ARMS: A Web-Based Attendance Reward and Monitoring System

DESCRIPTION (provided by applicant): This Phase I SBIR will develop a website to train community treatment providers on how to design and implement contingency management incentives (CM Incentives) interventions. CM Incentives is an innovative area of clinical practice that is a prime target for training development since it has a strong evidence base but currently little community implementation. This project builds on the expertise of training developers and content experts to design a technologically sound but user-friendly training for counselors that will help to move this innovative and effective intervention approach into clinical practice. This translational research is a pressing priority of the NIH Road Map and the Institute of Medicine's landmark report on Bridging the Gap between Research and Practice. The CM Incentives website will instruct on the principles and essential components of effective CM Incentives programs and train providers to design and implement a sound intervention. It will address common barriers that have inhibited diffusion of this effective intervention. This SBIR will also create for the website an electronic reward and monitoring system for providers so they can implement a CM Incentives program of positive reinforcements for patient attendance at treatment sessions. This system will reduce the decision- making complexity and aid with the additional record-keeping needed to maintain consistency when delivering CM Incentives interventions. Ambivalence about entering treatment is a persistent challenge for addiction providers as even those patients who are initially motivated may drop out of treatment soon after they arrive. The expected outcome (Phase II) will be successful translation of CM Incentives into practice at participating agencies and resulting increase in patient attendance and retention in programs. Alcohol dependent patients comprise the majority of substance abusers in outpatient treatment. However, CM Incentives studies have largely ignored alcohol patients as it is difficult to immediately measure and reinforce alcohol use; existing technology is inadequate for measuring blood alcohol concentration over several days. Reinforcing attendance at planned treatment sessions is feasible and important for alcohol patients. Attendance is an objective, critical behavior change measure that promotes achieving and maintaining alcohol and drug abstinence; session attendance is a necessary path to effective treatment. In Phase I, NERI will create a website prototype with two components: a) twenty screens of engaging, web-based instruction on the CM Incentives will be created from training content previously developed by clinical consultants, Drs. Maxine Stitzer and Nancy Petry; and b) the electronic reward and monitoring system will programmed and used to track attendance with clients and generate hypothetical rewards. Both components will be evaluated by 30 addiction providers in pre- and post-knowledge, attitude, and confidence questionnaires and a focus group with 8-10 providers on feasibility of implementing a CM Incentives intervention with the website.