Reducing Barriers to Drug Abuse Treatment Services

NCT ID: NCT00273845

Last Updated: 2009-02-24

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2/PHASE3
• Total Enrollment: 678 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2003-05-31
• Study Completion Date: 2008-05-31

Brief Summary

The broad goal of this study is to assess the effectiveness of two interventions to facilitate treatment linkage and treatment engagement. "Treatment linkage" is operationally defined as completion of agency intake procedures and attendance at the first clinical or therapy session. "Treatment engagement" represents a more comprehensive conceptualization of "treatment retention" and includes measures of the clinical and ancillary services actually received by the client over time; as such, client engagement focuses on the intensity and duration of treatment participation. This study will enhance the CIU concept by conducting a controlled trial, using a three-armed research design, of interventions designed to enhance treatment linkage and treatment engagement. These interventions - a Motivational Intervention and Strengths-Based Case Management - are science-based and have demonstrated efficacy in moving drug abusers towards treatment and supporting treatment engagement.

Detailed Description

The Specific Aims of the project are:

1. To conduct a detailed qualitative/ethnographic investigation to study: (a) the processes and factors operant in a person's decision to link with a substance abuse treatment agency once a formal (i.e., professional) assessment and referral have been made; and (b) the processes and factors operant in staying in treatment once it has been initiated.

2. To identify and classify, using quantitative methods, the operant barriers to treatment linkage and engagement. We will assess the factors that are associated with these barriers and examine the effects of the study's interventions on removing them.

3. To evaluate the effectiveness, using a controlled trial, of a Motivational Intervention and Strengths-Based Case Management, compared to the CIU's "standard" referral process, by examining differences between the Standard, Motivational Intervention, and Case Management conditions on treatment linkage and engagement outcomes. The conceptual framework for this controlled trial is the well-studied Andersen model of access and health service use, modified for chemical dependency services (Andersen, 1995). The interventions are designed to affect mutable factors such as perceived barriers to treatment. Data will be collected at baseline, and at 3 and 6 months thereafter. Analyses will examine whether the interventions work better with different groups of clients (e.g. cocaine users versus marijuana users, males versus females, different ethnicities, etc); as well as different treatment modalities (standard outpatient versus intensive outpatient.)

4. To conduct a quantitative investigation of the effects of Individual Level and Health Care System Level factors that predict treatment linkage and engagement in the context of the proposed interventions. This study component will develop comprehensive models to predict how these factors interact with the study's interventions to effect treatment linkage and treatment engagement.

Conditions

Substance Abuse

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

1

One session of motivational interviewing

Group Type: EXPERIMENTAL

Motivational interviewing

Intervention Type: BEHAVIORAL

One session

2

Five sessions of strengths-based case management

Group Type: EXPERIMENTAL

Strengths-Based Case Management

Intervention Type: BEHAVIORAL

5 sessions

Interventions

Motivational interviewing

One session

Intervention Type: BEHAVIORAL

Strengths-Based Case Management

5 sessions

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• substance abuse or dependence per DSM-IVR criteria

Exclusion Criteria

• active thought disorder

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role: collaborator

Wright State University

OTHER

Sponsor Role: lead

Responsible Party

Wright State University

Principal Investigators

Richard C Rapp, M.S.W.

Role: PRINCIPAL_INVESTIGATOR

Boonshoft School of Medicine, Wright State University

Locations

Samaritan CrisisCare

Dayton, Ohio, United States

Countries

United States

Other Identifiers

1R01DA015690

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HSP 2527

Identifier Type: -

Identifier Source: secondary_id

02-407-10

Identifier Type: -

Identifier Source: org_study_id