Disclosure Intervention for People in Recovery From Opioid Use Disorder

Not Applicable

Completed

Brief Summary: Many people with substance use disorders struggle with decisions regarding whether to disclose to others that they have a history of substance use and/or are in recovery. Yet, these decisions are important because disclosures can lead to reactions from others that harm or help recovery. For example, stigmatizing responses can harm the mental health of people in recovery whereas supportive responses can strengthen people's commitment to their sobriety. We have developed a brief intervention to help people decide whether and how to tell others about their recovery as well as build skills for disclosure. The purpose of this study is to pilot test this intervention and test its acceptability and feasibility as well as determine if it shows preliminary signs of efficacy in comparison to a control condition. We hypothesize that: (1) participants exposed to the intervention condition will agree that the intervention is acceptable and feasible, and (2) participants in the intervention condition will report higher quality decision making in comparison to participants in the control condition.

Detailed Description: Data will be collected from participants at two time points, spaced one month apart. All participants will be recruited from the waiting room at a local treatment center. The research assistant will screen interested individuals for eligibility in person and schedule study appointments, which may be coordinated with treatment appointments. All study screening and appointments will be conducted in private spaces at the treatment center. At the first study appointment, the research assistant will introduce the study, check for questions, and obtain consent for the study procedures, medical record review, and follow up procedures. Participants will be randomly assigned to receive either the disclosure intervention or a control intervention (i.e., an evidence-based mindfulness intervention). Following the intervention, participants will complete measures of acceptability, feasibility, and decision quality. At the second study appointment, participants will again be asked to respond to survey and interview questions designed to further evaluate the preliminary efficacy of the intervention. In particular, we will investigate whether participants who completed our disclosure intervention report better relationship outcomes than participants who completed the control condition.

Recruitment & Eligibility

Inclusion Criteria

18 years or older
currently receiving outpatient treatment at the recruitment site
are considering disclosing their recovery status to at least one person in the next month
have access to a phone that can receive text messages and phone calls

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Control Arm	Mindfulness	Participants will be able to choose from several guided meditations to promote mindfulness.

Primary Outcome Measures

Name	Time	Method
Decision Making Quality	Assessed immediately following intervention delivery, at time 1 study appointment.	Measured informed by recommendations for evaluating patient decision aids (Sepucha et al., 2013), focused on recognition of decision. Mean scores range 1-5, with higher scores indicating greater decision making quality.
Feasibility of Intervention	Assessed immediately following intervention delivery, at time 1 study appointment.	Measured with Feasibility of Intervention Measure (adapted from Weiner et al., 2017). Mean scores range 1-5, with higher scores indicating greater feasibility.
Acceptability of Intervention	Assessed immediately following intervention delivery, at time 1 study appointment.	Measured with Acceptability of Intervention Measure (adapted from Weiner et al., 2017). Mean scores range 1-5, with higher scores indicating greater acceptability.

Secondary Outcome Measures

Name	Time	Method
Commitment to Sobriety	Second study appointment out of two. Second appointment took place approximately one month after first study appointment.	Measured with Commitment to Sobriety Scale (Kelly \& Greene, 2014); Mean scores range 1-6, higher scores indicate greater commitment to sobriety.
Social Support	Second study appointment out of two. Second appointment took place approximately one month after first study appointment.	Measure adapted from Medical Outcomes Study Social Support Survey (Moser et al., 2012); Mean scores range 1-5, higher scores indicate more social support.
Enacted Stigma	Second study appointment out of two. Second appointment took place approximately one month after first study appointment.	Measure adapted from Methadone Maintenance Treatment Stigma Mechanisms Scale (Smith et al., 2019); Mean scores range 1-5, higher scores indicate greater stigma.