Kathleen M Grant1, Lance Brendan Young2, Kimberly A Tyler3, Jamie L Simpson4, R Dario Pulido5, Christine Timko6. 1. VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA. 2. Communication Department, Western Illinois University-Quad Cities,Moline, IL, USA. Electronic address: LB-Young@wiu.edu. 3. Sociology Department, University of Nebraska-Lincoln, Lincoln, NE, USA. 4. Psychology Department, Midland University, Fremont, NE, USA. 5. VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA. 6. Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA; Stanford University School of Medicine, Stanford, CA, USA.
Abstract
OBJECTIVE: A multisite field trial testing whether improved outcomes associated with intensive referral to mutual help groups (MHGs) could be maintained after the intervention was adapted for the circumstances and needs of rural veterans in treatment for substance use disorder (SUD). METHODS: In three Veterans Affairs treatment programs in the Midwest, patients (N=195) received standard referral (SR) or rural-adapted intensive referral (RAIR) and were measured at baseline and 6-month follow-up. RESULTS: Both groups reported significant improvement at 6-months, but no significant differences between SR and RAIR groups in MHG participation, substance use, addiction severity, and posttraumatic stress symptoms. Inconsistent delivery of the intervention resulted in only one-third of the RAIR group receiving the full three sessions, but this group reported significantly greater 6-month abstinence from alcohol than those receiving no sessions. CONCLUSION: Further research should explore implementation problems and determine whether consistent delivery of the intervention enhances 12-step facilitation. PRACTICE IMPLICATIONS: The addition of rural-specific elements to the original intensive referral intervention has not been shown to increase its effectiveness among rural veterans.
OBJECTIVE: A multisite field trial testing whether improved outcomes associated with intensive referral to mutual help groups (MHGs) could be maintained after the intervention was adapted for the circumstances and needs of rural veterans in treatment for substance use disorder (SUD). METHODS: In three Veterans Affairs treatment programs in the Midwest, patients (N=195) received standard referral (SR) or rural-adapted intensive referral (RAIR) and were measured at baseline and 6-month follow-up. RESULTS: Both groups reported significant improvement at 6-months, but no significant differences between SR and RAIR groups in MHG participation, substance use, addiction severity, and posttraumatic stress symptoms. Inconsistent delivery of the intervention resulted in only one-third of the RAIR group receiving the full three sessions, but this group reported significantly greater 6-month abstinence from alcohol than those receiving no sessions. CONCLUSION: Further research should explore implementation problems and determine whether consistent delivery of the intervention enhances 12-step facilitation. PRACTICE IMPLICATIONS: The addition of rural-specific elements to the original intensive referral intervention has not been shown to increase its effectiveness among rural veterans.