A Chatbot Utilizing Machine Learning and Natural Language Processing to Implement the Brief Negotiation Interview to Improve Engagement in Buprenorphine Treatment Among Justice-Involved Individuals

Enrollment and Randomization:

Individuals meeting inclusion/exclusion criteria with the research associate (RA), who will be following a "Recruitment Script" (see below) will be offered participation and written informed consent will be obtained. Participants will be randomly assigned (via http://www.randomization.com) to receive either the BNI Chatbot or Standard Care (SC).

• SC: The RA will provide participants with an electronic link, which provides OUD and bup education, and lists OUD treatment options and descriptions and locations, including bup prescribers. After reviewing, participants will be asked to choose from among the list of and a referral will be made based on the receiving treatment providers' procedures. These participants will not have access to the BNI chatbot. However, the referral facilitation, the electronic link will direct participants to a short Feasibility, Acceptability and Satisfaction (FAS) Assessment to obtain feedback on the process.
• BNI Chatbot: Participants will receive a link to register for the chatbot. Following registration, they will complete the initial chat, which includes instructions for the entire study. The chatbot will then guide the participant through multiple BNIs focused on the goal of bup engagement, with the following steps: 1) Raise the Subject/Establish Rapport; 2) Enhance Motivation; 3) Provide & Elicit Feedback; and 4) Negotiate a Plan. The chatbot then reminds the participant of their reasons why they might engage in OUD treatment based on their responses to Steps 2 & 3, and their negotiated plan. The chatbot will electronically connect participants to a treatment provider of their choice, based on available options. Based on their choice, individuals in the BNI Chatbot group choosing to engage in bup treatment will be assessed by the Clinical Opiate Withdrawal Scale (COWS) and those in active withdrawal may be offered a telehealth appointment immediately (to the extent possible), which would occur during the enrollment and help facilitate a prescription for bup. The telehealth appointment may be with a different treatment provider than the one that they choose to meet with post-enrollment. If the participant is prescribed bup during this telehealth appointment, the RA will pick up the prescription for participant and deliver it to the participant immediately upon release from the police, courthouse or probation office (to the extent possible). At the end of the encounter, participants will be prompted to complete the feasibility, acceptability and satisfaction (FAS) assessment electronically to obtain feedback on the process.

Note: While participants are financially responsible for their own healthcare, we will only refer them to treatment options that are listed as being covered by their health insurance.

Baseline Assessment: Demographics and status of the participant's case in the criminal justice system will be collected by the RA via a mobile tablet.