Motivational Assessment Program to Initiate Treatment (MAPIT)

University of North Texas Health Science Center

Status: Completed

Conditions: Substance-Related Disorders

Treatments: Behavioral: Motivational Computer; Behavioral: Motivational Interviewing

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01891656

R01DA029010-01

5R01DA029010-06 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Substance abuse treatment in the criminal justice system can reduce drug use and related criminal behavior. Although drug and alcohol treatment are common mandates in criminal justice programs, only a minority of clients actually initiate treatment. This proposal will compare two intervention formats that target motivation to initiate and engage in treatment among a group of probationers who have drug or alcohol treatment conditions. Six hundred drug and alcohol offenders in two probation sites (Baltimore, MD and Dallas, TX) will be randomized to receive: 1) an in-person motivational interviewing session (MI), 2) a motivational computer program (MC), or 3) supervision intake and monitoring as usual (SAU). The MI condition will be structured along the lines of the "Check-Up" format which consists of an assessment and personalized feedback delivered in an MI style; the content of the MC condition will be drawn from previous literature on effective motivational computer programs. Both interventions will be delivered at the start of the probation process, with follow-up assessments at 2 and 6 months. Primary outcomes include engagement and participation in substance abuse treatment; secondary outcomes include drug and alcohol use, probation progress, criminal behavior, and HIV testing and care. This project will be the first to develop and test two interventions for encouraging criminal justice clients to follow through with treatment recommendations, with the goal of increasing treatment initiation, and reducing subsequent drug use and criminal behavior. It also contributes to ongoing partnerships with two large probation agencies-the Dallas County Supervision and Corrections Department and the Maryland Division of Parole and Probation.

Full description

Specific Aims

• Develop two intervention formats (Motivational Interviewing (MI) and Motivational Computer (MC)) for increasing motivation to initiate and engage in substance abuse treatment and/or HIV / AIDS testing and, if appropriate, HIV care.
• Test the efficacy of MI and MC on treatment initiation and participation, substance abuse, HIV testing/care, and recidivism, as compared to Supervision As Usual (SAU);
• Evaluate offender characteristics (e.g., risk level, gender, ethnicity, motivation) as potential moderators of the intervention effect; and,
• Assess the relative cost and cost-effectiveness of MI and MC on substance abuse treatment and/or linkage to or participation in HIV/AIDS care, supervision outcomes, recidivism, and substance abuse.

Enrollment: 380 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• >=18 years old
• Drug or Alcohol use in the last 90 days

Exclusion criteria

• <18 years old
• Cannot speak English
• Already participate in a substance abuse treatment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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380 participants in 3 patient groups

Motivational Interviewing

Experimental group

Description:

Participants randomized to the MI group will receive a single 60-minute MI session focused on motivation to initiate and engage in treatment. The MI session will be organized around the "Check-Up" format, with additional planning components as desired by the client.

Treatment:

Behavioral: Motivational Interviewing

Supervision As Usual

No Intervention group

Description:

Participants randomized to the SAU group will receive the standard agency intake process as well as baseline and follow-up research interviews, but will not receive any additional intervention as part of the study. They will be referred to a treatment program as per the normal routine.

Motivational Computer

Experimental group

Description:

Participants randomized to the MC group will complete a 60 minute computer intervention focused on motivation to initiate and engage in treatment. The program will be self-guided, interactive, and to the extent possible, will mirror the features of MI session. The MC program will have two main components: a motivation component and a planning component.

Treatment:

Behavioral: Motivational Computer