Enhanced & Attendance Based Prize Contingency Management in Community Setting

增强型

• 批准号: 7643441
• 负责人: NANCY M PETRY
• 金额: $ 41.35万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7643441
• 关键词: Abstinence; Address; Behavioral; Caring; Characteristics; Clinical; Clinical Research; Clinical Trials Network; Cocaine; Cocaine Dependence; Communities; Condition; Criminal Justice; Drops; Drug usage; Effectiveness of Interventions; Employment; Exposure to; Family; Frequencies; Gender; Grant; HIV; Hospitalization; Individual; Intervention; Legal; Medical; Outcome; Outcome Measure; Patients; Personality Disorders; Prize; Probability; Procedures; Process; Productivity; Psychiatric therapeutic procedure; Psychological reinforcement; Purpose; Race; Randomized; Relative (related person); Research; Risk Behaviors; Sampling; Severities; Social Problems; Specimen; Staging; Standards of Weights and Measures; Subgroup; Symptoms; System; Techniques; Testing; Therapeutic; Time; Urinalysis; Urine; anti social; base; contingency management; cost; cost effectiveness; court; day; drug abstinence; follow-up; improved; response; treatment program; voucher

DESCRIPTION (provided by applicant): In our Center research evaluating contingency management (CM) that provides opportunities to win prizes with an average expense of under $250 per patient, we have noted that that the efficacy of CM may be dependent on the status of the individual as they initiate treatment. Patients who begin treatment with a cocaine-positive urinalysis result tend to drop out of treatment prematurely and to continue using while in treatment. CM interventions have been efficacious in reducing drug use in this subgroup, and the effects were magnitude dependent. However, we have thus far only tested up to a maximum of $250 in prizes, and larger magnitudes may further improve outcomes. One purpose of this proposal is to examine the efficacy of an enhanced CM procedure, in which increased frequencies of prize winnings are provided during initial periods of abstinence. Cocaine-dependent patients beginning treatment with a cocaine-positive urine sample (N=120) will be randomly assigned to one of three conditions: (a) standard, non-CM treatment, (b) standard treatment plus CM with an expected probability of winning about $250 in prizes, or (c) standard treatment plus CM with an expected probability of winning about $560 in prizes. We have also found that patients who present to treatment with cocaine-negative samples generally remit negative samples throughout their time in treatment, regardless of whether they received a non-CM or a CM treatment contingent upon abstinence. Thus, we will also conduct a parallel study that will assess whether simply reinforcing attendance at treatment enhances retention and improves long-term outcomes in this subgroup. Cocaine-dependent patients (N=330) initiating treatment with a cocaine-negative urine sample will be randomly assigned to one of three conditions: (a) standard treatment without CM or (b) standard treatment plus CM with an expected probability of winning about $250 worth of prizes contingent upon cocaine abstinence, or (d) standard treatment plus CM with an expected probability of winning about $250 worth of prizes contingent upon treatment attendance. Together, these studies will address the conditions under which lower and higher cost prize CM procedures may improve outcomes of cocaine-dependent patients.

描述（由申请人提供）： 在我们的中心研究评估应急管理（CM）的中心研究中，提供了赢得奖品的机会，平均费用低于每位患者250美元，我们注意到CM的疗效可能取决于个人开始治疗时的状态。开始治疗可卡因阳性尿液分析的患者往往会过早地退出治疗，并在治疗期间继续使用。 CM干预措施在减少该亚组中的药物使用方面有效，并且效果依赖于大小。但是，迄今为止，我们仅测试了最高250美元的奖品，较大的幅度可能会进一步改善结果。该提案的目的之一是检查增强的CM程序的功效，在该程序中，在禁欲的初始阶段提供了奖金的频率增加。可卡因依赖性患者开始使用可卡因阳性尿液样本（n = 120）的患者随机分配给三个 条件：（a）标准，非CM治疗，（b）标准治疗加上CM的预期 赢得大约250美元的奖品的概率，或（c）标准治疗加上CM的概率 赢得约560美元的奖品的可能性。我们还发现，与可卡因阴性样品进行治疗的患者在治疗过程中通常会使阴性样本在治疗过程中汇总，而不管他们是否接受过非CM还是CM治疗，包括禁欲。因此，我们还将进行一项平行研究，该研究将评估仅仅在治疗中加强出勤率是否可以增强保留率并改善该亚组的长期结局。 Cocaine-dependent patients (N=330) initiating treatment with a cocaine-negative urine sample will be randomly assigned to one of three conditions: (a) standard treatment without CM or (b) standard treatment plus CM with an expected probability of winning about $250 worth of prizes contingent upon cocaine abstinence, or (d) standard treatment plus CM with an expected probability of winning about $250 worth of prizes contingent upon治疗出席。这些研究将共同​​解决较低成本和更高成本的CM程序可以改善可卡因依赖性患者的预后的条件。