Encouraging Abstinence Behavior in a Drug Epidemic: Optimizing Dynamic Incentives

Conditions

• Cocaine Use
• Cocaine Use Disorder
• Methamphetamine Abuse
• Methamphetamine-dependence
• Opioid Use
• Opioid-use Disorder
• Substance Use

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Not accepted

Interventions

• App-Based Contingency Management — BEHAVIORAL
  Participants will receive financial incentives for submitting randomly generated drug-negative saliva tests across the intervention period.
• Sham Control — BEHAVIORAL
  Participants get access to the DynamiCare app but will not be provided with financial incentives.

Study Details

Combatting the rise of the opioid epidemic is a central challenge of U.S. health care policy. A promising approach for improving welfare and decreasing medical costs of people with substance abuse disorders is offering incentive payments for healthy behaviors. This approach, broadly known as "contingency management" in the medical literature, has repeatedly shown to be effective in treating substance abuse. However, the use of incentives by treatment facilities remains extremely low. Furthermore, it is not well understood how to design optimal incentives to treat opioid abuse. This project will conduct a randomized evaluation of two types of dynamically adjusting incentive schedules for people with opioid use disorders or cocaine use disorders: "escalating" schedules where incentive amounts increase with success to increase incentive power, and "de-escalating" schedules where incentive amounts decrease with success to improve incentive targeting. Both schemes are implemented with a novel "turnkey" mobile application, making them uniquely low-cost, low-hassle, and scalable. Effects will be measured on abstinence outcomes, including longest duration of abstinence and the percentage of negative drug tests. In combination with survey data, variation from the experiment will shed light on the barriers to abstinence more broadly and inform the understanding of optimal incentive design.

Key Dates

Start date

Sep 15, 2021

Status verified

Feb 2026

Primary completion

Sep 30, 2026

Completion

Sep 30, 2026

Study Design

Enrollment

600 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

SUPPORTIVE_CARE

Arms

• Active Comparator: Control
  Participants in this group will have access to the DynamiCare app; however, no behavioral incentives will be provided to this group.
• Experimental: Escalating Low
  Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every negative drug test up to a ceiling and "reset" to the lowest amount when a test is positive or missed. The "Low" group will receive incentives worth $2-$8.
• Experimental: Escalating High
  Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every negative drug test up to a ceiling and "reset" to the lowest amount when a test is positive or missed. The "High" group will receive incentives worth $4-$16.
• Experimental: De-Escalating Low
  Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every positive drug tests (up to a ceiling), and decrease by the same increment with every negative drug test (down to a floor). The "Low" group will receive incentives worth $6-12.
• Experimental: De-Escalating High
  Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every positive drug tests (up to a ceiling), and decrease by the same increment with every negative drug test (down to a floor). The "High" group will receive incentives worth $10-$20.
• Experimental: Constant High
  In the Constant groups, incentive amounts will remain unchanged across time. The "High" group will receive incentives worth $16.
• Experimental: Constant Low
  In the Constant groups, incentive amounts will remain unchanged across time. The "Low" group will receive incentives worth $8 every test.

Primary Outcome Measure

Percent of Negative Saliva Tests [ Time Frame: month 3 ]

Central Contacts

• Kevin Petranu
  414-293-9736
  [email protected]
• Mercedes Robaina, PhD
  813-352-9229
  [email protected]

Locations (2)

Find similar trials in Oconomowoc, WI

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