title: Predicting patient post-detoxification engagement in 12-step groups with an extended version of the theory of planned behavior.
abstract: BACKGROUND
  Individuals with substance use disorders can receive important abstinence-specific support in 12-step groups (TSGs). However, our understanding of key factors that influence TSG participation remains limited. This study used an extended version of the theory of planned behavior (TPB) to enhance the understanding of TSG affiliation.
  
  
  METHODS
  Data were retrieved from a controlled trial of a 12-step facilitation intervention conducted on an inpatient detoxification ward in Norway (N = 140). Surveys at baseline included a TPB questionnaire. The behavioral target was to attend at least two TSG meetings per month in the 6-month follow-up period. Structural equation modeling was used to analyze the predictors of behavior at follow-up.
  
  
  RESULTS
  We found that attitudes, the moral norm, and perceived behavior control accounted for 81 % of the variance in the intention to participate regularly in TSGs after treatment. Subjective norms did not significantly influence the intention to participate. Moreover, the intention to participate significantly predicted behavior (β = 0.42, p < 0.001). In contrast to theory, there was a substantial, model-independent pathway from past to later behavior (β = 0.22, p = 0.047). The model explained 46 % (p < 0.001) of the variance in behavior. Attending ≥ 12 TSG meetings in the follow-up period was associated with a high percentage of abstinent days at follow-up (β = 0.38, p = 0.023).
  
  
  CONCLUSIONS
  The present TPB questionnaire worked well for assessing patient intentions to attend a TSG. Treatment providers should encourage patient intentions to participate in TSGs post-detoxification.
authors.affiliation: Addiction Unit, Sørlandet Hospital HF, PO Box 4164, 604, Kristiansand, Norway. john-kare.vederhus@sshf.no.
authors.forename: John-Kåre
authors.initials: JK
authors.lastname: Vederhus
authors.affiliation: Alcohol Research Group, Emeryville, CA, USA. szemore@arg.org.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Zemore
authors.affiliation: Norwegian Institute for Alcohol and Drug Research, Oslo, Norway. jr@sirus.no.
authors.forename: Jostein
authors.initials: J
authors.lastname: Rise
authors.affiliation: Addiction Unit, Sørlandet Hospital HF, PO Box 4164, 604, Kristiansand, Norway. thomas.clausen@medisin.uio.no.|Norwegian Center for Addiction Research, University of Oslo, Oslo, Norway. thomas.clausen@medisin.uio.no.|Fulbright Scholar (2014-15), Alcohol Research Group, Emeryville, CA, USA. thomas.clausen@medisin.uio.no.
authors.forename: Thomas
authors.initials: T
authors.lastname: Clausen
authors.affiliation: University of Agder, Grimstad, Norway. magnhild.hoie@uia.no.
authors.forename: Magnhild
authors.initials: M
authors.lastname: Høie
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D009664:Norway; D012657:Self-Help Groups; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000523:psychology* / Q000628:therapy*