title: Gender-based Outcomes and Acceptability of a Computer-assisted Psychosocial Intervention for Substance Use Disorders.
abstract: BACKGROUND
  Digital technologies show promise for increasing treatment accessibility and improving quality of care, but little is known about gender differences. This secondary analysis uses data from a multi-site effectiveness trial of a computer-assisted behavioral intervention, conducted within NIDA's National Drug Abuse Clinical Trials Network, to explore gender differences in intervention acceptability and treatment outcomes.
  
  
  METHODS
  Men (n=314) and women (n=192) were randomly assigned to 12-weeks of treatment-as-usual (TAU) or modified TAU+Therapeutic Education System (TES), whereby TES substituted for 2hours of TAU per week. TES is composed of 62 Web-delivered, multimedia modules, covering skills for achieving and maintaining abstinence plus prize-based incentives contingent on abstinence and treatment adherence. Outcomes were: (1) abstinence from drugs and heavy drinking in the last 4weeks of treatment, (2) retention, (3) social functioning, and (4) drug and alcohol craving. Acceptability was the mean score across five indicators (i.e., interesting, useful, novel, easy to understand, and satisfaction).
  
  
  RESULTS
  Gender did not moderate the effect of treatment on any outcome. Women reported higher acceptability scores at week 4 (p=.02), but no gender differences were detected at weeks 8 or 12. Acceptability was positively associated with abstinence, but only among women (p=.01).
  
  
  CONCLUSIONS
  Findings suggest that men and women derive similar benefits from participating in a computer-assisted intervention, a promising outcome as technology-based treatments expand. Acceptability was associated with abstinence outcomes among women. Future research should explore characteristics of women who report less satisfaction with this modality of treatment and ways to improve overall acceptability.
authors.affiliation: Columbia University Department of Psychiatry New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Mount Sinai St. Luke's Hospital Department of Psychiatry and Behavioral Health, 1111 Amsterdam Ave, New York, NY 10025, USA. Electronic address: anc2002@columbia.edu.
authors.forename: Aimee N C
authors.initials: AN
authors.lastname: Campbell
authors.affiliation: Columbia University Department of Psychiatry New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
authors.affiliation: Columbia University Mailman School of Public Health Department of Biostatistics, 722 West 168th Street, 6th Floor, New York, NY 10032, USA.
authors.forename: Martina
authors.initials: M
authors.lastname: Pavlicova
authors.affiliation: University of Washington Department of Psychiatry and Behavioral Sciences and Alcohol and Drug Abuse Institute, 1107 NE 45th Street, Suite 120, Box 354805, Seattle, WA 98105, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Hatch-Maillette
authors.affiliation: Columbia University Medical Center, Department of Psychiatry, 630 West 168th Street, New York, NY 10032, USA.
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Hu
authors.affiliation: Stanley Street Treatment and Research Center and Brown University Alpert Medical School, 386 Stanley St, Fall River, MA 02720, USA.
authors.forename: Genie L
authors.initials: GL
authors.lastname: Bailey
authors.affiliation: Harvard Medical School, Department of Psychiatry and McLean Hospital Division of Alcohol and Drug Abuse, 115 Mill Street, Belmont, MA 02478, USA.
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Sugarman
authors.affiliation: Columbia University Department of Psychiatry New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Gloria M
authors.initials: GM
authors.lastname: Miele
authors.affiliation: Oregon Health and Science University School of Medicine, 3181S.W. Sam Jackson Park Rd., Portland, OR 97239, USA.
authors.forename: Traci
authors.initials: T
authors.lastname: Rieckmann
authors.affiliation: University of Texas Southwestern Medical Center Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Shores-Wilson
authors.affiliation: Columbia University Department of Psychiatry New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Turrigiano
authors.affiliation: Harvard Medical School, Department of Psychiatry and McLean Hospital Division of Alcohol and Drug Abuse, 115 Mill Street, Belmont, MA 02478, USA.
authors.forename: Shelly F
authors.initials: SF
authors.lastname: Greenfield
mesh_terms: D000328:Adult; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D019966:Substance-Related Disorders / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Acceptability; Computer-assisted treatment; Gender differences; Internet-delivered treatment; Substance use disorders