Trial Outcomes & Findings for Reinforcement of Abstinence and Continuing Care in Substance Abuse Treatment (NCT NCT00288886)
NCT ID: NCT00288886
Last Updated: 2015-04-24
Results Overview
Participants who were abstinent was assessed via Form-90 Interview (Form 90I) is a structured interview that assesses substance use and related behaviors over the previous 90 days employing a calendar-based follow-back method that provides continuous measures of substance use, and has good reliability. Measures include days abstinent, days using alcohol, days using drugs, total number of standard drinks, and days of self help meeting attendance. Briefer versions were constructed to collect data via telephone in instances when participants did not return for in-person interviews. As a reliability check on participants' self-report, a collateral interview was employed when contacting informants. Participants who denied use on the Form-90, but had a positive substance use screen were considered to be not abstinent for that follow-up point.
Recruitment status
COMPLETED
Study phase
PHASE2
Target enrollment
183 participants
Primary outcome timeframe
Assessed at 12 months
Results posted on
2015-04-24
Participant Flow
426 Consecutive Graduates Screened for Eligibility, 243 (57%) of those were excluded. \[203 (48%) not within a 60-minute drive of aftercare; 15 (4%) no transportation, or aftercare not available due to work schedule; 24 (6%) did not consent; 1 excluded for unknown reason(s)\]
Participant milestones
| Measure |
Standard Treatment (STX)
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Overall Study
STARTED
|
91
|
92
|
|
Overall Study
3-month Follow Up
|
82
|
85
|
|
Overall Study
6-month Follow Up
|
85
|
84
|
|
Overall Study
12-month Follow Up
|
80
|
81
|
|
Overall Study
COMPLETED
|
80
|
81
|
|
Overall Study
NOT COMPLETED
|
11
|
11
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Reinforcement of Abstinence and Continuing Care in Substance Abuse Treatment
Baseline characteristics by cohort
| Measure |
Standard Treatment (STX)
n=91 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=92 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
Total
n=183 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
50.63 years
STANDARD_DEVIATION 7.88 • n=5 Participants
|
49.55 years
STANDARD_DEVIATION 8.63 • n=7 Participants
|
50.09 years
STANDARD_DEVIATION 8.26 • n=5 Participants
|
|
Sex: Female, Male
Female
|
3 Participants
n=5 Participants
|
5 Participants
n=7 Participants
|
8 Participants
n=5 Participants
|
|
Sex: Female, Male
Male
|
88 Participants
n=5 Participants
|
87 Participants
n=7 Participants
|
175 Participants
n=5 Participants
|
|
Region of Enrollment
United States
|
91 participants
n=5 Participants
|
92 participants
n=7 Participants
|
183 participants
n=5 Participants
|
PRIMARY outcome
Timeframe: Assessed at 12 monthsParticipants who were abstinent was assessed via Form-90 Interview (Form 90I) is a structured interview that assesses substance use and related behaviors over the previous 90 days employing a calendar-based follow-back method that provides continuous measures of substance use, and has good reliability. Measures include days abstinent, days using alcohol, days using drugs, total number of standard drinks, and days of self help meeting attendance. Briefer versions were constructed to collect data via telephone in instances when participants did not return for in-person interviews. As a reliability check on participants' self-report, a collateral interview was employed when contacting informants. Participants who denied use on the Form-90, but had a positive substance use screen were considered to be not abstinent for that follow-up point.
Outcome measures
| Measure |
Standard Treatment (STX)
n=83 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=81 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Abstinence Rate (During the Preceding 90 Days) at 12 Months Follow-up Point as Assessed by the Form-90
Abstinence from alcohol and drugs
|
40 participants
|
38 participants
|
|
Abstinence Rate (During the Preceding 90 Days) at 12 Months Follow-up Point as Assessed by the Form-90
Abstinence from alcohol
|
47 participants
|
51 participants
|
|
Abstinence Rate (During the Preceding 90 Days) at 12 Months Follow-up Point as Assessed by the Form-90
Abstinence from drugs
|
55 participants
|
49 participants
|
SECONDARY outcome
Timeframe: Assessed at 3 and 6 monthsParticipants who were abstinent was assessed via Form-90 Interview (Form 90I) is a structured interview that assesses substance use and related behaviors over the previous 90 days employing a calendar-based follow-back method that provides continuous measures of substance use, and has good reliability. Measures include days abstinent, days using alcohol, days using drugs, total number of standard drinks, and days of self help meeting attendance. Briefer versions were constructed to collect data via telephone in instances when participants did not return for in-person interviews. As a reliability check on participants' self-report, a collateral interview was employed when contacting informants. Participants who denied use on the Form-90, but had a positive substance use screen were considered to be not abstinent for that follow-up point.
Outcome measures
| Measure |
Standard Treatment (STX)
n=91 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=92 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Abstinence Rate (During the Preceding 90 Days) at 3- and 6-months Follow-up Point as Assessed by the Form-90
Abstinence from alcohol and drugs (3 month)
|
57 participants
|
57 participants
|
|
Abstinence Rate (During the Preceding 90 Days) at 3- and 6-months Follow-up Point as Assessed by the Form-90
Abstinence from alcohol (3 month)
|
65 participants
|
69 participants
|
|
Abstinence Rate (During the Preceding 90 Days) at 3- and 6-months Follow-up Point as Assessed by the Form-90
Abstinence from drugs (3 month)
|
64 participants
|
62 participants
|
|
Abstinence Rate (During the Preceding 90 Days) at 3- and 6-months Follow-up Point as Assessed by the Form-90
Abstinence from alcohol and drugs (6 months)
|
43 participants
|
43 participants
|
|
Abstinence Rate (During the Preceding 90 Days) at 3- and 6-months Follow-up Point as Assessed by the Form-90
Abstinence from alcohol (6 month)
|
50 participants
|
61 participants
|
|
Abstinence Rate (During the Preceding 90 Days) at 3- and 6-months Follow-up Point as Assessed by the Form-90
Abstinence from drugs (6 month)
|
51 participants
|
55 participants
|
SECONDARY outcome
Timeframe: Baseline to 12 monthsOutcome measures
| Measure |
Standard Treatment (STX)
n=91 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=92 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Days Until First Use of Alcohol or Drugs
|
200.74 days
Standard Deviation 136.31
|
202.43 days
Standard Deviation 140.46
|
SECONDARY outcome
Timeframe: Assessed at 3-, 6-, 9-, and 12-monthsMeasures of aftercare attendance include: Percentage of participants who attended at least 1 aftercare session; percentage of participants who attended at least 2 aftercare sessions/month for at least 3, 6, 9 and 12 months; and percentage of participants who passed the VAMC's SUD continuity of care performance measure (a benchmark for retention of clients in aftercare for at least two visits each month for 3 months following initial treatment)
Outcome measures
| Measure |
Standard Treatment (STX)
n=91 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=92 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Aftercare Attendance
Attended at least 6 months of treatment
|
35 percentage of participants
|
48 percentage of participants
|
|
Aftercare Attendance
Attended at least 1 aftercare session
|
97 percentage of participants
|
97 percentage of participants
|
|
Aftercare Attendance
Passed the SUD continuity of care measure
|
58 percentage of participants
|
70 percentage of participants
|
|
Aftercare Attendance
Attended at least 3 months of treatment
|
64 percentage of participants
|
76 percentage of participants
|
|
Aftercare Attendance
Attended at least 9 months of treatment
|
22 percentage of participants
|
35 percentage of participants
|
|
Aftercare Attendance
Attended at least 12 months of treatment
|
10 percentage of participants
|
16 percentage of participants
|
SECONDARY outcome
Timeframe: Assessed over the past 90 days at 3, 6 and 12 months, and cumulative over 1 yearOutcome measures
| Measure |
Standard Treatment (STX)
n=91 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=92 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Self-help Support Group Attendance
Days of AA or NA attendance (3 months)
|
20.18 days
Standard Deviation 21.16
|
23.44 days
Standard Deviation 22.29
|
|
Self-help Support Group Attendance
Days of AA or NA attendance (6 months)
|
18.14 days
Standard Deviation 25.90
|
21.99 days
Standard Deviation 26.50
|
|
Self-help Support Group Attendance
Days of AA or NA attendance (12 months)
|
12.41 days
Standard Deviation 21.57
|
14.18 days
Standard Deviation 23.21
|
|
Self-help Support Group Attendance
Total Days of AA or NA attendance at 1 year
|
45.7 days
Standard Deviation 57.3
|
54.6 days
Standard Deviation 58.2
|
SECONDARY outcome
Timeframe: Assessed at Baseline, 3-, 6-, and 12-month follow-upOutcome measures
| Measure |
Standard Treatment (STX)
n=91 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=92 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Days of Substance Abuse (Across the Prior 90 Days)
% of days using alcohol or drugs (Baseline)
|
51 percentage of 90 days
Standard Deviation 33
|
58 percentage of 90 days
Standard Deviation 29
|
|
Days of Substance Abuse (Across the Prior 90 Days)
% of days using alcohol or drugs (3 month)
|
6 percentage of 90 days
Standard Deviation 17
|
7 percentage of 90 days
Standard Deviation 19
|
|
Days of Substance Abuse (Across the Prior 90 Days)
% of days using alcohol or drugs (6 month)
|
11 percentage of 90 days
Standard Deviation 23
|
8 percentage of 90 days
Standard Deviation 19
|
|
Days of Substance Abuse (Across the Prior 90 Days)
% of days using alcohol or drugs (12 month)
|
15 percentage of 90 days
Standard Deviation 28
|
15 percentage of 90 days
Standard Deviation 31
|
SECONDARY outcome
Timeframe: Assessed at Baseline, 3-, 6-, and 12-monthsNumber of days hospitalized for any reason per the previous 90 days
Outcome measures
| Measure |
Standard Treatment (STX)
n=91 Participants
Control condition: Routine residential treatment and orientation to continuing care.
An addiction therapist from the participants' treatment program met with each participant for an individual aftercare orientation session during the final 4 days of the initial treatment program and again during the ninth week of aftercare. Individuals were also encouraged to get an AA or NA sponsor during this session.
|
Contracts, Prompts and Reinforcement (CPR)
n=92 Participants
Contracting, Prompting \& Reinforcing Abstinence \& Attendance: Contingent reinforcement of abstinence and prompting of AA/NA attendance
CPR participants received the STX aftercare orientation except they were also provided with the contracting intervention during the orientation sessions, as well as the prompting and reinforcement components of the intervention.
* Contracting. Participant's completed a behavioral contract for continuing care participation that took approximately 20 minutes to complete during their final 4 days in initial treatment and after 9 weeks of participation in continuing care.
* Prompting. CPR participants received prompts (mailed appointment cards, telephone reminders) to attend all of their aftercare appointments and AA/NA meetings, and following missed aftercare sessions for 1 year (or until discharged from treatment).
* Reinforcement. CPR participants received social reinforcement (certificates, honor roll) for attending group therapy.
|
|---|---|---|
|
Rates of Hospitalization (Across the Prior 90 Days)
Days of hospitalization (Baseline)
|
9.23 days
Standard Deviation 14.42
|
6.87 days
Standard Deviation 12.39
|
|
Rates of Hospitalization (Across the Prior 90 Days)
Days of hospitalization (3 months)
|
1.18 days
Standard Deviation 4.74
|
1.93 days
Standard Deviation 8.21
|
|
Rates of Hospitalization (Across the Prior 90 Days)
Days of hospitalization (6 months)
|
2.14 days
Standard Deviation 8.74
|
4.23 days
Standard Deviation 14.73
|
|
Rates of Hospitalization (Across the Prior 90 Days)
Days of hospitalization (12 months)
|
1.47 days
Standard Deviation 4.07
|
2.08 days
Standard Deviation 11.27
|
Adverse Events
Standard Treatment (STX)
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Contracts, Prompts and Reinforcement (CPR)
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Steven Lash, Ph.D.
Salem Veterans Affairs Medical Center
Phone: (540)982-2463
Email: [email protected]
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place