Saturday, 15 January 2005 - 8:00 AM

This presentation is part of: Intervention Research Using Advanced Statistical Methods

Person-Level Measurement of Integrated Treatment Intervetnions

The HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study is a multi-site cooperative research program sponsored by NIDA, NIMH, NIAAA, SAMHSA and HRSA to investigate the effectiveness of integrated treatment interventions for persons living with HIV and co-occurring mental and substance abuse disorders. Client assessment data (SCID, SF-36, ASI-Lite) on a wide array of clinical diagnosis, symptom severity, medication adherence and service utilization factors were collected at baseline, 3-, 6-, and 12- month intervals for 1,183 subjects across eight sites. In addition, about 25,000 Intervention Service Records (ISR) were generated, which affords an unprecedented ability to examine the dose of integrated care at the individual subject and experimental intervention levels.

The authors describe the ISR instrumentation and administration methods focusing on the precision built into the customized data collection forms employed at each site to encourage local clinicians’ use of ISRs as well as the quality control procedures that were instituted to ensure reliability within and across sites. As expected, the type, intensity and duration of integrated service utilization at the person- and intervention-level was influenced by individual mediating factors, such as addiction severity and phase in treatment career, and by the correspondence between person-level factors and the participation requirements of the different integrated treatment models employed across sites. The authors illustrate these findings through across-site comparisons of, for example, the number of service encounters by encounter type, and the distribution of encounters by month after enrollment and type. This study is the first to address with person-level data the precise dose in integrated services received in conjunction with random assignment controlled intent-to-treat analyses of intervention effectiveness.

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