Effectiveness of a computerized motivational intervention on treatment initiation and substance use: Results from a randomized trial.

As many as 80% of the nearly five million adults under community supervision (i.e., probation, parole) are substance involved; however, treatment utilization is low. Using a multi-site randomized controlled trial, we tested the efficacy of in-person motivational interviewing (MI), a motivational computer intervention (MAPIT), or standard probation intake (SAU) to encourage treatment initiation among 316 substance-involved probationers in Dallas, Texas and Baltimore City, Maryland. Ninety-three percent (n=295) of participants completed the 2-month follow-up and 90% (n=285) completed the 6-month follow-up. At 2-months, individuals in the MAPIT condition were more likely to report treatment initiation compared to the SAU condition (OR=2.40, 95% CI=1.06, 5.47) via intent-to-treat analysis, especially among those completing both sessions (RE=0.50, 95% CI=0.05, 0.95) via instrumental variable analysis. At 6-months, MAPIT approached significance for treatment initiation in both analyses. MI did not achieve significance in any model. We did not find any differential impact on substance use. The success of MAPIT suggests that an integrated health-justice computerized intervention as part of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) can be used to address public safety and health issues.