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Development of a Multi-Target Contingency Management Intervention for HIV Positive Substance Users.

Journal of Substance Abuse Treatment 2017;72:66-71. [doi: 10.1016/j.jsat.2016.08.018]

Maxine L. Stitzer, PhD (Johns Hopskins University School of Medicine, MA Node), Donald A. Calsyn, PhD (University of Washington, PN Node), Timothy Matheson, PhD (San Francisco Department of Public Health), James L. Sorensen, PhD (University of California, San Francisco, WS Node), Lauren K. Gooden, PhD, MPH (University of Miami, FNA Node), Lisa R. Metsch, PhD (Columbia University, FNA Node).

Contingency management (CM) interventions generally target a single behavior such as attendance or drug use. However, disease outcomes are mediated by complex chains of both healthy and interfering behaviors enacted over extended periods of time. This paper describes a novel multi-target contingency management (CM) program developed for use with HIV positive substance users enrolled in a CTN multi-site study (CTN-0049, Project HOPE). Participants were randomly assigned to usual care (referral to health care and SUD treatment) or 6-months strength-based patient navigation interventions with (PN+CM) or without (PN only) the CM program. Primary outcome of the trial was viral load suppression at 12-months post-randomization. Up to $1160 could be earned over 6 months under escalating schedules of reinforcement. Earnings were divided among eight CM targets: two PN-related (PN visits, paperwork completion; 26% of possible earnings), four health-related (HIV care visits, labl blood draw visits, medication check, viral load suppression; 47% of possible earnings), and two drug-use abatement (treatment entry, submission of drug negative UAs; 27% of earnings).

This paper describes the rationale for selection of targets, pay amounts, and pay schedules. The CM program was compatible with and fully integrated into the PN intervention. The Project HOPE CM program offers one example of how a multi-target CM intervention might be structured and deployed to impact a critical outcome in a difficult to treat population (in this case, HIV positive substance users). Subsequent data analysis examining the impact of the CM intervention on behavior frequencies will inform the structure and content of future multi-target CM interventions, while considerations of sustainability and cost-effectiveness will be needed to inform implementation policy. (Article (Peer-Reviewed), PDF, English, 2016)

Keywords: Case management | Contingency Management (CM) | HIV/AIDS | Motivational incentives | Motivational interviewing (MI) | Retention - Treatment | Journal of Substance Abuse Treatment (journal)

Document No: 1233, PMID: 27624618, PMCID: PMC5154853.

Submitted by CTN Dissemination Librarians, 10/18/2016.

Calsyn, Donald A.
Gooden, Lauren K. search mail
Matheson, Timothy
Metsch, Lisa R. mail
Sorensen, James L. mail
Stitzer, Maxine L. mail
NIDA-CTN-004 www

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