Automated telephone assessment for substance abuse treatment

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DESCRIPTION (provided by applicant): The proposed study arises out of a prominent clinical need: routine assessment of psychiatric disorders that co-occur with substance use disorder. The past fifteen years have seen greater focus on co-occurring disorders as they can impact treatment planning, outcomes, and staff training needs. To our knowledge, this grant application offers the first proposed model for automated assessment of co-occurring disorders. Our system is designed to conduct both initial screening and later outcome evaluation. We have selected interactive voice response (IVR) technology as the platform for this project, which offers numerous advantages over other methods (in-person assessment, web, paper-and-pencil self-report). The PI and consultant team have expertise in co-occurring disorders, IVR, and substance abuse assessment and treatment. We have also selected a technology company with an outstanding record in IVR software for health-related assessment. This project would start with a "demonstration" phase in which a limited version of the IVR system would be evaluated by a small subsample of clinicians, clients, and program administrators. We are specifically targeting all three participant types as their views on the IVR system are all equally important. We would then construct the full IVR system proposed in this application, which is designed to assess five key co-occurring disorders (drug use disorder, alcohol use disorder, major depression, dysthymia, and PTSD), plus level of suicidality. We would have a sample of 60 clients complete the initial diagnostic screen, of which half (n=30) would also undergo an in-person interview to ascertain validity of the IVR diagnostic screening and outcome measures for these disorders. All clients would be assessed for outcomes on any of the disorders for which they met criteria on the initial screen, plus all would complete several general outcome measures. The outcome evaluations would occur monthly for three months (after initial baseline assessment on those same measures, which serves as the benchmark for subsequent change). In the research portion of this proposal, we focus on evaluation of several major questions: satisfaction with the IVR system by each participant type (clinicians, clients, program administrators); relationship between participant characteristics and satisfaction with the IVR system (e.g., age, gender, treatment setting); outcome changes over time (how much clients improve during the 3 month followup period); syndrome and symptom interplay (how co-occurring disorders occur and change in relation to each other). Our sample will be recruited from two major substance abuse treatment programs in the greater Boston area: We selected the measures for our IVR system based on a thorough literature search to identify psychometrically valid instruments that are brief and user-friendly. Moreover, our instrumentation also allows for expansion to additional co-occurring disorders on a later Phase II study, if warranted by our Phase I results. PUBLIC HEALTH RELEVANCE: In this project, we seek to develop a system to evaluate co-occurring disorders (substance abuse plus additional psychiatric conditions). We plan to use the telephone as an automated and low-cost method. A caller would dial a toll-free number, and then hear automated questions which s/he would then answer using the telephone keypad (e.g., "press 1 for yes or 2 for no"). We would also conduct a study to evaluate satisfaction with the telephone assessment system and related questions. This project could help more people obtain help for co-occurring disorders, if our system is found to work well.