Gender-based outcomes and acceptability of a computer-assisted psychosocial intervention for substance use disorders

Background: Digital technologies show promise for increasing treatment accessibility and improving quality of care, but little is known about gender differences. This secondary analysis uses data from a multi-site effectiveness trial of a computer-assisted behavioral intervention, conducted within NIDA's National Drug Abuse Clinical Trials Network, to explore gender differences in intervention acceptability and treatment outcomes. Methods: Men (n= 314) and women (n=192) were randomly assigned to 12-weeks of treatment-as-usual (TAU) or modified TAU. + Therapeutic Education System (TES), whereby TES substituted for 2. hours of TAU per week. TES is composed of 62 Web-delivered, multimedia modules, covering skills for achieving and maintaining abstinence plus prize-based incentives contingent on abstinence and treatment adherence. Outcomes were: (1) abstinence from drugs and heavy drinking in the last 4. weeks of treatment, (2) retention, (3) social functioning, and (4) drug and alcohol craving. Acceptability was the mean score across five indicators (i.e., interesting, useful, novel, easy to understand, and satisfaction). Results: Gender did not moderate the effect of treatment on any outcome. Women reported higher acceptability scores at week 4 (p= .02), but no gender differences were detected at weeks 8 or 12. Acceptability was positively associated with abstinence, but only among women (p= .01). Conclusions: Findings suggest that men and women derive similar benefits from participating in a computer-assisted intervention, a promising outcome as technology-based treatments expand. Acceptability was associated with abstinence outcomes among women. Future research should explore characteristics of women who report less satisfaction with this modality of treatment and ways to improve overall acceptability.