This project specifically addresses the research objectives in the area of client and program factors that influence treatment-seeking behavior, retention, and cost issues. The proposed effort is a logical extension of the community-based research our team has conducted with out-of-treatment substance abusers in collaboration with state officials and local treatment providers. It grows out of the need we saw when were unable to specifically address the needs of many crack abusers in our present study communities. The proposed community-based study involves a randomized field experiment to test the effectiveness of a brief intervention designed to enhance treatment readiness for African American crack abusers, a population that has been particularly difficult to engage in treatment. We believe that by helping participants to confront their drug use and associated problems, by preparing them to become treatment patients, and by assisting treatment programs in becoming more responsive to their needs, more crack abusers will enter and be retained in treatment. Participants will be assessed at intake (two sessions) by self- report and by drug testing and with follow-ups at 1 and 3 months. The four-session Pretreatment intervention includes a personalized feedback assessment and the development of a tangible plan of recovery in addition to educational and skills building groups. The design also incorporates (a) a process study to determine intervention and treatment exposure; (b) follow-up focus groups with both treatment program staff and participants who have completed the study to provide information on the efficacy of the intervention; and (c) collection of cost data for the economic analysis.
The specific aims of the proposed effort are as follows; 1) Characterize the clinical characteristics, treatment needs, external barriers, motivation and treatment readiness among African American crack cocaine abusers not in treatment; 2) Determine the effectiveness of a Pretreatment intervention (relative to a Control group) in reducing barriers to treatment, increasing motivation and treatment readiness, and increasing treatment participation; and determine the extent of differences by gender; 3) Determine the cost, cost effectiveness, and cost-benefit of the Pretreatment intervention.
| Zule, William A; Morgan-Lopez, Antonio A; Lam, Wendy K K et al. (2008) Perceived neighborhood safety and depressive symptoms among African American crack users. Subst Use Misuse 43:445-68 |
| Riehman, Kara S; Wechsberg, Wendee M; Zule, William et al. (2008) Gender differences in the impact of social support on crack use among African Americans. Subst Use Misuse 43:85-104 |
| Zule, William A; Lam, Wendy K K; Wechsberg, Wendee M (2003) Treatment readiness among out-of-treatment African-American crack users. J Psychoactive Drugs 35:503-10 |
