Incentives for retention of pregnant substance users: A secondary analysis.

Retention of pregnant substance users in treatment is challenging. In a multisite clinical trial conducted in the National Drug Abuse Treatment Clinical Trials Network (protocol CTN-0013), 200 pregnant substance users entering outpatient treatment at one of four programs were randomized to either three individual sessions of Motivational Enhancement Therapy for Pregnant Substance Users or three individual sessions normally provided. Gift certificates for local retail stores (from $25 to $30) were provided for attendance of research visits but not treatment visits. A post hoc analysis of the non-methadone-maintained participants (n=175) evaluated the hypothesis that monetary reinforcement for attendance would result in more consecutive, and overall, weeks of attendance of research versus nonincentivized treatment visits. Findings indicate participants were nearly three times as likely to attend four consecutive weeks of research visits versus treatment sessions. There was no effect for income, but additional analyses indicated that greater attendance of research visits, compared with treatment visits, was associated with having fewer dependents, which might indicate that the gift certificates were more reinforcing for those for whom the burden of attendance was less. In conclusion, it appears that incentives in the $25-$30 range may serve to significantly increase attendance and retention. The savings, both humanitarian and monetary, make this an important area for future research.

Related protocols: CTN-0013