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Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study

OBJECTIVES: Longer retention in treatment is associated with positive outcomes. For women, who suffer worse drug-related problems than men, social technologies, which are more readily adopted by women, may offer promise. This naturalistic study examined whether a smartphone-based relapse-prevention...

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Autores principales: Johnston, Darcie C, Mathews, W David, Maus, Adam, Gustafson, David H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614935/
https://www.ncbi.nlm.nih.gov/pubmed/31312084
http://dx.doi.org/10.1177/1178221819861377
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author Johnston, Darcie C
Mathews, W David
Maus, Adam
Gustafson, David H
author_facet Johnston, Darcie C
Mathews, W David
Maus, Adam
Gustafson, David H
author_sort Johnston, Darcie C
collection PubMed
description OBJECTIVES: Longer retention in treatment is associated with positive outcomes. For women, who suffer worse drug-related problems than men, social technologies, which are more readily adopted by women, may offer promise. This naturalistic study examined whether a smartphone-based relapse-prevention system, A-CHESS (Addiction-Comprehensive Health Enhancement Support System), could improve retention for women with substance use disorders in an impoverished rural setting. METHODS: A total of 98 women, age 18 to 40, in southeastern Kentucky and mandated to treatment, received A-CHESS with intensive outpatient treatment for 6 months. For comparison, data were obtained for a similar but non-equivalent group of 100 same-age women also mandated to treatment in the same clinics during the period. Electronic medical record data on length-of-stay and treatment service use for both groups were analyzed, with A-CHESS use data, to determine whether those using A-CHESS showed better retention than those without. RESULTS: Women with A-CHESS averaged 780 service units compared with 343 for the comparison group. For those with discharge dates prior to the study’s end, A-CHESS patients stayed in treatment a mean of 410 vs 262 days for the comparison group. CONCLUSIONS: Given associations between retention and positive outcomes, mobile health technology such as A-CHESS may help improve outcomes among women, especially in settings where access to in-person services is difficult. The findings, based on a non-equivalent comparison, suggest the need for further exploration with rigorous experimental designs to determine whether and to what degree access to a smartphone with A-CHESS may extend and support recovery for women.
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spelling pubmed-66149352019-07-16 Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study Johnston, Darcie C Mathews, W David Maus, Adam Gustafson, David H Subst Abuse Original Research OBJECTIVES: Longer retention in treatment is associated with positive outcomes. For women, who suffer worse drug-related problems than men, social technologies, which are more readily adopted by women, may offer promise. This naturalistic study examined whether a smartphone-based relapse-prevention system, A-CHESS (Addiction-Comprehensive Health Enhancement Support System), could improve retention for women with substance use disorders in an impoverished rural setting. METHODS: A total of 98 women, age 18 to 40, in southeastern Kentucky and mandated to treatment, received A-CHESS with intensive outpatient treatment for 6 months. For comparison, data were obtained for a similar but non-equivalent group of 100 same-age women also mandated to treatment in the same clinics during the period. Electronic medical record data on length-of-stay and treatment service use for both groups were analyzed, with A-CHESS use data, to determine whether those using A-CHESS showed better retention than those without. RESULTS: Women with A-CHESS averaged 780 service units compared with 343 for the comparison group. For those with discharge dates prior to the study’s end, A-CHESS patients stayed in treatment a mean of 410 vs 262 days for the comparison group. CONCLUSIONS: Given associations between retention and positive outcomes, mobile health technology such as A-CHESS may help improve outcomes among women, especially in settings where access to in-person services is difficult. The findings, based on a non-equivalent comparison, suggest the need for further exploration with rigorous experimental designs to determine whether and to what degree access to a smartphone with A-CHESS may extend and support recovery for women. SAGE Publications 2019-07-08 /pmc/articles/PMC6614935/ /pubmed/31312084 http://dx.doi.org/10.1177/1178221819861377 Text en © The Author(s) 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Johnston, Darcie C
Mathews, W David
Maus, Adam
Gustafson, David H
Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study
title Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study
title_full Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study
title_fullStr Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study
title_full_unstemmed Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study
title_short Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study
title_sort using smartphones to improve treatment retention among impoverished substance-using appalachian women: a naturalistic study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614935/
https://www.ncbi.nlm.nih.gov/pubmed/31312084
http://dx.doi.org/10.1177/1178221819861377
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