DOI: 10.3886/icpsr39317.v1
title: Interactive Computer-Assisted Recovery Enabler (ICARE): Treatment Support Tool for Substance-Using Offenders, North Carolina, 2022-2023
title: Version 1

description: This study addressed a critical gap regarding the use of mobile phone technologies to assist in the treatment process for explicitly justice-involved populations. To address this gap, the study research included designing, implementing, and assessing the use of an appointment notification system called the Interactive Computer-Assisted Recovery Enabler (ICARE) tool. ICARE was developed to improve and support behavioral health nonclinical care management and probation compliance among individuals under community supervision who are referred by their probation officer (PO).
The purpose of the ICARE was to automatically transmit appointment reminders to Treatment Accountability for Safe Communities (TASC) clients, starting from the point of probation referral to the program, with the goal of increasing their care management appointment attendance, increasing their care management completion, and improving their probation compliance.
This research included a two study approach, one formative and one focused on outcomes, where the goal was to enhance the ability to support clients by:

increasing their engagement and retention in care management and treatment
reducing the degree of their substance use and improving mental health
complying with their terms of supervision
and reducing their criminal behavior.
description: The purpose of this study included three objectives:

To develop the Interactive Computer-Assisted Recovery Enabler (ICARE) mobile phone automatic notification system to support clients referred to Treatment Accountability for Safer Communities (TASC) by enhancing care management
To assess the impact of ICARE on TASC compliance as well as user satisfaction with ICARE
To assess the impact of ICARE on probation outcomes, particularly the likelihood of technical violations
description: In partnership with Coastal Horizons, the Treatment Accountability for Safer Communities (TASC) provider for 53 counties in eastern North Carolina, and Uptrust (e.g., a public benefits software company that develops automated notifications to enhance communications for people who are systems involved), RTI designed, implemented, and assessed the use of an automated appointment notification tool that transmitted messages to individuals under community supervision who were referred to nonclinical care management. The developed tool was the Interactive Computer-Assisted Recovery Enabler (ICARE) mobile phone automatic notification system. This study included a formative and outcome study.
The formative study involved user-centered design activities including focus groups and interviews with TASC clients and care managers from four counties in North Carolina. The purpose of the focus groups and interviews was to obtain information about users' preferences for ICARE notification content and features. The feedback from the formative work contributed to the design of the ICARE tool and assessment phase approach.
The outcome study involved implementation and assessment using an randomized controlled trial (RCT) of the use of ICARE in TASC offices in 47 North Carolina counties. Using new client referral information that TASC receives from the Division of Community Supervision (DCS) at the North Carolina Department of Adult Corrections (NC DAC), Uptrust established a database of referrals and randomly assigned 1,018 adults who were referred by probation to TASC to two study groups: 504 participants in the control group only received reminders as usual (RAU) about their TASC appointments by probation officers or TASC care managers as typical operational practices and 514 participants in the treatment group received TASC appointment reminders plus RAU. Uptrust was responsible for scheduling and transmitting the treatment reminders as well as maintaining data on whether messages were delivered. Those clients without a mobile phone who could not be contacted via ICARE were ineligible for the intervention.
description: The study included variables recording respondent demographics, criminal history, and intervention indicators (total number of check-in appointments completed before or after intervention, total number of check-in appointments missed before or after intervention, and violations of Interactive Computer-Assisted Recovery Enabler (ICARE) enrollment).
description: During 9 months of enrollment, all Treatment Accountability for Safer Communities (TASC) referrals of people on probation in 47 North Carolina counties where Coastal Horizons operates a TASC office were included in the implementation study. Individuals were not recruited individually for participation in the outcome study as the Interactive Computer-Assisted Recovery Enabler (ICARE) notification messages served as an extension of current probation and TASC care management practice to remind individuals of their requirement to comply with the condition to report to TASC. Current notification practices vary depending on the probation officer (PO) and may include as few as one reminder during a PO visit that TASC attendance is a condition of supervision or additional reminders by the PO via text, phone, or email. The extent of reminding clients is at the discretion of each PO. Upon connection with TASC, care managers may also remind clients about TASC appointments via text, phone, or email at their discretion.
description: Datasets: 
DS1: Interactive Computer-Assisted Recovery Enabler (ICARE): Treatment Support Tool for Substance-Using Offenders, North Carolina, 2022-2023
description: Individuals on probation in Eastern North Carolina who were referred by North Carolina Department of Adult Correction to Treatment Accountability for Safer Communities for behavioral health care management.