Quality of Research
Review Date: February 2011
Documents Reviewed
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted.
Study 1Jason, L. A., Olson, B. D., Ferrari, J. R., Majer, J. M., Alvarez, J., & Stout, J. (2007). An examination of main and interactive effects of substance abuse recovery housing on multiple indicators of adjustment. Addiction, 102(7), 1114-1121. 
Supplementary Materials Jason, L. A., Davis, M. I., & Ferrari, J. R. (2007). The need for substance abuse after-care: Longitudinal analysis of Oxford House. Addictive Behaviors, 32(4), 803-818.
Jason, L. A., Ferrari, J. R., Freeland, M., Danielewicz, J., & Olson, B. D. (2005). Observing organizational and interaction behaviors among mutual-help recovery home members. International Journal of Self-Help and Self-Care, 3(1-2), 117-132.
Jason, L. A., Olson, B. D., Ferrari, J. R., & Lo Sasso, A. T. (2006). Communal housing settings enhance substance abuse recovery. American Journal of Public Health, 96(10), 1727-1729.
Majer, J. M., Jason, L. A., & Olson, B. D. (2004). Optimism, abstinence self-efficacy, and self-mastery: A comparative analysis of cognitive resources. Assessment, 11(1), 57-63.
McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment, 9(3), 199-213.
Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72(2), 271-324.
Outcomes
| Outcome 1: Substance use |
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Description of Measures
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Substance use was measured by the alcohol and drug use items from the Addiction Severity Index (ASI) Lite. The ASI Lite is a shortened version of the ASI, a semistructured interview instrument that measures problems and their severity in the following life domains: medical, employment, alcohol and drug use, legal, family/social, and psychiatric. Unlike the ASI, the ASI Lite does not include items relating to severity ratings and a family history grid. Study participants were asked whether they had consumed any alcohol or used any drugs during the prior 6 months (a dichotomous measure of substance use versus nonuse, or abstinence). Assessments were completed at baseline (2-3 days prior to discharge from an inpatient substance abuse treatment program) and at 6-month intervals for 2 years after inpatient treatment discharge (i.e., at 6-, 12-, 18-, and 24-month follow-ups). In addition, at the 24-month follow-up, each participant's self-reported substance use or nonuse was corroborated by a report from a "collateral," a person who is part of the participant's support network and has been rated by the participant as being most important in his or her life. If the collateral reported alcohol or drug use by the participant, but the participant reported no use, the response was coded as "using" for the outcome measure.
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Key Findings
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In a 2-year clinical trial, clients in an inpatient substance abuse treatment program were randomly assigned to an aftercare condition: the Oxford House Model or usual aftercare, which included placement into a relative's home, a staffed recovery home, a partner's or spouse's home, their own home or apartment, a homeless shelter, a substance abuse treatment program, or a friend's home. Findings from the study included the following:
- Across the 24-month follow-up period, participants receiving usual aftercare were more likely to report any substance use compared with those living in an Oxford House (p < .01). This group difference was associated with a very small effect size (odds ratio = 1.41).
- At the 24-month follow-up, the percentage of participants reporting any substance use was higher for those living in an Oxford House for fewer than 6 months compared with those living in an Oxford House for at least 6 months (45.7% vs. 15.6%; p < .05). This length-of-stay difference was associated with a small effect size (odds ratio = 1.59).
- Also at the 24-month follow-up, the percentage of young participants (≤36 years old) reporting any substance use was higher for those living in an Oxford House for fewer than 6 months compared with young participants living in an Oxford House for at least 6 months (62.5% vs. 6.7%; p < .05). This difference (age by length of stay) was associated with a small effect size (odds ratio = 2.46).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.3
(0.0-4.0 scale)
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| Outcome 2: Self-control tendencies |
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Description of Measures
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Self-control tendencies were measured by the Self-Control Scale, a 36-item instrument that assesses each participant's current state regarding his or her ability to regulate impulses or alter behavior, thoughts, and emotions. Study participants rated each item using a scale ranging from 1 (not at all like me) to 5 (very much like me). Example scale items are "I am good at resisting temptation," "I have a hard time breaking bad habits," and "I say inappropriate things." Ratings for each item were summed to produce a total score, and lower total scores reflect better current self-control tendencies. Assessments were completed at baseline (2-3 days prior to discharge from an inpatient substance abuse treatment program) and at 6-month intervals for 2 years after inpatient treatment discharge (i.e., at 6-, 12-, 18-, and 24-month follow-ups).
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Key Findings
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In a 2-year clinical trial, clients in an inpatient substance abuse treatment program were randomly assigned to an aftercare condition: the Oxford House Model or usual aftercare, which included placement into a relative's home, a staffed recovery home, a partner's or spouse's home, their own home or apartment, a homeless shelter, a substance abuse treatment program, or a friend's home. Findings from the study included the following:
- Across the 24-month follow-up period, the trend in total scores on the Self-Control Scale indicated that participants living in an Oxford House had better self-control tendencies than those receiving usual aftercare (p < .01).
- Also across the 24-month follow-up period, the trend in total scores on the Self-Control Scale indicated that young participants (≤36 years old) living in an Oxford House for at least 6 months had better self-control tendencies than young participants living in an Oxford House for fewer than 6 months (p < .05).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.3
(0.0-4.0 scale)
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| Outcome 3: Employment status |
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Description of Measures
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Employment status was measured by the employment items from the ASI Lite. The ASI Lite is a shortened version of the ASI, a semistructured interview instrument that measures problems and their severity in the following life domains: medical, employment, alcohol and drug use, legal, family/social, and psychiatric. Unlike the ASI, the ASI Lite does not include items relating to severity ratings and a family history grid. The primary employment item asked study participants whether they had been engaged in full- or part-time work in the prior 30 days. Assessments were completed at baseline (2-3 days prior to discharge from an inpatient substance abuse treatment program) and at 6-month intervals for 2 years after inpatient treatment discharge (i.e., at 6-, 12-, 18-, and 24-month follow-ups).
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Key Findings
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In a 2-year clinical trial, clients in an inpatient substance abuse treatment program were randomly assigned to an aftercare condition: the Oxford House Model or usual aftercare, which included placement into a relative's home, a staffed recovery home, a partner's or spouse's home, their own home or apartment, a homeless shelter, a substance abuse treatment program, or a friend's home. Findings from the study included the following:
- Across the 24-month follow-up period, participants living in an Oxford House were more likely to report being employed during the 30 days prior to each 6-month assessment compared with those receiving usual aftercare (p < .005). This group difference was associated with a very small effect size (odds ratio = 1.40).
- Also across the 24-month follow-up period, young participants (≤36 years old) living in an Oxford House for at least 6 months were more likely to report being employed during the 30 days prior to each 6-month assessment compared with young participants living in an Oxford House for fewer than 6 months (p < .05). This difference (age by length of stay) was associated with a medium effect size (odds ratio = 4.35).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.4
(0.0-4.0 scale)
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| Outcome 4: Awaiting criminal charges |
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Description of Measures
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Awaiting criminal charges was measured by the criminal justice item from the ASI Lite. The ASI Lite is a shortened version of the ASI, a semistructured interview instrument that measures problems and their severity in the following life domains: medical, employment, alcohol and drug use, legal, family/social, and psychiatric. Unlike the ASI, the ASI Lite does not include items relating to severity ratings and a family history grid. The criminal justice item asked study participants whether they were currently awaiting charges or had charges pending for a criminal activity in the prior 30 days. Assessments were completed at baseline (2-3 days prior to discharge from an inpatient substance abuse treatment program) and at 6-month intervals for 2 years after inpatient treatment discharge (i.e., at 6-, 12-, 18-, and 24-month follow-ups).
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Key Findings
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In a 2-year clinical trial, clients in an inpatient substance abuse treatment program were randomly assigned to an aftercare condition: the Oxford House Model or usual aftercare, which included placement into a relative's home, a staffed recovery home, a partner's or spouse's home, their own home or apartment, a homeless shelter, a substance abuse treatment program, or a friend's home. Findings from the study included the following:
- Across the 24-month follow-up period, participants receiving usual aftercare were more likely to be awaiting charges for a criminal activity in the 30 days prior to each 6-month assessment compared with those living in an Oxford House (p < .001). This group difference was associated with a medium effect size (odds ratio = 2.94).
- At the 12-month follow-up, the percentage of young participants (≤36 years old) awaiting charges for a criminal activity in the prior 30 days was smaller for those living in an Oxford House for at least 6 months compared with young participants living there for fewer than 6 months (0% vs. 8.3%; p < .05). This difference (age by length of stay) was associated with a medium effect size (odds ratio = 3.52). At the 18- and 24-month follow-ups, no young participants living in an Oxford House were awaiting charges for a criminal activity in the prior 30 days, regardless of their length of stay.
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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2.4
(0.0-4.0 scale)
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Study Populations
The following populations were identified in the studies reviewed for Quality of
Research.
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Study
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Age
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Gender
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Race/Ethnicity
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Study 1
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26-55 (Adult)
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62% Female
38% Male
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77.3% Black or African American
11.3% White
8% Hispanic or Latino
3.4% Race/ethnicity unspecified
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Quality of Research Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
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Outcome
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Reliability
of Measures
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Validity
of Measures
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Fidelity
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Missing
Data/Attrition
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Confounding
Variables
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Data
Analysis
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Overall
Rating
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1: Substance use
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2.5
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2.5
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1.0
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3.0
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2.5
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2.5
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2.3
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2: Self-control tendencies
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2.0
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2.5
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1.0
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3.0
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2.5
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3.0
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2.3
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3: Employment status
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2.5
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2.5
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1.0
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3.0
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2.5
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3.0
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2.4
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4: Awaiting criminal charges
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2.5
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2.5
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1.0
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3.0
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2.5
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3.0
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2.4
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Study Strengths The ASI Lite is very well established in the field and has strong psychometric properties. The Self-Control Scale has strong psychometric properties in studies with college students. The investigators obtained collateral report verification of prior 6-month substance use or nonuse at the final, 24-month follow-up, and the selected outcomes of employment status and awaiting criminal charges are important indicators of life stability. The attrition rate was very low across follow-up assessments, and random assignment controlled for many confounding variables. The study used an appropriate intent-to-treat approach and statistical modeling to address missing data, control for demographic variables, and incorporate the effects of age, psychiatric comorbidity, and length of stay on the outcomes in the intervention group.
Study Weaknesses Scores for responses to individual items from the ASI Lite were used, which differs from the instrument's designed use (i.e., to provide composite scores); there was no sample-based psychometric support to justify this modification. The absence of independent verification limits the validity of the self-report measures for employment status and awaiting criminal charges, and the collateral verification of the substance use self-report measure occurred only at the final, 24-month follow-up. No intervention fidelity measurement was used to evaluate what occurred therapeutically in each Oxford House or to determine intervention constancy across the multiple Oxford Houses participating in the study. The study lacked an alternative form of controlled housing (e.g., a therapeutic community) as a comparison, weakening a direct attribution of the outcomes to the Oxford House Model. Although hierarchical linear modeling of the data was used to provide a general trend analysis for each group (Oxford House vs. usual aftercare) over the entire 24-month follow-up period, there was no between-group testing at individual follow-up assessments (i.e., at 6-, 12-, and 18-month follow-ups), except for the final, 24-month follow-up.
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