The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72503

Anna K. Veluz, BA¹, Valerie Gruber, PhD, MPH¹, Anne Park, MA¹, Christine Lin, BA¹, Luisito Ramos, BA¹, and James L. Sorensen, PhD². (1) Department of Psychiatry, San Francisco General Hospital, University of California, San Francisco, 3180 18th Street, Suite 205, Substance Abuse Treatment Center, San Francisco, CA 94110, 415-476-7679, anna.veluz@alumni.tufts.edu, (2) Department of Psychiatry, University of California, San Francisco-San Francisco General Hospital, 1001 Potrero Ave, Building 20, Room 2117, San Francisco, CA 94110

Attrition is an important methodological issue in treatment research with drug-using populations. Potentially unstable, transient life circumstances can make it difficult to remain in complex treatment protocols over long periods of time. Contingency management (CM) procedures (providing incentives for specific behaviors) have been found to successfully reinforce submission of drug-free urine specimens, attendance of psychotherapy groups, and increasing responsible behaviors. This study seeks to examine if CM procedures curb attrition rates and keep Ss engaged in research participation in the comparison group of a clinical trial recruiting HIV+ methadone maintenance clients for 5-month CM medication adherence intervention. For every completed interview, Ss draw from a fishbowl lottery of small and large prizes (worth $2.00-$80.00). 16 Ss have been randomized to the comparison group, 8 of them participated before the implementation of the CM procedures (Fishbowl-lottery [FB]), 7 after FB implementation, 1 completed 11 weeks pre-FB and 9 post-FB. Pre-FB, mean attendance rate once randomized was 65.96% vs. 72.09% post-FB, mean number of completed visits was 23.38 vs. 29.67 of possible 32 total visits, mean number interviews never completed (missing data) was 9.38 vs. 3.57, and attrition due to unhappiness with randomized assignment was 25% vs. 0% post-FB. Possibly due to small N, comparison of means yielded no significant difference between pre- and post-FB groups on any item. This being said, attendance and completion has still improved in all 4 areas. Further work is needed to assess the efficacy of CM in maintaining research participation. Support: NIH Grant P50DA09253.

Learning Objectives:

At the conclusion of the session, the participant in ths session will be able to:
• Discuss ways to address and reduce research study attrition.
• Implement a contingency management fishbowl-lottery technique to curb attrition rates in non-intervention controls.

Keywords: Adherence, Intravenous Drug Use

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.