Reentry Incentives and Support for Engagement With Contingency Management

N/ANot Yet RecruitingNCT07322588

Oregon Health and Science University75 enrolled

Overview

People leaving jail face a very high risk of overdose, especially in the first few weeks after release. Staying on medication for opioid use disorder (MOUD) can greatly reduce this risk, but many people stop treatment during this transition. This study is testing whether a program that offers rewards, called contingency management (CM), can help people stay on MOUD after they return to the community. In this study, people who are taking MOUD in jail can choose to participate. While still incarcerated, they complete one visit where they may receive a small incentive, such as commissary credit or snacks, for enrolling in the CM program. After they leave jail, participants can earn gift cards when they attend their MOUD appointments and counseling sessions. Participants may take part in the study for up to three months after release. During this time, they can earn up to $600 in incentives based on their treatment engagement. Researchers will also ask participants to complete a baseline survey and a survey at 3 months. We will also review medical records to confirm whether they continued their MOUD. The researchers want to learn whether this adapted contingency management program is feasible, acceptable to participants, and helpful for supporting treatment engagement after release from jail. The findings will help determine whether this approach should be tested in a larger study to reduce overdose risk and improve health during the post-release period.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Opioid Use Disorder

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Be adults (age ≥18 years) currently incarcerated at Clatsop County Jail * Be enrolled in the jail's MOUD program at the time of recruitment * Plan to continue MOUD with Clatsop Behavioral Healthcare upon release * Speak English and be able to provide informed consent Exclusion Criteria Exclusion Criteria: * Are unable to provide informed consent due to cognitive impairment or acute psychiatric instability * Are scheduled for transfer to a different facility or geographic location that prevents post-release participation

Outcomes

Primary Outcomes

Number of patients receiving medication for opioid use disorder

We will assess patient reported receipt of medication for opioid use disorder and also use chart review to determine whether patients are receiving medications and three different time points.

Time frame: 1, 2, and 3 months

Secondary Outcomes

Number of contingency management sessions attended

Number of contingency management sessions attended per participant

Time frame: 3 months

Total contingency management rewards earned

Total dollar amount of contingency management rewards earned by participant throughout the intervention

Time frame: 3 months

Addiction Severity

Participant reported addiction severity using the validated Brief Addiction Monitor, a 17-item, multidimensional progress monitoring tool designed to support the provision of measurement-based care to patients commencing and matriculating through treatment for substance use disorders (SUD). The BAM items assess: (1) Risk for relapse or worsening severity of SUD (Range 0-180 with higher scores indicating higher risk), (2) Protective behaviors that support recovery and resistance to relapse (Range 0-180 with higher score indicating higher protective factors), and (3) Use of alcohol and other substances (Range 0-90 with higher score indicating higher substance use).

Time frame: Baseline and 3 months

Recovery Capital

Participant reported survey on recovery capital using the validated "Brief Assessment of Recovery Capital (BARC-10)" survey. Score range 10-60 with higher scores indicating higher recovery capital.