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Racial and Ethnic Differences in Treatment Outcomes Among Adults with Stimulant Use Disorders After a Dosed Exercise Intervention.

Journal of Ethnicity in Substance Abuse 2017;16(4):420-431. [doi: 10.1080/15332640.2017.1317310]

Katherine Sanchez, PhD, MSSW (University of Texas (UT) Arlington, TX Node), Tracy L. Greer, PhD, N. Robrina Walker, PhD, Thomas Carmody, PhD, Chad D. Rethorst, PhD, Madhukar H. Trivedi, MD (all from UT Southwestern Medical Center, TX Node)

The current study examined differences in substance abuse treatment outcomes among racial and ethnic groups enrolled in the Stimulant Reduction Intervention using Dosed Exercise (STRIDE) trial, a multisite randomized clinical trial implemented through the National Institute on Drug Abuse's (NIDA's) Clinical Trials Network (CTN). STRIDE aimed to test vigorous exercise as a novel approach to the treatment of stimulant abuse compared to a health education intervention. A hurdle model with a complier average causal effects (CACE) adjustment was used to provide an unbiased estimate of the exercise effect had all participants been adherent to exercise.

Among 214 exercise-adherent participants, we found significantly lower probability of use for Blacks (z= -2.45, p=.014) and significantly lower number of days of use for Whites compared to Hispanics (z= -54.87, p=<.001) and for Whites compared to Blacks (z= -28.54, p=<.001), which suggests that vigorous, regular exercise might improve treatment outcomes given adequate levels of adherence.

Conclusions: The STRIDE study demonstrated that intensive exercise interventions for people with stimulant use disorders, in community-based addiction treatment, are feasible. Examining race/ethnicity differences in treatment outcomes using novel approaches is important to understanding disparities and what contributes to success. There is a need for engagement strategies for sustaining Blacks in treatment and recruiting them into treatment earlier in life. Vigorous exercise may benefit racial and ethnic minority populations with stimulant use disorder. Future research should focus on intentional inclusion of race/ethnic groups, early in the study design, to test interventions targeted with a specific focus on what works for certain populations. (Article (Peer-Reviewed), PDF, English, 2017)

Keywords: African Americans | Behavior therapy | CTN platform/ancillary study | Exercise | Hispanics and Latinos | Minority groups | Stimulant abuse | Journal of Ethnicity in Substance Abuse (journal)

Document No: 1268, PMID: 28524806, PMCID: PMC5694709 (available 12/1/2018).

Submitted by CTN Dissemination Librarians, 5/23/2017.

Carmody, Thomas mail
Greer, Tracy L. mail
Rethorst, Chad D. mail
Sanchez, Katherine mail
Trivedi, Madhukar H. mail
Walker, N. Robrina mail
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