Prediction of Retention in Methadone Maintenance in a Contextual Model

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Abstract
This study investigated predictors of drug treatment retention of individual clients in terms of a contextual model. The model involved eight components: 1) socioecological factors, 2) clinic attributes, 3) clinic staffing and services, 4) clinic sociodemographic (aggregate) characteristics, 5) clinic deviance (aggregate) characteristics, 6) individual level client sociodemographic characteristics, 7) individual level client deviance characteristics, and 8) individual level client retention outcomes (time in treatment and quit or expelled termination status). The components were represented in the study by variables developed from census data, and National Institute of Drug Abuse (NIDA) CODAP and NDATUS data bases. This model was analyzed by path analysis for clients in methadone maintenance programs. There was consistent support for the relationships expected among the components of the model. The socioecological variables predicted the types of clients that entered treatment in terms of clinic level (aggregate) variables, and these were found to predict both the corresponding individual level client variables and client outcomes. Clinic attributes were found to predict clinic staffing and services and both of these components were found to be related to client outcomes in several analyses.

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