Factors related to client satisfaction with methadone maintenance treatment in China

Li, Li; Comulada, W. Scott; Lin, Chunqing; Hsieh, Julie; Luo, Sitong; Wu, Zunyou

doi:10.1016/j.jsat.2017.02.012

Cited by 10 publications

(19 citation statements)

References 36 publications

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“…Two level-1 evaluations are conducted. Figure 1a represents the model presented in Li et al (2017). A path from treatment progression to satisfaction is modeled at level 1 through progression () and variables measured at the patient level.…”

Section: Level-specific Fit Index Examples Using the Mmt Datamentioning

confidence: 99%

“…Stata’s generalized structural equation model (SEM) command () extends the capabilities of the SEM command () to fit multilevel SEM (Goldstein and McDonald 1988; Longford and Muthén 1992; Muthén 1994; Muthén and Satorra 1995) and related models to observations that are clustered across two or more levels of hierarchy. A motivating example is provided by Li et al (2017) in their mediation analysis (MA) of baseline data from a randomized controlled trial. The trial evaluated an intervention designed to improve patient care provided by Methadone Maintenance Treatment (MMT) clinics in China.…”

Section: Introductionmentioning

confidence: 99%

“…At present, fit indices are not produced by the command. No fit indices are presented by Li et al (2017).…”

Section: Introductionmentioning

confidence: 99%

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Calculating level-specific SEM fit indices for multilevel mediation analyses

Comulada

2021

The Stata Journal: Promoting communications on statistics and S

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Stata’s gsem command provides the ability to fit multilevel structural equation models (SEM) and related multilevel models. A motivating example is provided by multilevel mediation analyses (MA) conducted on patient data from Methadone Maintenance Treatment clinics in China. Multilevel MA conducted through the gsem command examined the mediating effects of patients’ treatment progression and rapport with counselors on their treatment satisfaction. Multilevel models accounted for the clustering of patient observations within clinics. SEM fit indices, such as the comparative fit index and the root mean squared error of approximation, are commonly used in the SEM model selection process. Multilevel models present challenges in constructing fit indices because there are multiple levels of hierarchy to account for in establishing goodness of fit. Level-specific fit indices have been proposed in the literature but have not been incorporated into the gsem command. I created the gsemgof command to fill this role. Model results from the gsem command are used to calculate the level-specific comparative fit index and root mean squared error of approximation fit indices. I illustrate the gsemgof command through multilevel MA applied to two-level Methadone Maintenance Treatment data.

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Section: Level-specific Fit Index Examples Using the Mmt Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Calculating level-specific SEM fit indices for multilevel mediation analyses

Comulada

2021

The Stata Journal: Promoting communications on statistics and S

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“…At the end of 2016, there were 789 MMT clinics with 162,000 clients in China (Office of China National Narcotics Control Commission, 2017). Despite its great effectiveness, the current MMT program is facing several challenges, such as dropout and suboptimal treatment satisfaction of MMT clients (Li, Comulada, Lin, Hsieh et al, 2017;. At the same time, MMT providers are reported to grapple with occupational burnout, which may be contributed to their negative feelings related to treating patients with substance dependence (Lin et al, 2010;Wu et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Stigma towards people who use drugs: A case vignette study in methadone maintenance treatment clinics in China

Luo

Lin

Feng

et al. 2019

International Journal of Drug Policy

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Background: Drug use stigma among service providers has been recognized as a barrier to improving the accessibility and outcomes of addiction treatment. This study examined the stigmatizing attitudes towards people who use drugs (PWUD) among service providers in methadone maintenance treatment (MMT) clinics in China and its associated factors. Methods: The cross-sectional study used the baseline data of a randomized intervention trial conducted in China, and the data were collected from January 2012 to August 2013. A total of 418 MMT service providers were included in the study. Stigma towards PWUD was measured via a 10-item scale embedded in two case vignettes (PWUD and non-PWUD). The Wilcoxon signed-rank test was performed to evaluate the vignette difference for each item of the scale. The linear mixed model was used to identify the adjusted association between drug use stigma and other interested variables including demographics, professional background, and MMT knowledge of the service providers. Results: The Wilcoxon signed-rank tests showed that the participants had a higher level of stigmatizing attitudes towards PWUD than non-PWUD (p-value < 0.001 for all items of the stigma scale). The linear mixed model identified that the reception of national MMT training was associated with a lower degree of drug use stigma (estimate=−1.79; 95% CI: −3.13, −0.45; p-value = 0.009). Conclusion: The findings of the study provide evidence of the existence of drug use stigma among MMT providers in China. The expansion of national-level training and the development of stigma reduction interventions are needed to address this issue.

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“…By the end of 2014, there were more than 300 MMT clinics providing services to 344,254 addicts [ 8 ]. Although the effectiveness of MMT has been demonstrated, its implementation still faces certain problems, including the high cost of MMT, a lack of psychotherapy, and the low dosage of methadone, which contributes to high rates of drop-out and relapse [ 9 , 10 ]. Together, these conditions suggest the need to develop new intervention strategies that meet the needs of people with drug addiction in China [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a Mobile Phone App to Support Recovery From Addiction in China: Secondary Analysis of a Pilot Study

Han

Zhang

Hser

et al. 2018

JMIR Mhealth Uhealth

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BackgroundMobile health technologies have been found to improve the self-management of chronic diseases. However, there is limited research regarding their feasibility in supporting recovery from substance use disorders (SUDs) in China.ObjectiveThe objective of this study was to examine the feasibility of a mobile phone-based ecological momentary assessment (EMA) app by testing the concordance of drug use assessed by the EMA, urine testing, and a life experience timeline (LET) assessment.MethodsA total of 75 participants dependent on heroin or amphetamine-type stimulant (ATS) in Shanghai were recruited to participate in a 4-week pilot study. Of the participants, 50 (67% [50/75]) were randomly assigned to the experimental group and 25 (33% [25/75]) were assigned to the control group. The experimental group used mobile health (mHealth) based EMA technology to assess their daily drug use in natural environments and received 2 short health messages each day, whereas the control group only received 2 short health messages each day from the app. Urine tests and LET assessments were conducted each week and a post-intervention survey was administered to both groups. The correlations among the EMA, the LET assessment, and the urine test were investigated.ResultsThe mean age of the participants was 41.6 (SD 8.0) years, and 71% (53/75) were male. During the 4 weeks of observation, 690 daily EMA survey data were recorded, with a response rate of 49.29% (690/1400). With respect to drug use, the percent of agreement between the EMA and the LET was 66.7%, 79.2%, 72.4%, and 85.8%, respectively, for each of the 4 weeks, whereas the percent of agreement between the EMA and the urine test was 51.2%, 65.1%, 61.9%, and 71.5%, respectively. The post-intervention survey indicated that 46% (32/70) of the participants preferred face-to-face interviews rather than the mHealth app.ConclusionsThis study demonstrated poor agreement between the EMA data and the LET and found that the acceptance of mHealth among individuals with SUDs in China was not positive. Hence, greater efforts are needed to improve the feasibility of mHealth in China.

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Factors related to client satisfaction with methadone maintenance treatment in China

Cited by 10 publications

References 36 publications

Calculating level-specific SEM fit indices for multilevel mediation analyses

Calculating level-specific SEM fit indices for multilevel mediation analyses

Stigma towards people who use drugs: A case vignette study in methadone maintenance treatment clinics in China

Feasibility of a Mobile Phone App to Support Recovery From Addiction in China: Secondary Analysis of a Pilot Study

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