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

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Michael Prendergast, University of California, Los Angeles
ClinicalTrials.gov Identifier:
NCT01090245
First received: March 16, 2010
Last updated: April 9, 2013
Last verified: April 2013
  Purpose

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.


Condition Intervention
Substance Abuse
HIV Infections
Behavioral: Contingency management: voucher/monetary incentives for treatment attendance
Behavioral: Information

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Using Incentives to Improve Parolee Participation and Attendance in Community Tx

Resource links provided by NLM:


Further study details as provided by University of California, Los Angeles:

Primary Outcome Measures:
  • Community treatment admission [ Time Frame: Within 7 days of release to parole ] [ Designated as safety issue: No ]
  • Community treatment retention [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  • Participation in HIV testing and counseling [ Time Frame: 2 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Substance abuse [ Time Frame: 18 months after release from prison ] [ Designated as safety issue: No ]
  • Arrest and reincarceration [ Time Frame: 18 months after release from prison ] [ Designated as safety issue: No ]
  • psychosocial: employment, education, family relationships, psychological functioning, and HIV risk [ Time Frame: 18 months after release from prison ] [ Designated as safety issue: No ]
    employment, education, family relationships, psychological functioning, and HIV risk


Estimated Enrollment: 200
Study Start Date: April 2010
Estimated Study Completion Date: August 2014
Estimated Primary Completion Date: January 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 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.
Behavioral: Information
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.
Behavioral: Contingency management: voucher/monetary incentives for treatment attendance
Contingency management: Escalation with reset for non-attendance. Daily. Up to $841.50 in incentives for treatment attendance.

Detailed Description:

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.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

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.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01090245

Sponsors and Collaborators
University of California, Los Angeles
Investigators
Principal Investigator: Michael L Prendergast, Ph.D. University of California, Los Angeles
Study Director: Elizabeth A Hall, Ph.D. University of California, Los Angeles
  More Information

No publications provided

Responsible Party: Michael Prendergast, Research Historian, University of California, Los Angeles
ClinicalTrials.gov Identifier: NCT01090245     History of Changes
Other Study ID Numbers: 1 R01 DA025627-01A1
Study First Received: March 16, 2010
Last Updated: April 9, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by University of California, Los Angeles:
contingency management
substance abuse treatment
criminal justice populations
substance abuse treatment retention
HIV prevention in criminal justice settings
voucher based reinforcement therapy
Parole treatment admission for substance abusing parolees
Parole treatment retention for substance abusing parolees
HIV testing and counseling for substance abusing parolees

Additional relevant MeSH terms:
HIV Infections
Acquired Immunodeficiency Syndrome
Substance-Related Disorders
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Slow Virus Diseases
Mental Disorders

ClinicalTrials.gov processed this record on July 08, 2014