Abstract
INTRODUCTION: Substance use disorder (SUD) treatment effectiveness relies on service continuity during care transitions (e.g., residential to outpatient). Motivational Enhancement for Engagement in Treatment (MEET) is a structured engagement-focused intervention designed to improve service utilization. This study tests the real-world effectiveness of MEET for individuals transitioning between SUD treatment settings. METHODS: Individuals receiving withdrawal management and residential SUD treatment in the San Diego County Behavioral Health Services Drug Medi-Cal Organized Delivery System between March 2021-January 2022 were included in this study. We used logistic regression via generalized estimating equations to calculate adjusted odds ratios (AORs) and 95 % confidence intervals (CIs) that accounted for clustering within treatment facilities and individuals, and stabilized inverse probability of treatment weighting (IPTW) of baseline covariates to assess the probability of connecting to step-down SUD treatment given intervention status (MEET or treatment as usual). We also assessed the probability of timely connection to step-down treatment (i.e., within 10 days of discharge). RESULTS: Of 10,011 participants in this quasi-experimental study, 141 (1.4 %) received MEET. Participants who received MEET were more likely to be connected to SUD treatment (AOR=1.79, 95 % CI: 1.11, 2.90) and of being connected in ≤ 10 days (AOR=1.65, 95 % CI: 1.01, 2.70) than participants who did not receive the intervention. CONCLUSIONS: Among individuals with a SUD, MEET demonstrated real-world effectiveness for improving connections to step-down care, with participants receiving the intervention having nearly twice the odds of timely connection. This indicates practical engagement-based interventions can improve SUD treatment continuity across care transitions.