Project Health Link: Connecting Patients With Services

Study Overview
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Brief Summary
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The proposed study will compare three alternative interventions in the emergency department (ED) to promote linkage to substance abuse assessment, referral and treatment entry for those who meet abuse/dependence criteria for stimulants, cannabis, and/or non-injected opioids: (1) a 5-session Strengths-Based Case Management (SBCM) model; (2) a 2-session Brief Motivational Enhancement (BME); or (3) a one-time Brief Informational Feedback (BIF) session. The primary outcome variables for this trial include receiving an assessment and referral and treatment entry. Other outcomes include degree of treatment completion, substance-related measures, health service utilization, health status changes, and psychosocial factors.

Official Title
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Services Interventions for Injured ED Substance Abusers

Conditions
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Drug Abuse

Intervention / Treatment
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* Behavioral: Strengths Based Case Management (SBCM)
* Behavioral: Motivational Enhancement Therapy (MET)
* Behavioral: Brief Informational Feedback (BIF) session


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: (1) adults age 19-60 presenting to the Hurley Medical Center ED within 24 hours of an injury; (2) ability to provide informed consent. Additional inclusion criteria for intervention study: meets criteria for substance abuse or dependence for stimulants (cocaine powder, crack cocaine, methamphetamine, amphetamine), cannabis (marijuana, hashish), and or opioids (noninjected heroin, other opioids such as hydrocodone and oxycodone) in the previous year. Exclusion Criteria: (1) adult patients who do not understand English; (2) prisoners; (3) adults classified by medical staff as Level 1 trauma; (4) adults deemed unable to provide informed consent as stated above (e.g., intoxication, mental incompetence); (5) patients treated in the ED for suicide attempts and sexual assaults; (6) patients who have been in treatment for substance abuse in the past six months; (7) patients who are triaged to psychiatric emergency services; and (8) patients who report injecting heroin or other opiates in the past year.

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Strengths Based Case Management Model (SBCM)<br>The Strengths Based Case Management Model (SBCM) consists of 5 case-management sessions designed to promote linkage and engagement in assessment and treatment services, while assisting with the patient's perceived needs, as well as personal strengths and barriers to linkage and engagement. | Behavioral: Strengths Based Case Management (SBCM)<br> <br> |
| Active Comparator: Motivational Enhancement Therapy (MET)<br>The MET therapist will conduct 2 motivational enhancement sessions to work through the content of an educational workbook targeting the participant's substance use/abuse with the goal of negotiating a 'contract' to: 1) link to services, with the eventual goal of seeking and receiving specialized substance treatment; or 2) provide a strategy to self-monitor substance use, consider consequences, and later seek assessment. | Behavioral: Motivational Enhancement Therapy (MET)<br> <br> |
| Active Comparator: Brief Informational Feedback (BIF) session<br>Subjects will receive brief informational feedback on the results of their alcohol screening and assessment and encouragement to seek treatment. | Behavioral: Brief Informational Feedback (BIF) session<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| receipt of assessment |  | 3 and 6 months post-baseline | 
| treatment entry |  | 3 and 6 months post-baseline |