Automated Prize-based Contingency Management to Increase Counseling Attendance in Opiate-Replacement-Therapy Patients
Condition: Opiate-Replacement Therapy
Study type: Interventional
Phase: Early Phase 1

Summary: 
      Background:

      - Treatment outcomes for substance abuse are improved by regular attendance at counseling
      sessions, and attending at counseling sessions can be futher improved by prize-based
      incentives. However, a system of prize-based incentives can be difficult to administer
      without computerization for accurate recordkeeping and rapid calculation of earnings. NIDA
      researchers have developed the eXtensible Platform for Motivational Incentives (XPMI), a
      computer program that for reinforcement of weekly counseling attendance. Users are eligible
      to win prizes through automated draws. The researchers are interested in testing the
      effectiveness and ease of use of the XPMI software so it can ultimately be run by staff in
      community treatment programs.

      Objectives:

        -  To test the XPMI program in a clinic setting, with emphasis on its functionality,
           usability, and acceptability for counselors.

        -  To test and validate XPMI s accuracy in calculating incentives to reinforce drug
           abstinence.

      Eligibility:

      - Individuals at least 18 years of age who are participating in clinical trials for treatment
      of heroin dependence in an outpatient treatment-research program, and have at least 14 weeks
      remaining in the program.

      Design:

        -  Participants will meet with their counselors as regularly scheduled. Twelve of the
           visits will count toward this study, with 2 extra weeks in case of counselor absence or
           clinic closure.

        -  Participants will receive an incentive in the form of a prize draw for arriving to
           counseling appointments on time, on the scheduled day. (Participants may reschedule one
           appointment per week without losing the chance for a prize draw.) For each consecutive
           appointment attended on time, participants will receive extra prize draws; attending
           three counseling appointments in a row can earn four bonus prize draws.

        -  To draw for prizes, participants will push a button on a computer. Each prize draw could
           result in a small prize worth $1 to $2, a large prize worth $20, a jumbo prize worth
           $100, or no prize at all. The average prize total per person is expected to be about
           $378.

        -  Participants will also be asked to fill out questionnaires about the computer program.
    

Detailed description: 
      Background. Community implementation is a barrier to technology transfer of contingency
      management (CM), an effective behavioral treatment for substance dependence. The Biomedical
      Informatics Section (BIS), the Treatment Section, and the NIDA Blending team are developing
      and validating software for automated contingency management (ACM) for free distribution and
      use in community treatment programs. This is part of a collaborative effort between NIDA and
      SAMHSA to facilitate use of CM in the community.

      Scientific goals. To validate the usability and robustness of our ACM program, eXtensible
      Platform for Motivational Incentives (XPMI), implemented under conditions simulating those of
      a community treatment program with minimal technology support.

      Participant population. Up to 30 outpatients (20 completers) participating in treatment
      studies at Archway clinic. Target enrollment for the outpatients will include 30% women and
      60% minorities (mostly African-American).

      Experimental design and methods. In this field test, Archway counseling staff will use XPMI
      to reinforce participants attendance at up to 12 counseling sessions for up to 14 weeks.
      (Participants who are still enrolled in the clinic at the end of this period will be
      considered completers.) Participants will earn opportunities to draw for prizes each time
      they attend their weekly counseling session on time and as scheduled. A record of any
      problems in using the program and the possible recommended solutions will be maintained.
      Feedback on problems, accuracy, and simplicity will be given to the software-development team
      at BIS on an ongoing basis. BIS will fix any problems as they arise.

      Benefits to participants and/or society. There are no direct benefits to the participants.
      Availability of XPMI may improve technology transfer of a proven effective treatment to the
      community.

      Risks to participants. Risks of participation are minimal. This is a secondary study;
      participants decisions about enrollment and compliance will not affect their status in their
      primary studies.
    

Intervention name(s): Automated Contingency Management (ACM) software
Intervention type(s): Device
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Motivational Incentive; Automation; Contingency Management; Counseling Adherance