An intervention targeting service providers and clients for methadone maintenance treatment in China: a cluster‐randomized trial

Abstract

This study examines the preliminary outcomes of an intervention targeting service providers in methadone maintenance therapy (MMT) clinics in China. The intervention effects on both service providers and clients are reported. The MMT CARE intervention pilot was developed and implemented collaboratively with local health educators. After three group intervention sessions, trained providers in intervention clinics delivered two individual motivational interviewing sessions with their clients. Six clinics in Sichuan, China, were randomized to either the MMT CARE intervention condition or a standard care condition. A total of 41 providers and 179 clients were sampled from the six clinics. At baseline and three-, six-, and nine-month assessments, providers completed self-administrated paper/pencil questionnaires regarding provider-client interaction, MMT knowledge, perceived job-related stigma and clinic support. Clients completed a face-to-face survey about their concurrent drug use and drug avoidance self-efficacy. Mixed-effects regression models with clinic-level random effect were used to assess the intervention effects. Significant intervention effects for providers were found in improved MMT knowledge, provider-client interaction and perceived clinic support. For clients, better improvements in drug avoidance self-efficacy and reduced concurrent drug use were observed for the intervention compared with the standard care group. The MMT CARE intervention targeting providers in methadone maintenance clinics can improve providers' treatment knowledge and their interaction with clients. The intervention can also reduce clients' drug-using behavior through motivational interviewing sessions conducted by trained providers.