Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study. (July 2019)

• Record Type: Journal Article
• Authors: Johnston, Darcie C; Mathews, W David; Maus, Adam; Gustafson, David H
• Is Part Of: Substance abuse. Volume 13(2019)
• Publication Date: 2019-07
• Subjects: Women -- telemedicine -- social networking -- aftercare -- retention in care -- rural health services -- Appalachian region -- opioid-related disorders -- substance-related disorders -- alcohol-related disorders; Substance abuse -- Periodicals; Substance abuse -- Treatment -- Periodicals; Drug abuse -- Periodicals; Drug abuse -- Treatment -- Periodicals; Substance Abuse & Addiction; Drug abuse; Drug abuse -- Treatment; Substance abuse; Substance abuse -- Treatment; Substance-Related Disorders -- therapy; Periodicals; 362.2905
• DOI: 10.1177/1178221819861377
• Languages: English
• ISSNs: 1178-2218

Abstract

Objectives: Longer retention in treatment is associated with positive outcomes. For women, who suffer worse drug-related problems than men, social technologies, which are more readily adopted by women, may offer promise. This naturalistic study examined whether a smartphone-based relapse-prevention system, A-CHESS (Addiction-Comprehensive Health Enhancement Support System), could improve retention for women with substance use disorders in an impoverished rural setting. Methods: A total of 98 women, age 18 to 40, in southeastern Kentucky and mandated to treatment, received A-CHESS with intensive outpatient treatment for 6 months. For comparison, data were obtained for a similar but non-equivalent group of 100 same-age women also mandated to treatment in the same clinics during the period. Electronic medical record data on length-of-stay and treatment service use for both groups were analyzed, with A-CHESS use data, to determine whether those using A-CHESS showed better retention than those without. Results: Women with A-CHESS averaged 780 service units compared with 343 for the comparison group. For those with discharge dates prior to the study's end, A-CHESS patients stayed in treatment a mean of 410 vs 262 days for the comparison group. Conclusions: Given associations between retention and positive outcomes, mobile health technology such as A-CHESS may help improve outcomes among women, especially in settings where access to in-person services is difficult. The findings, based on a non-equivalent comparison, suggest the need for further exploration with rigorous experimental designs to determine whether and to what degree access to a smartphone with A-CHESS may extend and support recovery for women.