Preventive interventions are often designed and tested with the immediate program period in mind, and little thought that the intervention sample might be followed up for years, or even decades beyond the initial trial. However, depending on the type of intervention and the nature of the outcomes, long-term follow-up may well be appropriate. The advantages of long-term follow-up of preventive interventions are discussed, and include the capacity to examine program effects across multiple later life outcomes, the ability to examine the etiological processes involved in the development of the outcomes of interest and the ability to provide more concrete estimates of the relative benefits and costs of an intervention. In addition, researchers have identified potential methodological risks of long-term follow-up such as inflation of type 1 error through post-hoc selection of outcomes, selection bias and problems stemming from attrition over time. The present paper presents a set of seven recommendations for the design or evaluation of studies for potential long-term follow-up organized under four areas: Intervention Logic Model, Developmental Theory and Measurement Issues; Design for Retention; Dealing with Missing Data; and Unique Considerations for Intervention Studies. These recommendations include conceptual considerations in the design of a study, pragmatic concerns in the design and implementation of the data collection for long-term follow-up, as well as criteria to be considered for the evaluation of an existing intervention for potential for long-term follow-up. Concrete examples from existing intervention studies that have been followed up over the long-term are provided.
A multisite, randomized trial within the National Drug Abuse Treatment Clinical Trials Network (CTN) was conducted to test three interventions to enhance treatment initiation following detoxification: 1) a single session, therapeutic alliance intervention (TA) added to usual treatment, 2) a 2-session, counseling and education, HIV/HCV risk reduction intervention (C&E), added to usual treatment and 3) treatment as usual (TAU) only. Injection drug users (n = 632) enrolled in residential detoxification at 8 community treatment programs were randomized to 1 of the 3 study conditions. There was a significant difference between TA participants and those receiving TAU in reported outpatient treatment entry. TA participants reported entering outpatient treatment sooner and in greater numbers than TAU participants. Reported treatment entry for C&E fell between TA and TAU with no significant differences between C&E and the other conditions. There were no differences among the interventions in retention, as measured by weeks of outpatient treatment for all participants who reported treatment entry. Alliance building interventions appear to be effective in facilitating transfer from detoxification to outpatient treatment, but additional treatment engagement interventions may be necessary to improve retention.Correspondence concerning this article should be addressed to Barbara K. Campbell, Oregon/Hawaii Node - CTN, 1942 (Gerstein et al., 1994;Hubbard, Craddock, Flynn, Anderson & Etheridge, 1997;Hubbard et al., 1989;Sells & Simpson, 1976;Simpson, Joe & Brown, 1997;Sorenson & Copeland, 2000). Most patients leaving detoxification report plans to enter some form of treatment (Tuten, Jones, Lertch & Stitzer, 2007). Research consistently shows, however, that many do not follow through. Lundgren, Sullivan and Amodeo (2006), for example, analyzed data for injection drug users with multiple treatment admissions in Massachusetts from 1997 through 2001; the most common treatment pattern (30%) was repeated admissions to detoxification only. reported that 43% of heroin and cocaine addicted patients received no treatment in the 30 days following detoxification. Similarly, Chutuape, Jasinski, Fingerhood and Stitzer (2001) followed patients for six months following a 3-day, inpatient detoxification for opiates; most (59%) had no formal treatment during the follow-up period. Only 26% of patients in a 21-day inpatient publicly-funded detoxification center transferred to residential or outpatient treatment following discharge (McCusker, Bigelow, Luippold, Zorn & Lewis, 1995). Finally, national hospital data suggest that the percentage of patients receiving inpatient or residential treatment following detoxification dropped from 38.9% to 21.1% between 1992(Mark, Dilonardo, Chalk &Coffey, 2002.Patients who enter treatment following detoxification have consistently better outcomes. Heroin users engaged in formal treatment for a minimum of seven days during the six months following detoxification reported significantly reduced drug us...
Collecting saliva is the most noninvasive way to detect changing levels of cortisol (Adam & Kumari, 2009;Soo-Quee Koh & Choon-Huat Koh, 2007), a stress hormone of interest to behavioral and health scientists, where there are benefits from multiple samples taken over a period of days. Various self-collection strategies have been employed, ranging from treated cards to cotton swabs and passive drool methods. The current study investigates the effectiveness of a variety of reminder techniques in encouraging adherence with procedures requiring 4 samples per day on 3 separate days of passive drool collection among African American and European American young adults. The findings suggest that direct texts were associated with the greatest level of adherence, while phone reminders were most effective when controlling for total number of contacts. Results indicate that both traditional and novel reminder methods can positively influence adherence, even with challenging populations.
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