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）： 在我们中心评估应急管理 (CM) 的研究中，该研究提供了赢得奖品的机会，每位患者的平均费用低于 250 美元，我们注意到，应急管理的疗效可能取决于个人开始治疗时的状态。开始治疗时尿液分析结果呈可卡因阳性的患者往往会过早退出治疗并在治疗期间继续使用。 CM 干预措施可有效减少该亚组的药物使用，且效果具有程度依赖性。然而，到目前为止，我们仅测试了最高 250 美元的奖金，更大的金额可能会进一步改善结果。该提案的目的之一是检查增强型 CM 程序的有效性，该程序在禁欲初期提供了更高的获奖频率。开始使用可卡因阳性尿样进行治疗的可卡因依赖患者 (N=120) 将被随机分配到以下三组之一 条件：(a) 标准、非 CM 治疗，(b) 标准治疗加 CM 并具有预期效果 赢得大约 250 美元奖金的概率，或 (c) 标准治疗加 CM 并具有预期 赢得大约 560 美元奖金的概率。我们还发现，接受可卡因阴性样本治疗的患者通常在整个治疗期间都会出现阴性样本，无论他们是否接受非 CM 治疗或戒断后的 CM 治疗。因此，我们还将进行一项平行研究，评估仅仅加强参加治疗是否可以提高该亚组的保留率并改善长期结果。可卡因依赖患者 (N=330) 开始使用可卡因阴性尿液样本进行治疗时，将被随机分配至以下三种情况之一：(a) 无 CM 的标准治疗或 (b) 标准治疗加 CM，预期获胜概率约为根据戒除可卡因，获得价值 250 美元的奖品，或 (d) 标准治疗加 CM，根据参加治疗的情况，预计有可能赢得价值约 250 美元的奖品。这些研究将共同​​探讨在何种条件下，较低和较高成本的 CM 手术可能会改善可卡因依赖患者的治疗结果。