TY - JOUR
T1 - Effectiveness of a computerized motivational intervention on treatment initiation and substance use
T2 - Results from a randomized trial
AU - Lerch, Jennifer
AU - Walters, Scott T.
AU - Tang, Liansheng
AU - Taxman, Faye S.
N1 - Funding Information:
We are grateful to the Dallas County Community Supervision and Corrections Department and the Maryland Department of Public Safety and Correctional Services for their assistance in conducting this study. This work was supported by the National Institute on Drug Abuse (R01 DA029010). The trial registration number is NCT01891656 (initiated on October 18, 2011).
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/9
Y1 - 2017/9
N2 - As many as 80% of the nearly five million adults under community supervision (i.e., probation, parole) are substance involved; however, treatment utilization is low. Using a multi-site randomized controlled trial, we tested the efficacy of in-person motivational interviewing (MI), a motivational computer intervention (MAPIT), or standard probation intake (SAU) to encourage treatment initiation among 316 substance-involved probationers in Dallas, Texas and Baltimore City, Maryland. Ninety-three percent (n = 295) of participants completed the 2-month follow-up and 90% (n = 285) completed the 6-month follow-up. At 2-months, individuals in the MAPIT condition were more likely to report treatment initiation compared to the SAU condition (OR = 2.40, 95% CI = 1.06, 5.47) via intent-to-treat analysis, especially among those completing both sessions (RE = 0.50, 95% CI = 0.05, 0.95) via instrumental variable analysis. At 6-months, MAPIT approached significance for treatment initiation in both analyses. MI did not achieve significance in any model. We did not find any differential impact on substance use. The success of MAPIT suggests that an integrated health-justice computerized intervention as part of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) can be used to address public safety and health issues.
AB - As many as 80% of the nearly five million adults under community supervision (i.e., probation, parole) are substance involved; however, treatment utilization is low. Using a multi-site randomized controlled trial, we tested the efficacy of in-person motivational interviewing (MI), a motivational computer intervention (MAPIT), or standard probation intake (SAU) to encourage treatment initiation among 316 substance-involved probationers in Dallas, Texas and Baltimore City, Maryland. Ninety-three percent (n = 295) of participants completed the 2-month follow-up and 90% (n = 285) completed the 6-month follow-up. At 2-months, individuals in the MAPIT condition were more likely to report treatment initiation compared to the SAU condition (OR = 2.40, 95% CI = 1.06, 5.47) via intent-to-treat analysis, especially among those completing both sessions (RE = 0.50, 95% CI = 0.05, 0.95) via instrumental variable analysis. At 6-months, MAPIT approached significance for treatment initiation in both analyses. MI did not achieve significance in any model. We did not find any differential impact on substance use. The success of MAPIT suggests that an integrated health-justice computerized intervention as part of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) can be used to address public safety and health issues.
KW - Computer
KW - MAPIT
KW - Motivation
KW - Probation
KW - Substance use
KW - Treatment initiation
UR - http://www.scopus.com/inward/record.url?scp=85022222046&partnerID=8YFLogxK
U2 - 10.1016/j.jsat.2017.07.002
DO - 10.1016/j.jsat.2017.07.002
M3 - Article
C2 - 28755774
AN - SCOPUS:85022222046
VL - 80
SP - 59
EP - 66
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
SN - 0740-5472
ER -