Effect of a Nursing Outreach Intervention to Drug Users in Detroit, Michigan

Abstract

The aim of the National Institute on Drug Abuse Cooperative Agreement Project's Detroit site was to compare the effectiveness of two outreach interventions in decreasing the AIDS-related high-risk behaviors of active, injecting drug users and crack cocaine users not in treatment programs. A sample of 539 drug users, 70% males and 30% females, was selected from two high-risk neighborhoods. All subjects participated in two standard AIDS educational and counseling sessions. Half of the subjects then participated in an enhanced intervention—a nursing intervention called Personalized Nursing LIGHT Model. A regression model was used to compare the effects within the two study groups on: (a) number of times injecting heroin, (b) crack cocaine usage, and (c) number of episodes of unprotected sex during the preceding 30 days. The differences between the enhanced group's actual post-test behavior and the behavior predicted by standard treatment alone may be attributable to the addition of the enhanced treatment. The results show the differences are in the expected direction during year two of the study when program conditions were at their maximum, staff were on board and trained, and clients participated actively. Significant decreases were obtained for all three risky behaviors; for heroin, for crack, and for unprotected sex. A dosage measure, participation in addiction treatment (“Tuesday group”), was also significant. These results show that enhanced treatment adds to behavior improvement beyond the contribution of the standard intervention—when the treatment conditions are operating as planned.