Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study

• Main Authors: Darcie C Johnston (Author), W David Mathews (Author), Adam Maus (Author), David H Gustafson (Author)
• Format: Book
• Published: SAGE Publishing, 2019-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1178-2218; 10.1177/1178221819861377
• Keywords: Public aspects of medicine; RA1-1270
• Source: Substance Abuse: Research and Treatment, Vol 13 (2019)

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.