Real‐World Implementation of Contingency Management and Benefits of a Controlled Environment “Head Start”
Bibliographic record
Abstract
OBJECTIVES: To use quality improvement (QI) principles to implement contingency management (CM) in an outpatient clinic. METHODS: Prize-based CM was implemented for stimulant use disorder using standard protocols with QI processes used to improve efficiency and effectiveness. RESULTS: CM was successfully implemented in an outpatient addictions clinic using clinical funds. Participants who were discharged to the outpatient clinic from a controlled environment (such as hospital, withdrawal management, residential treatment program) had 8.3 (SD = 3.1) weeks of consecutive abstinence (CA) and 10.7 (SD = 1.0) weeks total abstinence. CONCLUSIONS: Pragmatic clinical implementation of CM yielded results that are comparable to controlled trials in similar populations. QI processes identified that a controlled environment resulted in significant ongoing abstinence.CM was implemented in a small community clinic with no additional funding, and QI principles were used to improve efficiency and effectiveness. The initial implementation of 17 participants yielded a mean of 2.2 (SD = 3.2) weeks of CA. Recent discharge from a controlled environment resulted in 8.3 (3.1) weeks CA.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".