academic researchers.  It is our experience that a team such as this is necessary to innovate, develop, and implement interventions that help people make better decisions regarding health behaviors. Evaluating the effectiveness of developed interventions with this special population reflects our commitment to good stewardship of their time and other resources.

The RPL team encourages and engages researchers who are interested in translational research related to health risk behaviors and/or who have an interest in working with the military.

Some recent publications include:

Sleep Health

Ellis, J. M., Estevez Burns, R. A., Blue Star, B. A., Patience, M. A., Brown, L. N., Ruggieri, J., Joiner, A., V., Little, M. A., & Talcott, W. G. (2023). A social-ecological examination of sleep among Airmen in technical training. Military Psychology. Advance online publication. DOI: 10.1080/08995605.2023.2177470.

Tobacco Use

Aycock, C. A., Wang, X.-Q., Williams, J. B., Fahey, M. C., Talcott, G. W., Klesges, R. C., & Little, M. A. (2023). Motives for using electronic nicotine delivery systems (ENDS) as a cessation tool are associated with tobacco abstinence at 1-year follow-up: A prospective investigation among young adults in the United States Air Force.  Preventive Medicine Reports, 35, 102399. https://doi.org/10.1016/j.pmedr.2023.102399

Cassidy, D. G., Wang, X., Mallawaarachchi, I., Wiseman, K. P., Ebbert, J.O., Blue Star, J. A., Aycock, C. A., Estevez Burns, R., Jones, J. R., Krunnfusz, A. E., Halbert, J. P., Roy, N. M., Ellis, J. M., Williams, J. B., Klesges, R. C., and Talcott, G. W. (2023). Tobacco quitline performance: Comparing the impacts of early cessation and proactive re-engagement on callers’ smoking status at follow-up at 12 months. Tobacco Induced Diseases, 21 (Feb), 24.   https://doi.org/10.18332/tid/159125.

Wiseman, K., Aycock, C., Mallawaarachchi, I., Wang, X-Q., Cassidy, D., Patience, M., Little, M., Talcott, G.W., Klesges, R. (2023).  Predictors of re-engagement after relapse in a tobacco quit line intervention. Secondary analysis from a randomized clinical trial. International Journal of Environmental Research and Public Health. 2023 Jan 10;20(2):1229. PMID: 36673992.

Klesges, R.C., Talcott, G. W., Little, M.A., Mallawaarachchi, I.V., Wang, X-Q., Aycock, C.A., Patience, M.A., Halbert, J.P., Wiseman, K. P., Ebbert, J.O. (2023). Reengagement for Long-Term Smoking-Cessation In Military Personnel, Retirees, Family Members (TRICARE): A Randomized Trial. Nicotine and Tobacco Research. 2023 Jun 2:ntad085. doi: 10.1093/ntr/ntad085. Epub ahead of print. PMID: 37280113.

Little, M.A., Wang, X-Q, Fahey, M.C., Wiseman, K.P., Halbert, J.H., Klesges, R.C., Talcott, G.W. (2021). Efficacy of a Group-Based Brief Tobacco Intervention Among Young Adults in the U.S. Air Force Between 18 and 20 Years of Age. Tobacco Induced Diseases.

Little, M.A., Fahey, M.C., Wang, X-Q., Talcott, G.W., McMurry, T., Klesges, R.C. (2021). Trends in Tobacco Use among Young Adults Presenting for Military Service in the United States Air Force Between 2013-2018. Substance Use & Misuse.

Fahey, M.C., Talcott, G.W., McMurry, T.L., Klesges, R.C., Tubman, D., Krukowski, R.A., Little, M.A. (2020).  When, How, & Where Tobacco Initiation and Relapse Occur During U.S. Air Force Technical Training. Mil Med. Jun 8;185(5-6):e609-e615. doi: 10.1093/milmed/usaa016. PMID: 32060547; PMCID: PMC7282443.

Fahey, M.C., Krukowski, R.A., Talcott, G.W., Little, M.A. (2020). JUUL targets military personnel and veterans. Tob Control.  May 12:tobacco control-2019-055377. doi: 10.1136/tobaccocontrol-2019-055377. Epub ahead of print. PMID: 32398271.

Little, M.A., Fahey, M.C., Klesges, R.C., McMurry, T., Talcott, G.W. (2020).  Evaluating the Effects of a Brief Tobacco Intervention in the U.S. Air Force. Nicotine Tob Res. Jan 6:ntaa001. doi: 10.1093/ntr/ntaa001. Epub ahead of print. PMID: 31903494.

Little, M., Ebbert, J.O., Krukowski, R.A., Halbert, J., Kalpinski, M.R., Patten, C.A., Talcott, G.W., Klesges, R.C. (2020). Factors Associated with Cigarette Use During Airmen’s First Year of Service in the United States Air Force. Mil Med. Feb 12;185(1-2):e212-e220. doi: 10.1093/milmed/usz155. PMID: 31287888.

Little, M.A., Ebbert,J.O., Krukowski, R.A., Halbert, J.P., Kalpinski, R., Patten, C.A., Boothe, T.L., Pasker, C. K., Klesges, R.C., Talcott, G.W. (2019). Predicting cigarette initiation and reinitiation among active duty United States Air Force recruits. Subst Abus.2019;40(3):340-343. doi: 10.1080/08897077.2019.1577678. Epub 2019 Mar 18. PMID: 30883297; PMCID: PMC6751016.

Patten, C., Wang, X-Q., Ebbert, J.O., Little, M.A., Talcott, G.W., Hryshko-Mullen, A.S., Klesges, R.C. (2019). Influence of gender and peer tobacco use on tobacco use intentions after a period of involuntary tobacco abstinence among U.S. Air Force trainees. Prev Med Rep. 2019 Jan 20;13:270-276. doi: 1016/j.pmedr.2019.01.004. PMID: 30723662; PMCID: PMC6351393.

Kong A.Y., Golden S.D., Myers A.E., Little M.A., Klesges R., Talcott W., Vandegrift S., Cassidy D., Ribisl K.M. (2019).  Availability, price, and promotions for cigarettes and non-cigarette tobacco products: An observational comparison of US Air Force Bases with nearby tobacco retailers. Tobacco Control. Mar;28(2):189-194. Doi:10.1136/tobaccocontrol-2018-054266. Epub 2018 Apr 28. PMID: 29705745.

Little, M.A, Klesges, R.C., Bursac, Z., Halbert, J. P., Ebbert, J., Talcott, G.W., Weksler, B. (2018). Correlates of smoking status in Cancer Survivors. J. Cancer Surviv., Dec; 12(6): 828-834. Doi: 10.1007/s11764-018-0720-x. Epub 2018 Oct.

Little, M.A., Klesges, R.C., Bursac, Z., Ebbert, J.O., Talcott, G.W., Weksler, B. (2018). Correlates of Smoking Status in Cancer Survivors. Journal of Cancer Survivorship. J Cancer Survivorship. 2018 Dec; 12(6): 828–834. Published online 2018 Oct 20. doi: 10.1007/s11764-018-0720-x.

Bursac, Z., Klesges, R.C., Little, M.A., Linde, B.D., Popova, L., Talcott, G.W. (2018). The comparative effectiveness of two brief tobacco interventions in the U.S. Air Force:  Perceived harm and intentions to use tobacco products. Tobacco Induced Diseases, 16:1-10.

Problematic Drinking

Pebley, K., Murphy, J. G., Wang, X. Q., Talcott, G. W., Klesges, R. C., McDevitt-Murphy, M. E., McMurry, T. L., & Little, M. A. (2022). Validity of the alcohol purchase task with United States military personnel. Experimental and clinical psychopharmacology, 30(2), 141–150. https://doi.org/10.1037/pha0000392.

Talcott, G.W., McMurry, T., Ebbert, J. Fahey, M.C., Xin Qun, W., Murphy, J.G., McDevitt-Murphy, M., Little, M. A., Klesges, R.C.  (2021). Dissemination of a Universally Delivered Brief Alcohol Intervention in United States Air Force Technical Training.  J. Addict. Med. 2021 Jul-Aug;15(4):318-324. doi: 10.1097/ADM.0000000000000763.

Little, M.A., Klesges, R. C., Mallawaarachchi, I., McMurry, T., Pebley, K., McDevitt-Murphy, J.l., Talcott, G. W. (2021). Prevention of Alcohol Related Incidents in the US Air Force: Results from a Cluster Randomized Trial.  Military Medicine. 

Pebley, K., Krukowski, R.A., Mallawaarachchi, I, Talcott, G.W., Klesges, R.C., Little, M.A. (2021). Dual and Polytobacco Use After a Period of Enforced Tobacco Cessation. Addictive Behaviors. 2021 Dec;123:107077. doi: 10.1016/j.addbeh.2021.107077. Epub 2021 Aug 4.

Tao L, Waters TM, Kaplan EK, Kaplan CM, Nyarko K, Derefinko K, Talcott GW, Klesges RC (2017). Economic analyses of an alcohol misconduct prevention program in a military setting. Military Medicine, 2017 Jan;182(1):e1562-e1567. doi: 10.7205/MILMED-D-16-00098. PubMed PMID: 28051974.

Overweight and Obesity

Estevez Burns, R., Hare, M. E., Andres, A., Klesges, R. C., Talcott, G. W., LeRoy, K., Little, M. A., Hyrshko-Mullen, A., Waters, T. M., Harvey, J. R., Bursac, Z., & Krukowski, R. A. (2022). An interim analysis of a gestational weight gain intervention in military personnel and other TRICARE beneficiaries. Obesity (Silver Spring, Md.), 30(10), 1951–1962. https://doi.org/10.1002/oby.23523.

Webber, B.J., Ruiz, S.A., Talcott, G.W., Little, M.A., Tate, D.F. (2020). Weight Gain of Service Members After Basic Military Training. Am J Prev Med. Jan;58(1):117-121. doi: 10.1016/j.amepre.2019.08.022. PMID: 31862098.

Pebley, K., Beauvais, A., Gladney, L.A., Kocak, M., Klesges, R.C., Hare, M., Richey, P.A., Johnson, K.C., Hryshko-Mullen, A., Talcott, G.W., Krukowski, R.A. (2020).  Weight Loss Intervention Impact on the Physical Fitness Test Scores of Air Force Service Members. Mil Med.Jun 8;185(5-6):e781-e787. doi: 10.1093/milmed/usz371. PMID: 31735969; PMCID: PMC7282442.

Fahey, M.C., Klesges, R.C., Kocak, M., Wang, J., Talcott, G.W., Krukowski, R.A. (2019) Do the holidays impact weight and self-weighing behavior among adults engaged in a behavioral weight loss intervention? Obes Res Clin Pract. 2019 Jul-Aug;13(4):395-397. doi: 10.1016/j.orcp.2019.05.001. Epub 2019 Jun 8. PMID: 31182293; PMCID: PMC6698213.

Manz, K.C., Waters, T.M., Clifton, H.E., Kocak, M., Klesges, R.C., Talcott, G.W., Krukowski, R.A. (2020).  Cost-Effectiveness of a Weight Loss Intervention: An Adaptation of the Look AHEAD Lifestyle Intervention in the US Military. Obesity (Silver Spring).  Jan;28(1):89-96. doi: 10.1002/oby.22681. Epub 2019 Nov 26. PMID: 31773873; PMCID: PMC6925346.

Fahey, M.C., Hare, M.E., Talcott, G.W., Kocak, M., Hryshko-Mullen, A., Klesges, R.C., Krukowski, R.A. (2019). Characteristics Associated With Participation in a Behavioral Weight Loss Randomized Control Trial in the U.S. Military. Version 2. Mil Med. Mar 1;184(3-4):e120-e126. doi: 10.1093/milmed/usy199. PMID: 30125001;PMCID: PMC6375808.

Pebley, K., Klesges, R.C., Talcott, G.W., Kocak, M., Krukowski, R.A.  (2019). Measurement Equivalence of E-Scale and In-Person Clinic Weights. Obesity (Silver Spring). Jul;27(7):1107-1114. Doi:10.1002/oby.22512. Epub 2019 Jun 5. PMID: 31168928.

Fahey, M.C., Klesges, R.C., Kocak, M., Talcott, G.W., Krukowski, R.A. (2018). Changes in the perceptions of self-weighing across time in a behavioral weight loss intervention. Obesity (Silver Spring).  26 (10): 1566-1575. doi: 10.1002/oby.22275.

Fahey, M. C., Talcott, G. W., Bauer, C. M. C., Bursac, Z., Gladney, L., Hare, M. E., Harvey, J., Little, M., McCullough, D., Hryshko-Mullen, A. S., Klesges R. C., Kocack, M., Waters, T. M., Krukowski, R. A. (2018).  Moms Fit 2 Fight: Rationale, design, and analysis plan of a behavioral weight management intervention for pregnant and postpartum women in the U.S. military. Contemporary Clinical Trials Nov:74:46-54. Doi: 10.1016/j.cct.2018.09.012. Epub 2018 Oct 4.

Krukowski, R.A., Hare, M.E., Talcott, G.W., Gladney, L.A., Johnson, K.C., Richey, P.A., Kocak, M., Keller, P.L., Hryshko-Mullen, A., & Klesges, R.C. (2018).  Dissemination of the Look AHEAD Intensive Lifestyle Intervention Translation in the United States Military: A Randomized Controlled Trial. Obesity.Oct:26(10):1558-1565. Doi: 10.1002/oby22293.

Derefinko, K.J., Linde, B., Klesges, R.C., Puentes, L., Boothe, T., Leroy, K., Little, M.A., Colvin, L., Pasker, C., Murphy, J.G., McDevitt-Murphy, M.E., Bursac, Z., Ebbert, J.O., Waters, T., Brooks, I., & Talcott, G.W. (2018). Dissemination of the Brief Alcohol Intervention in the United States Air Force: Study Rationale, Design and Methods. Military Behavioral Health.

Methods

Little, M. A., Bonilla, G., McMurry, T., Pebley, K., Klesges, R.C., Talcott, G.W. (2021). The Feasibility of Using Self-Generated Identification Codes in Longitudinal Research With Military Personnel. Eval Health Prof: 1632787211031625

Haibach, J.P., Hoerster, K.D., Dorflinger, L., McAndrew, L.M., Cassidy, D.G., Goodrich, D.E., Bormann, J.E., Lowery, J., Asch, S.M., Raffa, S..D, Moin, T., Peterson, A.L., Goldstein, M.G., Neal-Walden, T., Talcott, G.W., Hunter, C.L., Knight, S.J. (2020). Research translation for military and veteran health: research, practice, policy. Transl Behav Med.  Feb 11:ibz195. doi: 10.1093/tbm/ibz195. Epub ahead of print. PMID: 32043529.

1. Klesges, R. C., Talcott, G. W., Oh, J., Colvin, L. W. (2014, Contributors). Tobacco Use in the Military.  Changes in the Smoking-and-Health Environment: 1964 to 2014, A Report of the Surgeon General. Atlanta, GA, Centers for Disease Control.

2. Haibach, JP, Glotfelter, MA, Hall, KS, Masheb, RM, Little, MA, Shepardson, RL, Dobmeyer, AC, Funderburk, JS, Hunter, CL, Dundon, M, Hausmann, LRM, Trynosky, SK, Goodrich, DE, Kilbourne, AM, Knight, SJ, Talcott, GW, Goldstein, MG (2016). Military and Veteran Health Behavior Research and Practice: Challenges and Opportunities. Journal of Behavioral Medicine.

1. Talcott, G. W., Ebbert, J. O., Klesges, R. C., Linde, B. D., Krukowski, R., Seals, R., … & Martin Zona, D. (2015). Tobacco research in the military: Reflections from 20 years of research in the United States Air Force. Military Medicine, Aug;180(8):848-850.

2. Little MA, Talcott GW, Bursac Z, Linde BD, Pagano LA, Messler EC, Ebbert JO, Klesges RC. Efficacy of a brief tobacco intervention for tobacco and nicotine containing product use in the US Air Force.  Nicotine Tob Res, 2016 May;18(5):1142-9 doi: 10.1093/ntr/ntv242.Epub 2015 Oct 27.

3. Cigrang, J., Talcott, G. W., Tatum, J., Baker, M., Cassidy, D., Sonnek, S., …& Slep, A. (2014).  Impact of combat deployment on psychological and relationship health: A longitudinal study. Journal of Traumatic Stress, 27, 1-8.

4. Klesges, R.C., Talcott, W., Ebbert, J. O., Murphy, J. G., McDevitt-Murphy, M., Thomas, F., … & Nicholas, R. A. (2013). Effect of the Alcohol Misconduct Prevention Program (AMPP) in Air Force technical training. Military Medicine, 178(4), 445-451. doi: 10.7205/MILMED-D-12-0040.