The IsoLation and Loneliness Underlying Misuse and INcreased use of Alcohol as a function of sTress and
coping Efforts (ILLUMINATE) project will test adaptive/maladaptive coping as the mechanisms of action linking
objective social isolation and subjective feelings of loneliness with alcohol use/misuse across the United States
and stress as the moderator of these mediational effects in two separate studies. We will enhance our ability to
test this model in our in-hand self-reported data from Study 1 on loneliness, stress, coping, and alcohol use
during the COVID-19 pandemic when changing executive orders limited social interaction by dint of closures
and reduced capacity. We collected data on a national sample of adults (N=1,550) during the first peak of US
average COVID-19 daily infections in April, 2020 and at five additional points over the subsequent 12 months.
Our surveys collected key self-report data on how people coped in the face of extensive social isolation,
loneliness and concurrent pervasive chronic stress and alcohol consumption. We propose to add geographic
location of the sample participants, which will allow us to create indicators of place-based social isolation and
stressors (including an index of shelter-in-place, restrictions/closing of places of social interaction, and
unemployment rates at each assessment point during COVID) and other stressors specific to a location such
as economic and social vulnerabilities, housing instability, racial and ethnic segregation, and crime rates. Our
first aim is to test adaptive (active coping, reappraisal) and maladaptive (avoidance) coping efforts as the
behavioral mechanism driving alcohol use and high risk drinking over the course of the pandemic, testing the
extent to which these coping processes mediate linkages between social isolation/loneliness and alcohol
use/misuse, and our second aim is to determine whether cumulative-multilevel stress burden (individual and
place-based) moderates the linkages between social isolation, loneliness, adaptive/maladaptive coping, and
alcohol use/misuse. We will then collect prospective data for Study 2 in a nationally representative sample over
6 assessment points (N=1,550), again integrating objective geospatial indicators, to test the model of these
linkages again (Aims 1 and 2) and to determine the extent to which our model of these relationships differed in
a time of enforced isolation and communal stress from a more ordinary time period post-pandemic (Aim 3).
Importantly, the repeated measures design in both samples allows us to model trajectories of alcohol use and
misuse and the complex relationships among social isolation, loneliness, stress, and adaptive/maladaptive
coping processes over time. Closely aligned with the NIH Funding Opportunity Announcement PAR-21-350,
our assessment of the impact of isolation and loneliness in the COVID-19 pandemic and post-pandemic
periods on alcohol use/misuse has considerable implications for developing prevention and intervention efforts
calibrated for the post-pandemic environment.
