Contingency Management for Recovery Oriented Activities at Recovery Houses

In this study, the investigators will implement contingency management at rural recovery houses, where individuals with substance use disorders reside. Contingency management is a behavioral intervention in which participants receive incentives (rewards) when they complete planned tasks that are consistent with their recovery efforts. House staff members will also participate in this study and will be trained to provide contingency management to residents. The investigators will compare recovery houses that implement contingency management to matched houses that do not, and the main outcomes will be engagement in the planned activities and retention in the recovery houses. Participants will receive contingency management for up to 12 weeks and follow-up will occur 6 months post-treatment.

Study Overview

• Status: Recruiting
• Conditions: Substance Use Disorders
• Intervention / Treatment: Behavioral: Contingency management; Behavioral: Usual Care

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: David Ledgerwood, PhD; Phone Number: 313-993-1380; Email: dledgerw@med.wayne.edu

Study Locations

• United States
  • Michigan
    • Detroit, Michigan, United States, 48201
      • Recruiting
      • Wayne State University School of Medicine
      • Contact: David Ledgerwood; Phone Number: 313-993-1380; Email: dledgerw@med.wayne.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Age 18 or older;
2. a resident of the recovery house; and
3. able to provide informed consent.

Exclusion Criteria:

1. expected to be discharged from the recovery house in the next two months;
2. experiencing uncontrolled mania, psychosis or suicidality.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Contingency management; In addition to receiving usual care at the recovery house, participants assigned to this arm will receive contingency management by trained recovery house staff in addition to their usual care. Contingency management sessions will be led by a trained recovery house staff member who is also a research participant in the study. Contingency management will occur once weekly for sessions of approximately 10-15 minute duration for up to 12 weeks. Participants will plan three recovery-oriented activities with the staff member each week, and upon verification of completion of the tasks, the resident participant can earn prize draws of varying monetary amounts.	Behavioral: Contingency management; The investigators will implement a prize-based contingency management protocol in which residents will complete three pre-planned recovery-oriented activities each week for a period of up to 12 weeks. Upon verified completion of the activities each week, participants may earn prize incentives through drawing from a prize fishbowl or spinning a virtual prize wheel. Prizes will be money added to a debit card. On the first week and individual has completed pre-planned activities, s/he can receive up to 1 draw per activity completed (3 total), and each week the number of prize draws per activity will escalate by 1. If a participant fails to complete any activities, he/she will not receive the draws for the uncompleted activities, and the prize draws would be reset to 1 in the next week. Participants can earn up to $75 in incentives in total.; Behavioral: Usual Care; Participants in this arm will receive usual care that they would normally receive at the recovery houses. Recovery residences vary considerably, this form of housing benefits individuals in recovery by reinforcing a substance-free lifestyle and providing direct connections to other peers in recovery, mutual support groups and recovery support services.
Active Comparator: Usual Care; Participants in this arm will receive usual care that they would normally receive at the recovery houses. Recovery houses are safe, healthy, family-like substance-free living environments that support individuals in recovery from addiction. Although recovery residences vary considerably, this form of housing benefits individuals in recovery by reinforcing a substance-free lifestyle and providing direct connections to other peers in recovery, mutual support groups and recovery support services.	Behavioral: Usual Care; Participants in this arm will receive usual care that they would normally receive at the recovery houses. Recovery residences vary considerably, this form of housing benefits individuals in recovery by reinforcing a substance-free lifestyle and providing direct connections to other peers in recovery, mutual support groups and recovery support services.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment retention	Length of time (in days) a resident resides in the recovery house	Time until leaving the recovery home from study baseline up to one year
Engagement in recovery-oriented activities	Participants will engage in up to 3 planned recovery activities (noted on a tracking form)	up to 12 week treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment Satisfaction	Treatment Satisfaction Questionnaire (Scores range from 1 to 7 with higher scores reflecting greater satisfaction)	Post-treatment (Week 12)
Quality of Life Assessment	Self-report Quality of Life inventory (scores range from -3 to 3 with higher scores reflecting greater quality of life)	Baseline, post-treatment (week 12) and 6-month follow up
Self-Reported Health	Short Form 36 (SF-36) is a brief measure of overall self-reported health. Scores range from 0 (maximum disability) to 100 (no disability)	Baseline, post-treatment (week 12) and 6-month follow up
Patient Health Questionnaire - 9	A measure of depression symptoms. Scores on the PHQ 9 range from 0 (no depression) to 27 (severe depression).	Baseline, post-treatment (week 12) and 6-month follow up
Substance Use	Urine drug screen of metabolites for cocaine, methamphetamine, barbiturates, opioids, cannabis, alcohol and benzodiazepines	Baseline, weekly for 12 weeks, post-treatment (week 12) and 6-month follow up
Timeline Follow-back for substance use	Timeline Follow-back (TLFB) is a self-report, calendar-based measure of the frequency of substance use	Baseline, weekly for 12 weeks, post-treatment (week 12) and 6-month follow up
Treatment Feasibility	Treatment Feasibility will assessed as the proportion of eligible participants who are willing to participate after initial screening.	Baseline

Collaborators and Investigators

• Sponsor: Wayne State University

Publications and helpful links

General Publications

• Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.
• Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83.
• Frisch, M.B., Cornell, J., Villanueva, M. & Retzlaff, P.J. (1992). Clinical validation of the quality of life inventory: A measure of life satisfaction for treatment planning and outcome assessment. Psychological Assessment, 4, 92-101.
• Novy, D.M., Nelson, D.V., Goodwin, J. & Rowzee, R.D. (1993). Psychometric comparability of the State-Trait Anxiety Inventory for different ethnic subpopulations. Psychological Assessment, 5, 343-349.
• Petry NM, Alessi SM, Ledgerwood DM. A randomized trial of contingency management delivered by community therapists. J Consult Clin Psychol. 2012 Apr;80(2):286-98. doi: 10.1037/a0026826. Epub 2012 Jan 16.
• Petry NM, Alessi SM, Ledgerwood DM. Contingency management delivered by community therapists in outpatient settings. Drug Alcohol Depend. 2012 Apr 1;122(1-2):86-92. doi: 10.1016/j.drugalcdep.2011.09.015. Epub 2011 Oct 5.
• Petry NM, Alessi SM, Ledgerwood DM, Sierra S. Psychometric properties of the contingency management competence scale. Drug Alcohol Depend. 2010 Jun 1;109(1-3):167-74. doi: 10.1016/j.drugalcdep.2009.12.027. Epub 2010 Feb 11.
• Petry NM, Martin B, Finocche C. Contingency management in group treatment: a demonstration project in an HIV drop-in center. J Subst Abuse Treat. 2001 Sep;21(2):89-96. doi: 10.1016/s0740-5472(01)00184-2.
• Rash CJ, Petry NM, Kirby KC, Martino S, Roll J, Stitzer ML. Identifying provider beliefs related to contingency management adoption using the contingency management beliefs questionnaire. Drug Alcohol Depend. 2012 Mar 1;121(3):205-12. doi: 10.1016/j.drugalcdep.2011.08.027. Epub 2011 Sep 16.
• Shapiro, S.S. & Wilk, M.B. (1965). An analysis of variance test for normality (complete samples). Biometrika, 52.3/4, 591-611.
• Sobell, L.C., & Sobell, M.B. (1992). Timeline follow-back: A technique for assessing self-reported alcohol consumption. In R.Z. Litten and J.P. Allen (eds.), Measuring alcohol consumption: Psychosocial and biochemical methods (pp. 41-72). Totowa, NJ: Humana Press.
• Yi R, Johnson MW, Giordano LA, Landes RD, Badger GJ, Bickel WK. THE EFFECTS OF REDUCED CIGARETTE SMOKING ON DISCOUNTING FUTURE REWARDS: AN INITIAL EVALUATION. Psychol Rec. 2008 Spring;58(2):163-174. doi: 10.1007/BF03395609.

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2022
• Primary Completion (Estimated): September 1, 2024
• Study Completion (Estimated): September 20, 2024

Study Registration Dates

• First Submitted: October 5, 2022
• First Submitted That Met QC Criteria: October 17, 2022
• First Posted (Actual): October 18, 2022

Study Record Updates

• Last Update Posted (Actual): March 8, 2024
• Last Update Submitted That Met QC Criteria: March 7, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: contingency management; Rural recovery houses
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders
• Other Study ID Numbers: IRB-21-08-3875

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No