Powerpoint template for scientific posters (Swarthmore College)

Background:

The low retention rates among African Americans insubstance abuse treatment (Milligan et al., 2004)combined with the limited number of treatments withdemonstrated efficacy for African American substanceusers (Nagayama-Hall, 2001) are both public healthconcerns. This study is designed to address theseconcerns by determining the efficacy of MotivationalEnhancement Therapy (MET) for increasing retentionand reducing drug use among African Americans whoabuse substances (i.e., alcohol, cocaine, marijuana,opioids, benzodiazepines, methamphetamines and otherdrugs). MET is a client-centered approach grounded inMotivational Interviewing (MI) that enhances intrinsicmotivation in the client to change their behaviors.

A recent meta-analysis revealed that MI yielded alarger effect size for ethnic minority populations thanWhite populations (Hettema et al., 2005). Few studieshave focused exclusively on substance abusing AfricanAmericans. Results from these studies are promising. Forexample, Longshore and Grills (2000) examined theefficacy of a culturally tailored version of MET forAfrican American substance users. They found that METwas successful in reducing drug use among AfricanAmericans. The current study is among the few to assessthe efficacy of a generic (i.e., not culturally tailored)version of MET as compared to counseling as usual(CAU) with an African American sample. The study wasa secondary analysis of a multi-site randomized clinicaltrial of MET conducted by the National Institute of DrugAbuse (NIDA) Clinical Trials Network (CTN) 0004.

Hypotheses:

Hypothesis 1: African Americans in MET will usefewer substances (i.e., self-report of drug use and urinescreens) than African Americans in CAU.

Hypothesis 2: African Americans in MET will havehigher retention rates than African Americans in CAU.

Acknowledgments:

The authors would like to thank Dr. KathleenCarroll and the rest of the NIDA CTN 0004research team for sharing data for this project.

Outcome Variables:

Urine screens: Probability of receiving at leastone positive urine screen during the four week activephase

Self-report of drug use: Self-report of weeklydrug use for each of the 16 study weeks

Retention: Number of days between the day ofenrollment and the last day that the participantreceived services

Discussion:

The efficacy of MET appeared to be more evident whenurine screens rather than self report were used to assesssubstance use. Moreover, even the positive findings for urinescreens were limited to primary alcohol users. This findingsuggests that those primary alcohol users assigned to METwere less likely than those assigned to CAU to use otherdrugs during the 4 week active phase. The finding that METwas associated with better retention for African Americanfemales is promising. However, the fact that this finding wasevident for females but not males suggests that the benefitsof MET may vary for specific subgroups of AfricanAmericans.

FUTURE STUDIES:

The pattern of findings was somewhat different for theAfrican American sample than the overall sample. Thissuggests that outcomes should be analyzed separately forAfrican Americans.

Future studies should focus more on identifying the specificsubgroups of African Americans who may benefit fromMET.

Future studies should examine whether a culturally adaptedversion of MET might yield better outcomes for AfricanAmericans.

LaTrice Montgomery, M.A. 1, Kathleen Burlew, Ph.D. 1, Andrzej S. Kosinski, Ph.D. 2, & Alyssa Forcehimes, Ph.D. 3

1University of Cincinnati, 2Duke Clinical Research Institute, 3University of New Mexico

References:

Hettema, J., Steele, J., & Miller, W.R. (2005). Motivationalinterviewing. Annual Review of Clinical Psychology,1,91-111.

Longshore, D., & Grills, C. (2000). Motivating illegal druguse recovery: Evidence for a culturally congruentintervention. Journal of Black Psychology, 26(3), 288-301.

Milligan, C., Celeste, O., Nich, C., & Carroll, K. (2004).Ethnic differences in substance abuse treatment,retention, compliance and outcome from two clinicaltrials. Psychiatric Services, 55, 167-173.

Nagayama-Hall, G. (2001). Psychotherapy research with

ethnic minorities: Empirical, ethical, and conceptualissues. Journal of Consulting and Clinical Psychology,69, 502-510.

Hypothesis 1:

Self-Report of Drug Use (Linear Mixed Modeling):

Overall, African Americans in MET reported using moredrugs than those in CAU throughout the 16 study weeks (p <0.001).

Urine Screens (Logistic Regression):

Among alcohol users only, African Americans in MET wereless likely to have a positive urine screen than those in CAUduring the 4 week active phase (p = 0.05, OR = 0.28, 95% CI0.08 – 1.01).

However, the probability of positive urines did notsignificantly differ among African Americans in MET andthose in CAU overall during the 4 week active phase (p =0.52).

Hypothesis 2:

Retention (Survival Analysis):

Among African American females, those in MET had betterretention than those in CAU during the initial 12 weeks (log-rank p = 0.05 when considering the initial 12 weeks; log-rank p= 0.09 when considering the entire 16 week period).

However, the retention rates did not differ for AfricanAmerican males in MET and CAU (p = .10).

The Efficacy of Motivational Enhancement Therapy for African American Substance Users