Help us to learn if financial rewards paid directly to clinicians and front-line staff can improve client access and retention in treatment.
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Study Overview:
Building on Maine’s extensive experience with financial incentives, the overall goal of this study is to obtain a better understanding of the effects of financial incentives within addiction treatment programs. The study focuses on adults in outpatient (OP) and intensive outpatient (IOP) addiction treatment programs that receive payments from the Maine Office of Substance Abuse and Mental Health Services (SAMHS) under Maine’s incentivized contract.
The study is conducted by researchers at the Institute for Behavioral Health at Brandeis University, in collaboration with the SAMHS and with input from Maine’s Association of Substance Abuse Providers (MASAP) and others. The study is funded by the National Institute on Drug Abuse (NIDA), which is part of the National Institutes of Health. The study is not funded or conducted by SAMHS.
Phase 1 of the study included analysis of data from SAMHS studying the impact of the SAMHS incentivized contract on service delivery as well as program director interviews and a staff survey to examine how programs respond to incentives and approaches to quality improvement. You may have participated in the staff survey. Phase 2 is a study that considers incentive payments paid directly to eligible staff members for program level performance. Phase 2 will begin in February 2015 and will last for 1 year.
Purpose of this Research:
The goal of the study is to learn more about how programs and individuals respond to financial rewards in order to identify ways to improve addiction treatment. This part of the study will help us to learn if rewards paid directly to staff with direct client contact (e.g., clinicians, intake staff, receptionist, nurses, psychiatrists, etc.) can improve program performance. We also want to learn about what program directors and direct service staff think about this type of financial reward.
The reward payments, also called financial incentives or bonus payments, are based on the program’s performance, not individual clinician or staff performance. Within each agency, all staff members participating in the study will receive the same reward amount.
Who is eligible?
OP and IOP programs that treat adults and already have a program-level incentivized contract with SAMHS were invited to participate. Programs were randomized to be in the group where direct service staff could receive rewards or to be in the control group. Your program was selected to be in the group where you could receive rewards. You are asked to participate because you work at an eligible program, and your role within the program is to either (1) help individuals seeking substance abuse treatment to access counseling services at your program or (2) provide counseling to individuals who may have a substance use problem.
- Participation is voluntary, and you can withdraw from the study at any time.
- Neither your employer nor SAMHS will know if you chose to participate in the study or not, only the researchers at Brandeis will know of your decision.
What happens in this study?
You will be eligible to receive financial payments every 3 months based on how well your program is able to meet the performance targets and whether the program improved from baseline. We will use 3 performance measures that mirror what SAMHS is using for your program overall:
- time from first contact to first treatment (IOP and OP)
- percent of clients in treatment 4 or more days (IOP) or sessions (OP)
- percent of clients completing treatment (IOP) or staying 90 days or more (OP).
Each measure has a target performance level. See below for an example of targets and rewards for the 4+ sessions measure.
Using data from SAMHS, each quarter Brandeis will calculate how well your program was able to meet the target measures and how much your program improved from baseline. We will send you a report with this information, which may be helpful as you think about what you can do to help to improve your program’s performance on these measures. We will use the report to calculate how much of a payout you will receive (if any) for each measure, and in total for the quarter.
Payments will be issued to all participating staff on a quarterly basis and will be sent to the address you provided. We encourage you to use your home (or other) address, rather than a work address, to protect your confidentiality. You will be eligible to receive 4 payments that we estimate will range from $0 to $350, with a possibility of earning up to $2500 in a year, although we expect most will receive less. There is no penalty to you if your program does not meet targets or improve.
We will also ask you to complete two brief surveys, about 15 minutes long, at the beginning of the study and at the end of your participation (about 1 year later, or earlier should you leave your position or choose to withdraw from the study). You will receive $25 for each completed survey.
We don’t know the answer to our research question. We need your help!
To learn more about the study, please visit our website.
To speak with someone about the study:
Prior to the start of the study we will visit all eligible programs to invite staff members to participate. We will also be available to speak with you on an individual basis should you have any questions or concerns. Should you have any questions or concerns regarding the study or the surveys, please feel free to contact: Sharon Reif, PhD, the Principal Investigator, or Maureen Stewart, Project Director.
- Sharon Reif, PhD; 781-736-3924; reif@brandeis.edu
- Maureen Stewart, PhD; 781-736-3717; mstewart@brandeis.edu
If you have concerns about this study and would like to discuss them with someone who is not directly associated with the study, you may contact the Brandeis Committee for Protection of Human Subjects (BCPHS), which is the Institutional Review Board (IRB) at Brandeis University.
- Ms. Morgen Sarpeshkar
Institutional Review Board
Office of Research Administration
Brandeis University
415 South Street, Mailstop 116
Waltham, MA 02454
Phone: (781) 736-8133, Fax: (781) 736-2123
e-mail: irb@brandeis.edu
[NOTE: These are preliminary target levels]
