VOUCHER INCENTIVE THERAPIES FOR PREGNANT DRUG ABUSING WOMEN

怀孕期间使用药物是一个主要的公共卫生问题。 鼓励怀孕吸毒妇女参加门诊治疗， 然而，这是一个重大的问题。行为激励已被证明 在减少门诊期间非法药物使用方面取得了巨大成功 治疗。这项拟议的研究将确定 孕期吸毒妇女参加戒毒的行为激励研究 门诊治疗。据推测，上座率的提高将 导致患者更多地接触治疗服务，这在 转而将带来更好的结果，包括改善保留率和 减少非法药物的使用。这些奖励将是物质奖励。 以证书的形式提供，可兑换各种证书 在当地社区的商品和服务。研究对象将 是低收入孕妇滥用药物的妇女，需要无数的 治疗服务(药物滥用咨询、产科、妇科)。 几乎所有受试者都吸食可卡因，超过50%的受试者依赖于 阿片类药物，并在治疗期间维持在美沙酮上。这项研究 将在一个综合治疗计划中进行，该计划是 专门为治疗这类妇女而设立的。初步研究 将研究基本变量的影响，这些变量预计将 重要的是使用行为激励来加强计划 出席率。不同强度钢筋的加固效果 (研究1)和不同的加固期限(研究2) 检查过了。根据这两项研究中获得的数据，一项临床试验 然后进行(研究3)，以直接比较效果 一种行为策略，其目标是将计划出席人数定为 门诊戒毒(尿检阴性)的目标 滥用药物。这项研究还将确定是否将两者结合起来 策略将比单独应用任何一种策略都更有效。 结果衡量标准将包括行为干预对 方案参与和保留、非法药物使用、酗酒、 心理社会功能以及产妇和胎儿/婴儿的结局(例如， 新生儿出生体重、产科并发症、住院情况 重症监护病房)。预计这项研究的结果将 提供有关最适当行为的临床有用信息 以药物滥用的行为治疗为目标，以及基准 关于在治疗中使用行为激励的有效性的数据 怀孕的吸毒妇女。

Substance use during pregnancy is a major public health problem. Motivating pregnant drug-abusing women to attend outpatient treatment, however, is a significant problem. Behavioral incentives have proven highly successful in reducing illicit drug use during outpatient treatment. The proposed research will determine the effectiveness of behavioral incentives in motivating pregnant drug-abusing women to attend outpatient treatment. It is hypothesized that improved attendance will result in greater exposure of patients to treatment services, which in turn will result in better outcomes including improved retention and reduced illicit drug use. The incentives will be material rewards made available in the form of certificates that can be exchanged for a variety of goods and services in the local community. The research subjects will be low income pregnant drug-abusing women who are in need of a myriad of treatment services (drug abuse counseling, obstetric, gynecological). Nearly all of the subjects abuse cocaine and over 50% are dependent on opiates and are maintained on methadone during treatment. The research will be conducted in a comprehensive treatment program that was established specifically for treating such women. The initial research will study the effects of basic variables that are expected to be important in the use of behavioral incentives to reinforce program attendance. The effectiveness of different magnitudes of reinforcement (Study 1) and different durations of reinforcement (Study 2) will be examined. Based on data obtained in these two studies, a clinical trial will then be conducted (Study 3) to directly compare the effectiveness of a behavioral strategy that targets program attendance to that which targets drug abstinence (negative urinalysis) in the outpatient treatment of drug abuse. The research will also determine if combining both strategies will be more effective that applying either strategy alone. Outcome measures will include effects of the behavioral interventions on program participation and retention, illicit drug use, alcohol use, psychosocial functioning, and maternal and fetal/infant outcomes (e.g., birthweight, obstetrical complications, hospitalization in the neonatal intensive care unit). The results of the research are expected to provide clinically useful information on the most appropriate behaviors to target in the behavioral treatment of drug abuse, as well as benchmark data on the effectiveness of using behavioral incentives in the treatment of pregnant drug-abusing women.