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Published in: Substance Abuse Treatment, Prevention, and Policy 1/2010

Open Access 01-12-2010 | Research

An exploratory study of engagement in a technology-supported substance abuse intervention

Authors: Nancy R VanDeMark, Nicole R Burrell, Walter F LaMendola, Catherine A Hoich, Nicole P Berg, Eugene Medina

Published in: Substance Abuse Treatment, Prevention, and Policy | Issue 1/2010

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Abstract

Background

The continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings.

Methods

This study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed.

Results

The data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community.

Conclusions

The authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions. Additional investigation into ways technology may be useful to enhance treatment access for certain subgroups is needed.
Appendix
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Literature
2.
go back to reference Miller WR, Rollnick S: Motivational Interviewing: Preparing People for Change. 2002, New York: The Guilford Press, 2 Miller WR, Rollnick S: Motivational Interviewing: Preparing People for Change. 2002, New York: The Guilford Press, 2
3.
go back to reference U.S. Department ofHealth and Human Services: Enhancing Motivation for Change in Substance Abuse Treatment. 1999, Rockville, MD: Substance Abuse and Mental Health Services Administration; U.S. Department ofHealth and Human Services: Enhancing Motivation for Change in Substance Abuse Treatment. 1999, Rockville, MD: Substance Abuse and Mental Health Services Administration;
4.
go back to reference Fogg BJ: Persuasive Technology: Using computers to change what we think and do. 2003, San Francisco, CA: Morgan Kaufmann Fogg BJ: Persuasive Technology: Using computers to change what we think and do. 2003, San Francisco, CA: Morgan Kaufmann
5.
go back to reference Alemi F, Haack MR, Nemes S, Aughburns R, Sinkule J, Neuhauser D: Therapeutic emails. Substance Abuse Treat Prev Policy. 2007, 2: Alemi F, Haack MR, Nemes S, Aughburns R, Sinkule J, Neuhauser D: Therapeutic emails. Substance Abuse Treat Prev Policy. 2007, 2:
6.
go back to reference Alemi F, Stephens RC, Javalghi RG, Dyches H, Butts J, Ghadiri A: A randomized trial of telecommunications network for pregnant women who use cocaine. Med Care. 1996, 34: OS10-OS20.CrossRefPubMed Alemi F, Stephens RC, Javalghi RG, Dyches H, Butts J, Ghadiri A: A randomized trial of telecommunications network for pregnant women who use cocaine. Med Care. 1996, 34: OS10-OS20.CrossRefPubMed
7.
go back to reference Ruggiero KJ, Resnick HS, Acierno R, Coffey SF, Carpenter MJ, Ruscio AM, Stephens RS, Kilpatrick DG, Stasiewicz PR, Roffman RA: Internet-based intervention for mental health and substance use problems in the aftermath of mass violence and disasters: a pilot feasibility study. Behav Ther. 2006, 37: 190-205. 10.1016/j.beth.2005.12.001.CrossRefPubMed Ruggiero KJ, Resnick HS, Acierno R, Coffey SF, Carpenter MJ, Ruscio AM, Stephens RS, Kilpatrick DG, Stasiewicz PR, Roffman RA: Internet-based intervention for mental health and substance use problems in the aftermath of mass violence and disasters: a pilot feasibility study. Behav Ther. 2006, 37: 190-205. 10.1016/j.beth.2005.12.001.CrossRefPubMed
8.
go back to reference Hester RK, Miller JH: Computer-based tools for diagnosis and treatment of alcohol problems. Alcohol Res Health. 2006, 29: 36-40.PubMed Hester RK, Miller JH: Computer-based tools for diagnosis and treatment of alcohol problems. Alcohol Res Health. 2006, 29: 36-40.PubMed
9.
go back to reference Lieberman DZ, Huang SW: A technological approach to reaching a hidden population of problem drinkers. Psychiatr Serv. 2008, 59: 297-303. 10.1176/appi.ps.59.3.297.CrossRefPubMed Lieberman DZ, Huang SW: A technological approach to reaching a hidden population of problem drinkers. Psychiatr Serv. 2008, 59: 297-303. 10.1176/appi.ps.59.3.297.CrossRefPubMed
10.
go back to reference Bischof G, Grothues JM, Reinhardt S, Meyer C, Ulrich J, Rumpf H-J: Evaluation of a telephone-based stepped care intervention for alcohol-related disorders: a randomized controlled trial. Drug Alcohol Depend. 2008, 93: 244-251. 10.1016/j.drugalcdep.2007.10.003.CrossRefPubMed Bischof G, Grothues JM, Reinhardt S, Meyer C, Ulrich J, Rumpf H-J: Evaluation of a telephone-based stepped care intervention for alcohol-related disorders: a randomized controlled trial. Drug Alcohol Depend. 2008, 93: 244-251. 10.1016/j.drugalcdep.2007.10.003.CrossRefPubMed
11.
go back to reference Riper H, Kramer J, Smit F, Conijin B, Schippers G, Cuijpers P: Web-based self-help for problem drinkers: a pragmatic randomized trial. Addiction. 2008, 103: 218-227. 10.1111/j.1360-0443.2007.02063.x.CrossRefPubMed Riper H, Kramer J, Smit F, Conijin B, Schippers G, Cuijpers P: Web-based self-help for problem drinkers: a pragmatic randomized trial. Addiction. 2008, 103: 218-227. 10.1111/j.1360-0443.2007.02063.x.CrossRefPubMed
12.
go back to reference Copeland J, Martin G: Web-based interventions for substance use disorders: a qualitative review. Subst Abuse Treat. 2004, 26: 109-116. 10.1016/S0740-5472(03)00165-X.CrossRef Copeland J, Martin G: Web-based interventions for substance use disorders: a qualitative review. Subst Abuse Treat. 2004, 26: 109-116. 10.1016/S0740-5472(03)00165-X.CrossRef
13.
go back to reference Griffiths M: Online therapy for addictive behaviors. CyberPsychol Behav. 2005, 8: 555-561. 10.1089/cpb.2005.8.555.CrossRefPubMed Griffiths M: Online therapy for addictive behaviors. CyberPsychol Behav. 2005, 8: 555-561. 10.1089/cpb.2005.8.555.CrossRefPubMed
14.
go back to reference Carroll K, Ball SA, Martino S, Nich C, Babuscio TA, Rounsaville BJ: Enduring effects of a computer-assisted training program for cognitive behavioral therapy: a 6-month follow-up of CBT4CBT. Drug Alcohol Depend. 2009, 100: 178-181. 10.1016/j.drugalcdep.2008.09.015.PubMedCentralCrossRefPubMed Carroll K, Ball SA, Martino S, Nich C, Babuscio TA, Rounsaville BJ: Enduring effects of a computer-assisted training program for cognitive behavioral therapy: a 6-month follow-up of CBT4CBT. Drug Alcohol Depend. 2009, 100: 178-181. 10.1016/j.drugalcdep.2008.09.015.PubMedCentralCrossRefPubMed
15.
go back to reference Postel MG, De Jong CAJ, De Haan HA: Does e-therapy for problem drinking reach hidden populations?. Am J Psychiatry. 2005, 162: 2393-10.1176/appi.ajp.162.12.2393.CrossRefPubMed Postel MG, De Jong CAJ, De Haan HA: Does e-therapy for problem drinking reach hidden populations?. Am J Psychiatry. 2005, 162: 2393-10.1176/appi.ajp.162.12.2393.CrossRefPubMed
16.
go back to reference King Vl, Stoller KB, Kidorf M, Kindbom K, Hursch S, Brady T, Brooner RK: Assessing the effectiveness of an internet-based videoconferencing platform for delivering intensified substance abuse counseling. Subst Abuse Treat. 2009, 36: 331-338. 10.1016/j.jsat.2008.06.011.CrossRef King Vl, Stoller KB, Kidorf M, Kindbom K, Hursch S, Brady T, Brooner RK: Assessing the effectiveness of an internet-based videoconferencing platform for delivering intensified substance abuse counseling. Subst Abuse Treat. 2009, 36: 331-338. 10.1016/j.jsat.2008.06.011.CrossRef
17.
go back to reference Kreuter MW, Wray RJ: Tailored and targeted health communication: strategies for enhancing information relevance. Am J Health Behav. 2003, 27: S227-232.CrossRefPubMed Kreuter MW, Wray RJ: Tailored and targeted health communication: strategies for enhancing information relevance. Am J Health Behav. 2003, 27: S227-232.CrossRefPubMed
18.
go back to reference Rimer B, Kreuter MW: Advancing tailored health communication: a persuasion and message effects perspective. J Commun. 2006, 56: S184-201. 10.1111/j.1460-2466.2006.00289.x.CrossRef Rimer B, Kreuter MW: Advancing tailored health communication: a persuasion and message effects perspective. J Commun. 2006, 56: S184-201. 10.1111/j.1460-2466.2006.00289.x.CrossRef
19.
go back to reference Dijkstra A, De Vries H: The development of computer-generated tailored interventions. Patient Educ Couns. 1999, 36: 193-203. 10.1016/S0738-3991(98)00135-9.CrossRefPubMed Dijkstra A, De Vries H: The development of computer-generated tailored interventions. Patient Educ Couns. 1999, 36: 193-203. 10.1016/S0738-3991(98)00135-9.CrossRefPubMed
20.
go back to reference Lustria MA, Cortese J, Noar SM, Gleuckauf RL: Computer-tailored health interventions delivered over the web: review and analysis of key components. Patient Educ Couns. 2009, 74: 156-173. 10.1016/j.pec.2008.08.023.CrossRefPubMed Lustria MA, Cortese J, Noar SM, Gleuckauf RL: Computer-tailored health interventions delivered over the web: review and analysis of key components. Patient Educ Couns. 2009, 74: 156-173. 10.1016/j.pec.2008.08.023.CrossRefPubMed
21.
go back to reference Portnoy DB, Scott-Sheldon LAJ, Johnson BT, Carey MP: Computer-delivered interventions for health promotion and behavioral risk reduction: a meta-analysis of 75 randomized controlled trials, 1988-2007. Prev Med. 2008, 47: 3-16. 10.1016/j.ypmed.2008.02.014.PubMedCentralCrossRefPubMed Portnoy DB, Scott-Sheldon LAJ, Johnson BT, Carey MP: Computer-delivered interventions for health promotion and behavioral risk reduction: a meta-analysis of 75 randomized controlled trials, 1988-2007. Prev Med. 2008, 47: 3-16. 10.1016/j.ypmed.2008.02.014.PubMedCentralCrossRefPubMed
22.
go back to reference Wantland DJ, Potillo CJ, Holzemer WL, Slaughter R, McGhee EM: The effectiveness of web-based vs. non-web-based interventions: a meta-analysis of behavioral change outcomes. J Med Internet Res. 2004, 6: e40-10.2196/jmir.6.4.e40.PubMedCentralCrossRefPubMed Wantland DJ, Potillo CJ, Holzemer WL, Slaughter R, McGhee EM: The effectiveness of web-based vs. non-web-based interventions: a meta-analysis of behavioral change outcomes. J Med Internet Res. 2004, 6: e40-10.2196/jmir.6.4.e40.PubMedCentralCrossRefPubMed
23.
go back to reference Ondersma SJ, Chase SK, Svikis DS, Schuster CR: Computer-based brief motivational intervention for perinatal drug use. Subst Abuse Treat. 2005, 28: 305-312. 10.1016/j.jsat.2005.02.004.CrossRef Ondersma SJ, Chase SK, Svikis DS, Schuster CR: Computer-based brief motivational intervention for perinatal drug use. Subst Abuse Treat. 2005, 28: 305-312. 10.1016/j.jsat.2005.02.004.CrossRef
24.
go back to reference Prochaska JO, DiClemente CC, Norcross JC: In search of how people change: applications to the addictive behaviors. Am Psychol. 1992, 47: 1102-1114,. 10.1037/0003-066X.47.9.1102.CrossRefPubMed Prochaska JO, DiClemente CC, Norcross JC: In search of how people change: applications to the addictive behaviors. Am Psychol. 1992, 47: 1102-1114,. 10.1037/0003-066X.47.9.1102.CrossRefPubMed
25.
go back to reference DiClemente CC, Velasquez MM: Motivational interviewing and stages of change. Motivational Interviewing. Edited by: Miller WR, Rollnick S. 2002, New York: Guilford Press, 201-216. 2 DiClemente CC, Velasquez MM: Motivational interviewing and stages of change. Motivational Interviewing. Edited by: Miller WR, Rollnick S. 2002, New York: Guilford Press, 201-216. 2
26.
go back to reference Carroll K, Ball SA, Niche C, Martino S, Frankforter TL, Farentinos C, Kunkel LE: Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study. Drug Alcohol Depend. 2006, 81: 301-312. 10.1016/j.drugalcdep.2005.08.002.PubMedCentralCrossRefPubMed Carroll K, Ball SA, Niche C, Martino S, Frankforter TL, Farentinos C, Kunkel LE: Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study. Drug Alcohol Depend. 2006, 81: 301-312. 10.1016/j.drugalcdep.2005.08.002.PubMedCentralCrossRefPubMed
27.
go back to reference Burke BL, Arkowitz H, Dunn C: The efficacy of motivational interviewing. Motivational Interviewing: Preparing people for change. Edited by: Miller WR, Rollnick S. 2002, New York: Guilford Press, 217-250. 2 Burke BL, Arkowitz H, Dunn C: The efficacy of motivational interviewing. Motivational Interviewing: Preparing people for change. Edited by: Miller WR, Rollnick S. 2002, New York: Guilford Press, 217-250. 2
28.
go back to reference Dunn C, Derro L, Rivara FP: The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction. 2001, 96: 1725-1742. 10.1046/j.1360-0443.2001.961217253.x.CrossRefPubMed Dunn C, Derro L, Rivara FP: The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction. 2001, 96: 1725-1742. 10.1046/j.1360-0443.2001.961217253.x.CrossRefPubMed
29.
go back to reference Zweben A, Zuckoff A: Motivational interviewing and treatment adherence. Motivational Interviewing: Preparing People for Change. Edited by: Miller WR, Rollnick S. 2002, New York: Guilford Press, 299-319. Zweben A, Zuckoff A: Motivational interviewing and treatment adherence. Motivational Interviewing: Preparing People for Change. Edited by: Miller WR, Rollnick S. 2002, New York: Guilford Press, 299-319.
30.
go back to reference Hettema J, Steele J, Miller WR: Motivational interviewing. Annu Rev Clin Psychol. 2005, 1: 91-111. 10.1146/annurev.clinpsy.1.102803.143833.CrossRefPubMed Hettema J, Steele J, Miller WR: Motivational interviewing. Annu Rev Clin Psychol. 2005, 1: 91-111. 10.1146/annurev.clinpsy.1.102803.143833.CrossRefPubMed
31.
go back to reference Ijsselsteijn W, de Kort Y, Midden C, Eggen B, van den Hoven E: Persuasive Technology: First International Conference on Persuasive Technology for Human Well-Being, PERSUASIVE 2006. Lecture Notes in Computer Science Series 3962; Eindhoven, The Netherlands. 2006, Springer Ijsselsteijn W, de Kort Y, Midden C, Eggen B, van den Hoven E: Persuasive Technology: First International Conference on Persuasive Technology for Human Well-Being, PERSUASIVE 2006. Lecture Notes in Computer Science Series 3962; Eindhoven, The Netherlands. 2006, Springer
32.
go back to reference Ley BL: live Les roses!: the architecture of commitment in an online pregnancy and mothering group. Computer-Mediated Commun. 2007, 12: 1388-1408. 10.1111/j.1083-6101.2007.00378.x.CrossRef Ley BL: live Les roses!: the architecture of commitment in an online pregnancy and mothering group. Computer-Mediated Commun. 2007, 12: 1388-1408. 10.1111/j.1083-6101.2007.00378.x.CrossRef
33.
go back to reference Short J, Williams W, Christie B: The Social Psychology of Telecommunications. 1976, London: Wiley & Sons; Short J, Williams W, Christie B: The Social Psychology of Telecommunications. 1976, London: Wiley & Sons;
34.
go back to reference Biocco F, Harms C, Burgoon JK: Toward a more robust theory and measure of social presence: review and suggested criteria. Presence. 2003, 12: 456-480. 10.1162/105474603322761270.CrossRef Biocco F, Harms C, Burgoon JK: Toward a more robust theory and measure of social presence: review and suggested criteria. Presence. 2003, 12: 456-480. 10.1162/105474603322761270.CrossRef
35.
go back to reference Gunawardena CN, Zittle FJ: Social presence as a predictor of satisfaction within a computer-mediated conferencing environment. Am J Distance Educ. 1997, 11: 8-26. 10.1080/08923649709526970.CrossRef Gunawardena CN, Zittle FJ: Social presence as a predictor of satisfaction within a computer-mediated conferencing environment. Am J Distance Educ. 1997, 11: 8-26. 10.1080/08923649709526970.CrossRef
36.
go back to reference Richardson JC, Swan K: Examining social presence in online courses in relation to students' perceived learning and satisfaction. J Asynchonous Learn Netw. 2003, 7: 68-88. Richardson JC, Swan K: Examining social presence in online courses in relation to students' perceived learning and satisfaction. J Asynchonous Learn Netw. 2003, 7: 68-88.
37.
go back to reference Grolleman J, van Dijk EMAG, Nijholt A, van Emst A: Break the habit! Designing an e-therapy intervention using a virtual coach in aid of smoking cessation. First International Conference on Persuasive Technology for Human Well-Being, PERSUASIVE 2006; 18-19 May Eindover, The Netherlands. Edited by: IJssselsteijn W, de Kort Y, Eggen B, Van den Hoven E. 2006, Springer Grolleman J, van Dijk EMAG, Nijholt A, van Emst A: Break the habit! Designing an e-therapy intervention using a virtual coach in aid of smoking cessation. First International Conference on Persuasive Technology for Human Well-Being, PERSUASIVE 2006; 18-19 May Eindover, The Netherlands. Edited by: IJssselsteijn W, de Kort Y, Eggen B, Van den Hoven E. 2006, Springer
38.
go back to reference Walters S, Hester RK, Chiauzzi EM, Miller E: Demon rum: High tech solutions to an age-old problem. Alcohol Clin Exp Res. 2005, 29: 270-277. 10.1097/01.ALC.0000153543.03339.81.CrossRefPubMed Walters S, Hester RK, Chiauzzi EM, Miller E: Demon rum: High tech solutions to an age-old problem. Alcohol Clin Exp Res. 2005, 29: 270-277. 10.1097/01.ALC.0000153543.03339.81.CrossRefPubMed
39.
go back to reference DiClemente CC, Hughes SO: Stages of change profiles in alcoholism treatment. Subst Abuse Treat. 1990, 2: 217-235. 10.1016/S0899-3289(05)80057-4.CrossRef DiClemente CC, Hughes SO: Stages of change profiles in alcoholism treatment. Subst Abuse Treat. 1990, 2: 217-235. 10.1016/S0899-3289(05)80057-4.CrossRef
41.
go back to reference Ryan RM, Plant RW, O'Malley SS: Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement and dropout. Addic Behav. 1995, 20: 279-297. 10.1016/0306-4603(94)00072-7.CrossRef Ryan RM, Plant RW, O'Malley SS: Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement and dropout. Addic Behav. 1995, 20: 279-297. 10.1016/0306-4603(94)00072-7.CrossRef
42.
go back to reference Ferron JC: Psychological Mechanisms to Treatment Adherence among People with Severe Mental illness: Validating Treatment Motivation and Working Alliance Measures. 2007, University of North Carolina School of Social Work Ferron JC: Psychological Mechanisms to Treatment Adherence among People with Severe Mental illness: Validating Treatment Motivation and Working Alliance Measures. 2007, University of North Carolina School of Social Work
43.
go back to reference Garnick DW, Lee MT, Horgan CM, Acevedo A: Adapting Washington Circle performance measures for public sector substance abuse treatment systems. Subst Abuse Treat. 2009, 36: 265-277. 10.1016/j.jsat.2008.06.008.CrossRef Garnick DW, Lee MT, Horgan CM, Acevedo A: Adapting Washington Circle performance measures for public sector substance abuse treatment systems. Subst Abuse Treat. 2009, 36: 265-277. 10.1016/j.jsat.2008.06.008.CrossRef
44.
go back to reference Fox S: Health Information Online. 2005, Washington, DC: Pew Internet & American Life Project Fox S: Health Information Online. 2005, Washington, DC: Pew Internet & American Life Project
45.
go back to reference Finkelstein N: Using the relational model as a context for treating pregnant and parenting chemically dependent women. Chemical Dependency: Women at Risk. Edited by: Underhill BL, Finnegan DG. 1996, New York: Hayworth Press, 23-44. Finkelstein N: Using the relational model as a context for treating pregnant and parenting chemically dependent women. Chemical Dependency: Women at Risk. Edited by: Underhill BL, Finnegan DG. 1996, New York: Hayworth Press, 23-44.
Metadata
Title
An exploratory study of engagement in a technology-supported substance abuse intervention
Authors
Nancy R VanDeMark
Nicole R Burrell
Walter F LaMendola
Catherine A Hoich
Nicole P Berg
Eugene Medina
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Substance Abuse Treatment, Prevention, and Policy / Issue 1/2010
Electronic ISSN: 1747-597X
DOI
https://doi.org/10.1186/1747-597X-5-10

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