Performance-Based Strategy for Substance Abuse Intervention

(SAT2HIV-II Trial)

Not currently recruiting at 1 trial location

Overseen By Bryan R. Garner, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: RTI International

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test whether monetary bonuses for staff can improve their performance in assisting people with substance use issues. The study compares two strategies: a standard approach involving facilitation, training, feedback, and consultation (FTFC), and an enhanced version that adds pay-for-performance incentives (FTFC+PFP). Individuals with HIV who face substance use challenges might be suitable for this trial. The researchers aim to determine if incentivizing staff can lead to better client outcomes.

As an unphased trial, this study offers participants the chance to contribute to innovative strategies that could enhance support for individuals with substance use challenges.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these strategies are safe for implementation?

In a previous study, the FTFCI Strategy was used with adults who have HIV and substance use disorders, showing promise in reducing drug use without serious side effects. Research suggests that rewards, such as bonuses, can encourage positive behavior changes in substance abuse treatments. This method is generally well-tolerated, as it emphasizes motivation over medication, reducing the risk of physical side effects.

Overall, current research indicates that the strategy appears safe. Participants can expect a focus on improving treatment through support and motivation, avoiding the usual risks associated with drug-based treatments. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Performance-Based Strategy for Substance Abuse Intervention because it explores innovative ways to enhance treatment delivery. Unlike traditional methods that rely solely on counseling or medication, this approach incorporates a multilevel implementation strategy called FTFC, which includes facilitation, training, feedback, and consultation to improve treatment effectiveness. Even more promising is the FTFC+PFP strategy, which adds a pay-for-performance component, rewarding staff for achieving specific outcomes. This incentivization could lead to more motivated healthcare providers and better results for clients, potentially transforming how substance abuse treatments are implemented and evaluated.

What evidence suggests that this trial's strategies could be effective for substance abuse intervention?

This trial will compare two strategies for substance abuse intervention. Research has shown that the facilitation, training, feedback, and consultation (FTFC) strategy aids in applying proven methods to treat substance use. This strategy emphasizes training staff to enhance their skills and ensure correct treatment application. Studies have found that these methods can lead to better outcomes for individuals dealing with substance use issues.

Another arm of this trial will evaluate an enhanced strategy that includes incentives (FTFCI). Research suggests that adding monetary rewards can further boost staff performance. This approach aims to increase motivation and commitment to treatment goals, potentially making substance use treatments even more effective. Overall, both strategies are designed to improve the quality of care and outcomes for those facing substance use challenges. ^{1 6 7 8 9}

Who Is on the Research Team?

Bryan R Garner, PhD

Principal Investigator

Ohio State University

Are You a Good Fit for This Trial?

This trial is for adults over the age of 18 who have been diagnosed with HIV and are dealing with substance use disorders or substance abuse.

Inclusion Criteria

I am over 18 and have been diagnosed with HIV.

Exclusion Criteria

No specific exclusion criteria for staff participants

No specific exclusion criteria for client participants.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

Implementation of motivational interviewing-based brief intervention for substance use with a pay-for-performance strategy

12 months

Follow-up

Participants are monitored for substance use and anxiety disorder outcomes

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• The facilitation, training, feedback, and consultation (FTFC) Strategy
• The facilitation, training, feedback, consultation, and pay-for-performance (FTFC+PFP) Strategy

Trial Overview The study tests two strategies to improve substance abuse treatment in HIV care. One includes facilitation, training, feedback, and consultation (FTFC), while the other adds pay-for-performance bonuses (FTFC+PFP).

How Is the Trial Designed?

Group I: Facilitation, Training, Feedback, Consultation, and Incentivization (FTFCI) Staff Experimental Treatment 1 Intervention

An enhanced version of the multilevel implementation strategy

Group II: Facilitation, Training, Feedback, Consultation, and Incentivization (FTFCI) Clients Experimental Treatment 1 Intervention

Clients served within the context of an enhanced multilevel implementation strategy

Group III: Facilitation, Training, Feedback, and Consultation (FTFC) Staff Active Control 1 Intervention

A multilevel implementation strategy

Group IV: Facilitation, Training, Feedback, and Consultation (FTFC) Clients Active Control 1 Intervention

Clients served within the context of a multilevel implementation strategy

Who Is Running the Clinical Trial?

RTI International

Lead Sponsor

Trials

201

Recruited

942,000+

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Published Research Related to This Trial

In a study involving 118 clinicians across 20 outpatient substance abuse treatment clinics, a semiautomated patient feedback system was tested over 12 weeks, but it did not show any significant impact on reducing drug and alcohol use among over 1,500 patients.

The intervention also failed to improve secondary outcomes related to therapeutic alliance and clinician job satisfaction, suggesting that the feedback system may need alternative approaches to enhance clinical effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled study of a web-based performance improvement system for substance abuse treatment providers. Crits-Christoph, P., Ring-Kurtz, S., McClure, B., et al.[2021]

Citations

1. withpower.com withpower.com/trial/phase-substance-related-disorders-2021-d45db

Performance-Based Strategy for Substance Abuse ... Trial Overview The study tests two strategies to improve substance abuse treatment in HIV care. One includes facilitation, training, feedback, and consultation ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40216298/

Outcomes from a randomized trial of the SIC-coaching ... The SIC-Coaching approach was developed as an implementation strategy to facilitate implementation with the use of SIC data to provide feedback.

3. unodc.org unodc.org/documents/prevention/Family_Compilation_Update_2025.pdf

Compilation of Evidence-Based Family Skills Training ... The Guide to Implementing Family Skills Training Programmes for Drug Abuse Prevention provides guidelines for the adaptation of existing evidence-based ...

4. cdc.gov cdc.gov/overdose-prevention/media/pdfs/2025/08/ENGAGE_Resource-for-Action_508c.pdf

Evidence-Based Strategies to Prevent Youth Substance Use This strategy includes school-based interventions that develop youth skills to prevent substance use initiation and to engage in healthy behaviors. Approach.

5. tandfonline.com tandfonline.com/doi/full/10.1080/15374416.2025.2521855

Evidence Base on Outpatient Behavioral Treatments for ... Objective. This systematic review (1) updates the evidence base on outpatient behavioral treatments for adolescent substance use (ASU) since ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12086100/

Facilitating implementation of a substance use intervention ... One intervention that might help address the drug use crisis among adolescents is Multidimensional Family Therapy (MDFT; Liddle et al., 1992, ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3120122/

Strategies for Training Counselors in Evidence-Based ... An initial 6-month formal phase included group didactic sessions about adolescent development, families, and drug abuse treatment; skill-building workshops; and ...

8. jsatjournal.com jsatjournal.com/article/S2949-8759(24)00225-X/pdf

California's Recovery Incentives Program The. T.E. Freese et al. Journal of Substance Use and Addiction Treatment 167 (2024) 209513. 3. Page 4. details of the Fidelity Monitoring Self- ...

9. library.samhsa.gov library.samhsa.gov/sites/default/files/contingency-management-advisory-pep24-06-001.pdf

contingency-management-advisory-pep24-06-001.pdf based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: A national drug abuse treatment clinical trials network study.