Developing a New Scale of Treatment Readiness

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DESCRIPTION (provided by applicant): This application responds to NIH PA-06-343 (Methodology and Measurement in the Behavioral and Social Sciences); the project is also consistent with PA-06-307 and PA-06-337. The proposed research aims to develop, and provide preliminary validity data for, a new scale of treatment readiness. Low rates of treatment seeking and retention in substance abuse treatment have provoked sustained inquiry into understanding, and enhancing, the motivation to change. However, current scales of treatment readiness have a number of limitations that our scale will address. Unlike current measures of motivation, our instrument assesses the specific factors that have contributed to treatment readiness. Also unlike current measures, we expect that our scale will show strong validity as an indicator of the intention to pursue treatment. The proposed scale is theoretically grounded in Aizen's theory of planned behavior (TPB; 1985, 1991), a powerful, parsimonious model that has been widely applied in the field of public health. The TPB offers a strong history of empirical support and tightly specified relations between the intention to pursue treatment and predictors of that intention (i.e., the individual's attitude, subjective norm, and perceived control). In Phase One, the study will develop a preliminary readiness scale via reviewing the available literature; a focus group including 15 clients recruited from intake appointments at an outpatient substance abuse treatment site in Contra Costa County, CA; and consultation with an expert panel. The scale will address all four components of the TPB (i.e., attitudes, subjective norms, perceived control, and intentions). In Phase Two, the preliminary scale will be computer-administered to a new cohort of 200 clients recruited from the same site. Respondents will also complete existing measures of treatment-related attitudes and stage of change scales; problem severity and consequences; social influence variables; and demographic variables. Half this initial sample (selected at random) will also be recontacted for telephone follow-ups, completing the TPB scale again one week later. Treatment utilization for 6 months following the interview will be collected from program records for the entire sample. Data will be analyzed to refine the scale and establish the scale's psychometric properties, concurrent validity, predictive validity, and test-retest reliability. By developing a new readiness scale, the project aims to clarify the sources of treatment readiness, suggesting points of intervention for increasing treatment initiation and retention. The study will also develop a screening instrument useful for identifying (and intervening with) individuals low on treatment readiness at intake. The project is developmental/exploratory because the aim is to develop and test a new psychosocial measure.