Remotely Administered Incentive-Based Treatment for Alcohol Use Disorder With Participant-Funded Incentives is Effective but Less Accessible to Low-Income Participants

Mikhail Koffarnus, Anita S. Kablinger, Brent A. Kaplan, Elisa M. Crill

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

The delivery of monetary incentives contingent on verified abstinence is an effective treatment for alcohol use disorder. However, incentive cost has often been cited as a barrier to delivering this type of treatment. In the present randomized parallel groups trial, we systematically replicated a previous trial we conducted that employed remote alcohol monitoring and incentive delivery to promote abstinence from alcohol, but with the additional requirement for participants to partially self-fund their abstinence incentives. Treatmentseeking participants with alcohol use disorder (n = 92) who met inclusion criteria (n = 36) were randomized to either a Contingent or Noncontingent group (n = 18 each). Those not meeting inclusion criteria included 15 participants who agreed to the deposit requirement but failed to make the deposit payment. The Contingent group received nearly immediate monetary incentives each day they remotely provided negative breathalyzer samples. The Noncontingent group received matched incentives each day they successfully provided samples independent of alcohol content. Days abstinent in the Contingent group were 86%, which was significantly higher than the 44% recorded in the Noncontingent group, corresponding to an odds ratio of 8.2. Exploratory analyses revealed that the deposit requirement prevented participation in those with lower incomes and those with greater alcohol use. These results support the efficacy of this remotely deliverable alcohol abstinence reinforcement incentive intervention with a deposit requirement. However, the requirement to provide a monetary deposit to self-fund abstinence incentives may prevent those with greater alcohol use and/or those experiencing extreme poverty from participating in the intervention.

Original languageEnglish
Pages (from-to)555-565
Number of pages11
JournalExperimental and Clinical Psychopharmacology
Volume29
Issue number5
DOIs
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 American Psychological Association

Keywords

  • alcohol use disorder
  • contingency management
  • deposit contracts
  • incentives
  • poverty

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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