Does change in readiness influence retention among African American women and men in substance abuse treatment?

African Americans are less likely than other racial groups to engage in and complete outpatient substance abuse treatment. This secondary analysis of CTN-0004 examined whether Readiness to Change (RTC) over time influences retention and whether gender moderates the relationship between changes in RTC and retention among 194 African American women and men.

Participants completed the University of Rhode Island Change Assessment at baseline and at the end of the 16-week study. Positive increases in RTC from baseline to week 16 were associated with higher retention rates among African American substance users. This finding is consistent with the stage-of-change model suggesting that the emergence of positive behaviors may be associated with an increasing motivation (i.e., readiness) to change maladaptive behaviors. While previous research supports the stage-of-change model by demonstrating a link between initial readiness to change and retention, these findings further contribute to the model by providing convincing evidence that an increase in readiness to change is also associated with treatment retention.

The study also suggests that change in RTC is another factor that differentially influences retention for African American women and men. Nevertheless, additional research is needed to examine why change in RTC is more strongly associated with retention among African American men.

Conclusions: Consideration of changes in RTC during treatment may help to improve retention among African American substance users, especially men, and will contribute to the reduction of racial/ethnic health disparities found in rates of substance abuse treatment completion.

Related protocols: CTN-0004