Acceptability of a web-based psychosocial intervention among American Indian/Alaska Native substance users: Implications for dissemination.

Long standing disparities in substance use and treatment access exist among American Indian/Alaska Native (AI/AN) communities. A web-delivered intervention could address some of the access barriers and improve service delivery. The purpose of this CTN platform study was to assess the acceptability of the Therapeutic Education System (TES), a web-based version of the Community Reinforcement Approach, among AI/AN men and women enrolled in outpatient substance abuse treatment. Acceptability was measured by (a) proportion of participants who agreed to participate; (b) treatment retention; and (c) participant feedback collected after each TES module across seven acceptability indicators. Sixty-eight clients were approached for the study and 40 enrolled (58.8%). Participants completed an average of 19.5 modules. Results indicate high acceptability across seven indicators: interesting (M=8.3), useful (M=8.5); introduction of new material (M=8.3), easy to understand (M=7.4); satisfaction (M=8.5); relevance (M=8.4), and overall likability (M=8.2). Efficacious interventions often require context or population-specific adaptation to maintain effectiveness during implementation. Overall, these findings suggest that core TES content is acceptable among a diverse AI/AN client population who agreed to participate. Initial, lower acceptance rates may indicate that web-based interventions need more comprehensive introduction. Acceptability may improve for several modules with greater visibility and integration of AI/AN-specific culture.

Related protocols: CTN-0044-A-2