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The National Center on Addiction and Substance Abuse (CASA)
at Columbia University has been contracted to evaluate three
innovative programs instituted by The Division of Addiction
Services of the State of New Jersey (NJDAS). These programs
are designed to provide services for disenfranchised substance
abusing high HIV risk populations that use opiates intravenously
(IVDUs) to increase treatment access, improve the continuum
of care, and address barriers to recovery, such as access
to treatment for Subjects without benefits and new treatment
options such as mobile Suboxone treatment. The three programs
include: 1) Six treatment outreach programs that offer motivational
interventions, counseling, treatment referrals and medication
services, 2) Two supportive housing programs, and 3) Two sub-acute
medical detoxification programs for Subjects who are not being
served by the current system. CASA is sub-contracting the
data collection (interviewing of Subjects) to the National
Council on Alcoholism and Drug Dependence - New Jersey (NCADD-NJ).
CASA and NCADD-NJ have been working together on research projects
for nearly 10 years. We will be providing assessments at baseline,
6 months, 12 months and 18 months.
The goals of the project are to conduct a thorough evaluation
of these programs including:
AIM 1: To describe the population that is served, including
pathways into program; Subject's health, including HIV status;
socio-demographics, such as age, gender, housing status, employment
status; and intra-venous drug use.
AIM 2: To describe the compendium of services and experiences
for Subjects, including: services received through the program
and through referral; Subjects meeting 12-week recommendation
for Suboxone treatment; HIV treatment and risk reduction services;
Subjects enrolled in methadone services, program tenure/retention;
reasons for treatment discharge and drop-out; and Subject
satisfaction.
AIM 3: To evaluate clinical and social functioning outcomes
over an 18 month period of follow-up including: quality of
life, health status, substance use outcomes, crisis care;
employment, housing, and HIV risk behaviors.
AIM 4: The comparative cost effectiveness of these programs
compared to traditional care or absence of care when taking
into account all state and federal expenditures for these
Subjects (e.g. medical care).
We will achieve these objectives through the following:
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The evaluation of the treatment
outreach program will include four assessments of 540
individuals over an 18-month period using a single group
longitudinal design and an administrative review of the
NJDAS data collection system called NJSAMs. |
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An analysis of administrative
data (e.g., NJSAMS, Medicaid) for all NETI Subjects enrolled
over the first two years of the project and compare these
to a statistically matched group of methadone treatment
Subjects. |
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The evaluation of the supportive
housing program will include all 62 Subjects enrolled
in the supportive housing program who will be interviewed
four times over an 18 month period and an administrative
review of NJSAMs. |
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The evaluation of the sub-acute
medical detoxification program will be conducted through
an administrative review of NJSAMs assessing the trajectory
of these Subjects drug use and quality of life outcomes.
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The evaluation of the cost
effectiveness of the program by examining incidence of
crisis events (e.g. ER visits), overall health outcomes,
and quality of life outcomes. This will be conducted through
analysis of administrative data, including NJSAMS and
Medicaid, as well as estimates of government expenditures
(e.g., criminal justice) derived from Subject self-reports.
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Timeline:
Recruitment for all aspects of the evaluation will begin
in April 2009, and continue through 2012. Each Subject will
be evaluated when she is first recruited into the study (baseline)
and again six, 12 and 18 months later. Subjects will complete
a 90-120 minute battery of measures at baseline and a 90 minutes
battery at follow-up.
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