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Using Incentives to Improve Parolee Participation and Attendance in Community Treatment (PIP)

9 de mayo de 2017 actualizado por: Michael Prendergast, University of California, Los Angeles

Using Incentives to Improve Parolee Participation and Attendance in Community Tx

Under funding from the National Institute on Drug Abuse, the UCLA Integrated Substance Abuse Programs (ISAP), in collaboration with Walden House and the California Department of Corrections and Rehabilitation, is conducting a five-year study that will involve a randomized test of the use of incentives with parolees in a community-based residential substance abuse treatment program to increase treatment admission and treatment retention, and thereby increase the likelihood of improved outcomes. Study participants will be recruited from clients in a prison-based treatment program who have a referral to the Walden House community program. The Admission Phase of the study assesses the effect of an incentive (voucher) on enrolling in the Walden House program. The Attendance Phase assesses the effect of incentives on treatment attendance and on post-treatment drug use, crime, and psychosocial behaviors, including HIV risk behaviors. In addition, an incentive protocol will test whether an incentive will encourage participation in HIV testing and counseling. The intervention will last for six months.

Hypothesis 1. The use of incentives will significantly increase subject enrollment in community treatment.

Hypothesis 2. The use of incentives will significantly increase subject retention in community treatment.

Huypothesis 3. The use of incentives will significantly increase subject participation in HIV testing and counseling.

Study participants will be interviewed at baseline and at 12 months following the intervention. Treatment and criminal justice data will be obtained. Data on acceptability, satisfaction, and sustainability will be collected from focus groups with staff and clients.

Descripción general del estudio

Descripción detallada

A considerable body of research indicates that prison-based treatment followed by continuing treatment in the community is effective in reducing drug abuse and crime among drug-abusing offenders. However, the impact of providing treatment is less than optimal because offenders often fail to follow through on treatment referrals, leave treatment early, or have poor engagement in treatment activities. In particular, participation in prison-based treatment alone is seldom effective in reducing drug use or recidivism unless it is followed by participation in community treatment. For correctional systems that provide a continuum of care model from prison to community, low rates of admission and retention result in poor outcomes and poor resource utilization. One way to address this problem is to provide incentives to parolees for community treatment participation. Although research supports the effectiveness of behavioral reinforcement, mainly in the form of contingency management (CM), for general substance abuse populations, CM has not yet been tested or adapted for use in community-based programs for offender populations, particularly to encourage treatment attendance.

In addition, recent research has documented elevated rates of HIV infection among incarcerated populations compared to the general population, with prevalence of HIV among inmates in US prisons being estimated to be 6 to 10 times higher than in the general population. Upon release from prison, parolees often immediately resume high-risk behaviors that they engaged in prior to incarceration. Because of the high level of exposure to HIV infection that accompanies drug use, particularly by injection, drug treatment programs for high-risk offenders can serve as a valuable setting for preventing the spread of HIV, both through HIV prevention/education activities and through access to HIV testing and counseling.

Under funding from the National Institute on Drug Abuse, the UCLA Integrated Substance Abuse Programs (ISAP), in collaboration with Walden House and the California Department of Corrections and Rehabilitation, is conducting a five-year study that will involve a randomized test of the use of incentives with parolees in a community-based residential substance abuse treatment to increase treatment admission and treatment retention, and thereby increase the likelihood of improved outcomes. Study participants will be recruited from clients in a prison-based treatment program who have a referral to the Walden House community program. The Admission Phase of the study assesses the effect of an incentive (voucher) on enrolling in the Walden House program. The Attendance Phase assesses the effect of incentives on treatment attendance and on post-treatment drug use, crime, and psychosocial behaviors, including HIV risk behaviors. In addition, an incentive protocol will test whether an incentive will encourage participation in HIV testing and counseling. The intervention will last for six months.

Hypothesis 1. The use of incentives will significantly increase subject enrollment in community treatment.

Hypothesis 2. The use of incentives will significantly increase subject retention in community treatment.

Huypothesis 3. The use of incentives will significantly increase subject participation in HIV testing and counseling.

Study participants will be interviewed at baseline and at 12 months following the intervention. Treatment and criminal justice data will be obtained. Data on acceptability, satisfaction, and sustainability will be collected from focus groups with staff and clients.

Tipo de estudio

Intervencionista

Inscripción (Actual)

202

Fase

  • No aplica

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Masculino

Descripción

Inclusion Criteria:

  • At least 18 years of age
  • English speaking
  • Within one month of parole
  • Able to provide informed consent to participate in the study
  • Received a referral to the Walden House Los Angeles Transitional Treatment Center

Exclusion Criteria:

  • Potential subjects will be excluded from participating if they have serious cognitive problems that preclude their ability to provide informed consent or understanding of the questionnaire items, if they are a sexually violent predator or a child molester or if they have severe mental health problems.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: Attendance Information Group
Participants in the Attendance Information Group will receive an individual information session along with a pamphlet describing the benefits of remaining in treatment after release from prison and on the benefits of HIV prevention and testing. In addition, they will receive the standard treatment offered by the Walden House Los Angeles program.
Attendance Information Group will receive an individual information session along with a pamphlet describing the benefits of remaining in treatment after release from prison and on the benefits of HIV prevention and testing.
Experimental: Attendance Incentive Group
Participants in the Attendance Incentive Group could receive up to $841.50 in incentives for their treatment attendance and the standard treatment offered by the Walden House Los Angeles program.
Contingency management: Escalation with reset for non-attendance. Daily. Up to $841.50 in incentives for treatment attendance.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Periodo de tiempo
Community treatment admission
Periodo de tiempo: Within 7 days of release to parole
Within 7 days of release to parole
Community treatment retention
Periodo de tiempo: 6 months
6 months
Participation in HIV testing and counseling
Periodo de tiempo: 2 months
2 months

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Substance abuse
Periodo de tiempo: 18 months after release from prison
18 months after release from prison
Arrest and reincarceration
Periodo de tiempo: 18 months after release from prison
18 months after release from prison
psychosocial: employment, education, family relationships, psychological functioning, and HIV risk
Periodo de tiempo: 18 months after release from prison
employment, education, family relationships, psychological functioning, and HIV risk
18 months after release from prison

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Michael L Prendergast, Ph.D., University of California, Los Angeles
  • Director de estudio: Elizabeth A Hall, Ph.D., University of California, Los Angeles

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de abril de 2010

Finalización primaria (Actual)

1 de enero de 2014

Finalización del estudio (Actual)

1 de agosto de 2014

Fechas de registro del estudio

Enviado por primera vez

16 de marzo de 2010

Primero enviado que cumplió con los criterios de control de calidad

18 de marzo de 2010

Publicado por primera vez (Estimar)

19 de marzo de 2010

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

10 de mayo de 2017

Última actualización enviada que cumplió con los criterios de control de calidad

9 de mayo de 2017

Última verificación

1 de mayo de 2017

Más información

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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