Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Psychological Science, Northern Michigan University, Marquette, MI, United States.
Prev Med. 2023 Nov;176:107655. doi: 10.1016/j.ypmed.2023.107655. Epub 2023 Aug 3.
This study evaluated the effectiveness of abstinence-contingent wage supplements in promoting alcohol abstinence and employment in adults experiencing homelessness and alcohol use disorder. A randomized clinical trial was conducted from 2019 to 2022. After a 1-month Induction period, 119 participants were randomly assigned to a Usual Care Control group (n = 57) or an Abstinence-Contingent Wage Supplement group (n = 62). Usual Care participants were offered counseling and referrals to employment and treatment programs. Abstinence-Contingent Wage Supplement participants could earn stipends for working with an employment specialist and wage supplements for working in a community job but had to maintain abstinence from alcohol as determined by transdermal alcohol concentration monitoring devices to maximize pay. Abstinence-Contingent Wage Supplement participants reported significantly higher rates of alcohol abstinence than Usual Care participants during the 6-month intervention (82.8% vs. 60.2% of months, OR = 3.4, 95% CI 1.8 to 6.3, p < .001). Abstinence-Contingent Wage Supplement participants were also significantly more likely to obtain employment (51.3% vs. 31.6% of months, OR = 2.6, 95% CI 1.5 to 4.4, p < .001) and live out of poverty (38.2% vs. 16.7% of months, OR = 3.7, 95% CI 2.0 to 7.1, p < .001) than Usual Care participants. These findings suggest that Abstinence-Contingent Wage Supplements can promote alcohol abstinence and employment in adults experiencing homelessness and alcohol use disorder. ClinicalTrials.gov Identifier: NCT03519009.
这项研究评估了戒酒条件性工资补贴在促进无家可归和酗酒的成年人戒酒和就业方面的有效性。一项随机临床试验于 2019 年至 2022 年进行。在 1 个月的诱导期后，119 名参与者被随机分配到常规护理对照组（n=57）或戒酒条件性工资补贴组（n=62）。常规护理组的参与者接受咨询，并被转介到就业和治疗计划。戒酒条件性工资补贴组的参与者可以通过与就业专家合作和在社区工作中获得工资补贴来赚钱，但为了最大限度地获得报酬，他们必须通过透皮酒精浓度监测设备保持戒酒。在 6 个月的干预期间，戒酒条件性工资补贴组的参与者报告的酒精戒断率明显高于常规护理组（82.8% vs. 60.2%的月份，OR=3.4，95%CI 1.8 至 6.3，p<.001）。戒酒条件性工资补贴组获得就业的可能性也明显高于常规护理组（51.3% vs. 31.6%的月份，OR=2.6，95%CI 1.5 至 4.4，p<.001），摆脱贫困的可能性也更高（38.2% vs. 16.7%的月份，OR=3.7，95%CI 2.0 至 7.1，p<.001）。这些发现表明，戒酒条件性工资补贴可以促进无家可归和酗酒的成年人戒酒和就业。临床试验.gov 标识符：NCT03519009。
