Substance Abuse Clinical Trial
Official title:
Reducing Barriers to Drug Abuse Treatment Services
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.
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.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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