Healthy Activities for Prize Incentives
| Status: | Completed |
|---|---|
| Conditions: | HIV / AIDS, Psychiatric |
| Therapuetic Areas: | Immunology / Infectious Diseases, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 12/27/2018 |
| Start Date: | September 2008 |
| End Date: | May 2013 |
In this Stage 1 therapy development project, we plan to develop, formalize, and derive effect
size estimates of a contingency management (CM) therapy that focuses on improving health,
especially as related to increasing low intensity physical activities, such as walking,
resistance training, and stretching. The Healthy Activities for Prize Incentives (HAPI)
intervention will be targeted toward and tested within HIV-positive substance abusers who
attend HIV drop-in centers. After initial therapy development in a Stage 1a pilot project
with 9 patients, the therapy manuals and materials will be adapted and refined. In a Stage 1b
controlled trial, we will recruit and randomize 70 substance abusing HIV-positive patients to
(a) HAPI plus 12-step facilitation therapy or (b) contingency management for abstinence plus
12-step facilitation therapy. Each intervention will consist of one weekly individual therapy
session for 16 weeks. All participants will provide urine and breath specimens twice weekly
that will be tested for opioids, cocaine, methamphetamine, marijuana and alcohol. Patients in
both conditions will earn the chance to win prizes for submitting drug-negative specimens,
and those randomized to the HAPI condition will also earn the chance to win prizes for
engaging in healthy activities. Physical activity levels, drug use, psychological symptoms,
and subjective and objective indicators of health (body mass index, waist circumference,
blood pressure, viral load) will be measured pre-treatment and at months 2 and 4
(post-treatment), as well as at a 7-month (3 months after treatment) follow-up evaluation.
Compared to those receiving 12-step facilitation with contingency management for abstinence,
we expect that those in the HAPI condition will participate in more physical activities,
decrease drug use to a greater extent, evidence reduced depression, and show trends toward
improvements in health indices. If effect sizes in at least the small to medium range are
noted across all domains, we will consider the therapy appropriate for further evaluation in
a Stage 2 therapy development study.
size estimates of a contingency management (CM) therapy that focuses on improving health,
especially as related to increasing low intensity physical activities, such as walking,
resistance training, and stretching. The Healthy Activities for Prize Incentives (HAPI)
intervention will be targeted toward and tested within HIV-positive substance abusers who
attend HIV drop-in centers. After initial therapy development in a Stage 1a pilot project
with 9 patients, the therapy manuals and materials will be adapted and refined. In a Stage 1b
controlled trial, we will recruit and randomize 70 substance abusing HIV-positive patients to
(a) HAPI plus 12-step facilitation therapy or (b) contingency management for abstinence plus
12-step facilitation therapy. Each intervention will consist of one weekly individual therapy
session for 16 weeks. All participants will provide urine and breath specimens twice weekly
that will be tested for opioids, cocaine, methamphetamine, marijuana and alcohol. Patients in
both conditions will earn the chance to win prizes for submitting drug-negative specimens,
and those randomized to the HAPI condition will also earn the chance to win prizes for
engaging in healthy activities. Physical activity levels, drug use, psychological symptoms,
and subjective and objective indicators of health (body mass index, waist circumference,
blood pressure, viral load) will be measured pre-treatment and at months 2 and 4
(post-treatment), as well as at a 7-month (3 months after treatment) follow-up evaluation.
Compared to those receiving 12-step facilitation with contingency management for abstinence,
we expect that those in the HAPI condition will participate in more physical activities,
decrease drug use to a greater extent, evidence reduced depression, and show trends toward
improvements in health indices. If effect sizes in at least the small to medium range are
noted across all domains, we will consider the therapy appropriate for further evaluation in
a Stage 2 therapy development study.
Inclusion Criteria:
- HIV+ and a member of Connections
- Age 18-65 years
- English speaking
- Past-year DSM-IV diagnosis of opioid, cocaine, methamphetamine, alcohol, or marijuana
abuse or dependence
- Written permission from one's primary care or infectious disease physician to
participate in the study and an exercise program
- Plans to reside in the local area for the next 8 months and
- Willing to sign informed consent
Exclusion Criteria:
- Inability to comprehend the study as assessed by the Informed Consent Quiz and
Mini-Mental Status Exam (MMSE)
- Severely disruptive behavior
- In recovery for pathological gambling (due to potential similarity between the
contingency management procedure and gambling)
- Serious uncontrolled psychiatric disorder other than substance use disorders that
require inpatient hospitalization (e.g., active bipolar disorder, psychosis, suicidal)
- History of myocardial infarction, stroke, unstable angina, coronary artery bypass
grafting, angioplasty/stent, uncontrolled arrhythmia, or hyperthyroidism in the past 6
months as reported by patient or physician
- Blood pressure >165/95 mmHg and
- Grossly abnormal findings on indices of physical functioning (>2 SDs above means for
sedentary age/gender norms according to ACSM, 2006)
- Pregnancy
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