Dataset Information

The Dynamic Assessment and Referral System for Substance Abuse (DARSSA): development, functionality, and end-user satisfaction.

ABSTRACT: The Dynamic Assessment and Referral System for Substance Abuse (DARSSA) conducts a computerized substance abuse assessment; prints personalized summary reports that include tailored substance abuse treatment referral lists; and, for individuals who provide authorization, automatically faxes their contact information to a "best match" substance abuse treatment provider (dynamic referral). After piloting the program and resolving problems that were noted, we enrolled a sample of 85 medical patients. The DARSSA identified 48 (56%) participants who were risky substance users, many of whom had not been identified during their routine medical assessment. Mean satisfaction scores for all domains ranged between "Good" to "Excellent" across patients, nurses, doctors, and substance abuse treatment providers. The median completion time was 13min. Of the 48 risky substance using participants, 20 (42%) chose to receive a dynamic referral. The DARSSA provides a user-friendly, desirable service for patients and providers. It has the potential to improve identification of substance abuse in medical settings and to provide referrals that would not routinely be provided. Future studies are planned to establish its efficacy at promoting treatment initiation and abstinence.

SUBMITTER: Boudreaux ED

PROVIDER: S-EPMC2636871 | biostudies-literature | 2009 Jan

REPOSITORIES: biostudies-literature

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The Dynamic Assessment and Referral System for Substance Abuse (DARSSA): development, functionality, and end-user satisfaction.

Boudreaux Edwin D ED Bedek Kristyna L KL Gilles Donna D Baumann Brigitte M BM Hollenberg Steven S Lord Sherrill A SA Grissom Grant G

Drug and alcohol dependence 20080904 1-3

The Dynamic Assessment and Referral System for Substance Abuse (DARSSA) conducts a computerized substance abuse assessment; prints personalized summary reports that include tailored substance abuse treatment referral lists; and, for individuals who provide authorization, automatically faxes their contact information to a "best match" substance abuse treatment provider (dynamic referral). After piloting the program and resolving problems that were noted, we enrolled a sample of 85 medical patient ...[more]

PMID: 18775606

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Project description:BACKGROUND:While treatment satisfaction has been associated with better outcomes in substance abuse treatment, there is an obvious need for a more profound understanding of what predicts client's satisfaction with treatment. This study elucidates factors relevant to treatment outcome measured at follow-up in terms of satisfaction with the treatment received. METHODS:The research was implemented as a multisite study in outpatient clinics (N?=?7) in southern and western Finland. Data consists of therapists (N?=?33) and their clients (N?=?327). Each consenting client beginning a treatment period was accepted as a research subject and all therapists at the clinics in question participated. The study was conducted as part of the clinic's normal activity. Clients were allocated to therapists according to a randomization list drawn up in advance. Apart from the randomisation and the completion of questionnaires, it did not interfere with the progress of treatment. Follow-up lasted 6 months. Multiple Classification Analysis (MCA) was used through combinations of variables organized by content, e.g. client demographics, previous substance use, therapist's characteristics and client's expectations. The analyses were based in part on conventional statistical testing (t -test, ?2-test, ANOVA). RESULTS:Among 37 independent variables few were statistically significant in the final model. The results suggest that high treatment expectations at baseline are a strong predictor of satisfaction at follow-up. Also, previous substance use predicted treatment satisfaction; people using multiple substances were less satisfied than those taking only one substance. Stronger predictors reduced the statistical significance of those independent variables that were statistically significant in the first analyses. Therefore, therapist's role in recovery and readiness to change should be also seen as antecedents to treatment satisfaction. CONCLUSIONS:It seems that treatment expectations are fulfilled among those participating in follow-up. Yet many are lost during treatment and by follow-up. Service users have experiential knowledge that differs from professionals' and policymakers' knowledge. It is clinically relevant to understand what factors affect client's satisfaction. Hence, it is possible to identify the population whose treatment should receive the most attention, how the client's experience, their commitment to treatment, and treatment effectiveness could be improved.

Project description:BackgroundEcological momentary assessment (EMA) can be a useful tool for collecting real-time behavioral data in studies of health and health behavior. However, EMA administered through mobile technology can be burdensome, and it tends to suffer from suboptimal user engagement, particularly in low health-literacy populations.ObjectiveThis study aimed to report a case study involving the design and evaluation of a mobile EMA tool that supports context-sensitive EMA-reporting of location and social situations accompanying eating and sedentary behavior.MethodsAn iterative, user-centered design process with obese, middle-aged women seeking care in a safety-net health system was used to identify the preferred format of self-report measures and the look, feel, and interaction of the mobile EMA tool. A single-arm feasibility field trial with 21 participants receiving 12 prompts each day for momentary self-reports over a 4-week period (336 total prompts per participant) was used to determine user satisfaction with interface quality and user engagement, operationalized as response rate. A second trial among 38 different participants randomized to receive or not to receive a feature designed to improve engagement was conducted.ResultsThe feasibility trial results showed high interface satisfaction and engagement, with an average response rate of 50% over 4 weeks. Qualitative feedback pointed to the need for auditory alerts. We settled on 3 alerts at 10-min intervals to accompany each EMA-reporting prompt. The second trial testing this feature showed a statistically significant increase in the response rate between participants randomized to receive repeat auditory alerts versus those who were not (60% vs 40%).ConclusionsThis paper reviews the design research and a set of design constraints that may be considered in the creation of mobile EMA interfaces personalized to users' preferences. Novel aspects of the study include the involvement of low health-literacy adults in design research, the capture of data on time, place, and social context of eating and sedentary behavior, and reporting prompts tailored to an individual's location and schedule.Trial registrationClinicalTrials.gov NCT03083964; https://clinicaltrials.gov/ct2/show/NCT03083964.

Dataset Information

The Dynamic Assessment and Referral System for Substance Abuse (DARSSA): development, functionality, and end-user satisfaction.

Publications

The Dynamic Assessment and Referral System for Substance Abuse (DARSSA): development, functionality, and end-user satisfaction.

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