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  This file contains the text of part of the September/October 1999 issue of Research in Brief (ISSN 1047-8418), a newsletter published six times a year by the Research Institute on Addictions, a component of the University at Buffalo, The State University of New York. Permission to reproduce this material is granted with the condition that users identify the Research Institute on Addictions as the source. For more information, contact: RIA Public Communications, 1021 Main Street, Buffalo , N.Y. 14203-1016. |
A Comparison of Three “Interventions” on Pretreatment Dropout Rates in an Outpatient Substance Abuse ClinicPaul R. Stasiewicz, Ph.D. and Robert Stalker, M.S.W., C.S.W.Abstracted from Addictive Behaviors, 24, 579-582, 1999.You’re a counselor, therapist, or social worker who sees clients with substance use or abuse issues every day. How do you help clients to keep their first appointment? A recent study at the Clinical Research Center of the Research Institute on Addictions examined the impact of three interventions on pretreatment dropout rates. Previous studies looked at ways to retain treatment clients already in treatment, the sociodemographics of the clients themselves, and how the length of time between initial phone contact and the scheduled intake appointment resulted in higher patient show rates. RIA’s Paul R. Stasiewicz, Ph.D. wanted to build on previous research regarding time-to-intake, which had shown that fewer days between the initial phone contact and scheduled intake appointment resulted in higher patient show rates (e.g., Festinger, Lamb, Kirby, & Marlowe, 1996). He decided to compare time-to-intake with two other interventions hypothesized to increase attendance at the initial intake appointment. Participants scheduled within 48 hours of the initial telephone intake were more likely to attend the initial appointment than those who had to wait a longer period of time. Who participated and how After a brief telephone intake interview, 128 individuals who called the Clinical Research Center seeking treatment for an alcohol problem were randomly assigned to one of four groups. Group 1 was scheduled within 48 hours of the telephone call. Individuals in the other three groups were scheduled 48 hours or more after the telephone call and received either a reminder call 24 hours prior to their appointment (Group 2), a clinic brochure and an appointment card in the mail (Group 3), or no intervention at all (Group 4). The average age of participants was 35.9 years, 62.5% were male, 66.7% were Caucasian, and 26.4% were African American. Forty-six percent were employed and forty-nine percent reported previous outpatient treatment for substance abuse. What we found When individuals arrived for the initial intake appointment they were asked if they had received a reminder and what kind. The data indicate that the interventions were delivered as intended with 69% of Group 2 reporting a reminder phone call and 81% of Group 3 reporting having received the appointment card and brochure. It is not known how these rates might have differed for those who did not show for their initial intake appointment. Table 1 shows the average number of hours between the telephone call and the scheduled intake appointment for each group. Table 2 displays the show rates for each group indicating that individuals in Group 1 were more likely to show for the initial intake appointment as compared to individuals in the other three groups. In addition, there were no differences in attendance between Groups 2, 3, and 4. Table 1. Mean number of hours elapsed between telephone call and scheduled appointment
Table 2. Initial intake appointment show rates by group
Indications Dr. Stasiewicz’s study is the first of its kind to compare the relative effectiveness of several different interventions on pretreatment dropout rates in an outpatient substance abuse clinic. Participants scheduled within 48 hours of the initial telephone call were more likely to attend the initial intake appointment than those who had to wait a longer period of time. For those who did wait more than 48 hours, reminder calls, appointment cards or brochures did not improve their attendance beyond that of clients who received no reminder. These findings should heighten the awareness of the impact of treatment system variables on client behavior and suggest that a responsive treatment system can result in more clients engaging in treatment (Fehr, Weinstein, Sterling & Gottheil, et al, 1991). References
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