title: Racial/ethnic subgroup differences in outcomes and acceptability of an Internet-delivered intervention for substance use disorders.
abstract: The Therapeutic Education System (TES), an Internet version of the Community Reinforcement Approach plus prize-based motivational incentives, is one of few empirically supported technology-based interventions. To date, however, there has not been a study exploring differences in substance use outcomes or acceptability of TES among racial/ethnic subgroups. This study uses data from a multisite (N = 10) effectiveness study of TES to explore whether race/ethnicity subgroups (White [n = 267], Black/African American [n = 112], and Hispanic/Latino [n = 55])moderate the effect of TES. Generalized linear mixed models were used to test whether abstinence, retention, social functioning, coping, craving, or acceptability differed by racial/ethnic subgroup. Findings demonstrated that race/ethnicity did not moderate the effect of TES versus TAU on abstinence, retention, social functioning, or craving. A three-way interaction (treatment, race/ethnicity, and abstinence status at study entry) showed that TES was associated with greater coping scores among nonabstinent White participants (p = .008) and among abstinent Black participants (p < .001). Acceptability of the TES intervention, although high overall, was significantly different by race/ethnicity subgroup with White participants reporting lower acceptability of TES compared to Black (p = .006) and Hispanic/Latino (p = .008) participants. TES appears to be a good candidate treatment among a diverse population of treatment-seeking individuals with substance use disorders.
authors.affiliation: a Columbia University Medical Center , New York , New York.|b New York State Psychiatric Institute , New York , New York.
authors.forename: Aimee N C
authors.initials: ANC
authors.lastname: Campbell
authors.affiliation: c Mental Health and Substance Abuse Counseling Program , University of Cincinnati, School of Human Services , Cincinnati , Ohio.
authors.forename: L
authors.initials: L
authors.lastname: Montgomery
authors.affiliation: d School of Social Work , University of Texas at Arlington , Arlington , Texas.
authors.forename: Katherine
authors.initials: K
authors.lastname: Sanchez
authors.affiliation: e Columbia University, Mailman School of Public Health , New York , New York.
authors.forename: M
authors.initials: M
authors.lastname: Pavlicova
authors.affiliation: a Columbia University Medical Center , New York , New York.
authors.forename: M
authors.initials: M
authors.lastname: Hu
authors.affiliation: f University of Washington , Seattle , Washington.
authors.forename: H
authors.initials: H
authors.lastname: Newville
authors.affiliation: g Icahn School of Medicine at Mount Sinai , New York , New York.
authors.forename: L
authors.initials: L
authors.lastname: Weaver
authors.affiliation: a Columbia University Medical Center , New York , New York.
authors.forename: E V
authors.initials: EV
authors.lastname: Nunes
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Acceptability; Internet-delivered treatment; race/ethnicity; substance use disorders; technology