Motivational Assessment Program to Initiate Treatment (MAPIT)

In-Person VS. Computer Interventions for Increasing Probation Compliance

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.

Study Overview

Detailed 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.

Study Type

Interventional

Enrollment (Actual)

380

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Texas
      • Fort Worth, Texas, United States, 76107
        • University of North Texas Health Science Center
    • Virginia
      • Fairfax, Virginia, United States, 22030
        • George Mason University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Motivational Interviewing
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.
MI is a "client centered, directive style of interacting with a person to help explore and resolve ambivalence about change" (Miller & Rollnick, 2002). MI borrows from Client-Centered Counseling in its emphasis on empathy, optimism, and respect for client choice (Rogers, 1961). MI also draws from Self-Perception Theory, which says that a person becomes more or less committed to an action based on the verbal stance he or she takes (Bem, 1972). The effects of MI tend to be in the small-to-medium range when compared to no treatment, and nonsignificant when compared to more extensive treatment.
Other Names:
  • Motivational Enhancement Therapy
No Intervention: Supervision As Usual
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.
Experimental: Motivational Computer
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.
The growing use of technology has led to the development of automated interventions for behavior change, including some that target drug and alcohol use (Elliott, et al, 2008; Lustria, et al, 2009; Revere & Dunbar, 2001; Walters, et al, 2006) and treatment interest (Lieberman & Massey, 2008). As discussed by Hester & Miller (2006), automated interventions have several potential advantages over face-to-face interventions: (I) They require little or no staff contact, which may increase cost-effectiveness; (2) they can allow for automatic data collection and follow-up; and (3) they can be disseminated with little loss of fidelity.
Other Names:
  • Web-Based Interventions

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment Progress
Time Frame: 6 months
Treatment progress assesses initiation, engagement and retention at 2 and 6 months via telephone. In-person visits are assessed at baseline and during a 6 month visit.
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Drug and Alcohol Use
Time Frame: 6 months
Drug and alcohol use is a secondary outcome measured at baseline and 6 months during an in-person interview. In addition, this outcome is measured at 2 via telephone.
6 months
Probation Progress
Time Frame: 6 months
Probation progress is measured at baseline and 6 months via in-person interview. In addition, this outcome is measured at 2 via a telephone interview.
6 months
Criminal Behavior
Time Frame: 6 months
Criminal Behavior is measured during in-person interviews at baseline and 6 months. In addition, this outcome is measured at 2 months via telephone.
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Scott T Walters, PhD, UNT Health Science Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2012

Primary Completion (Actual)

June 1, 2015

Study Completion (Actual)

February 1, 2016

Study Registration Dates

First Submitted

October 18, 2011

First Submitted That Met QC Criteria

June 28, 2013

First Posted (Estimate)

July 3, 2013

Study Record Updates

Last Update Posted (Estimate)

April 13, 2016

Last Update Submitted That Met QC Criteria

April 11, 2016

Last Verified

April 1, 2016

More Information

Terms related to this study

Other Study ID Numbers

  • R01DA029010-01 (U.S. NIH Grant/Contract)
  • 5R01DA029010-06 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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