VanDeMark et al. Substance Abuse Treatment, Prevention, and Policy 2010, 5:10 http://www.substanceabusepolicy.com/content/5/1/10 Open Access RESEARCH © 2010 VanDeMark et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Com- mons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduc- tion in any medium, provided the original work is properly cited. Research An exploratory study of engagement in a technology-supported substance abuse intervention Nancy R VanDeMark* 1 , Nicole R Burrell 2 , Walter F LaMendola 1 , Catherine A Hoich 3 , Nicole P Berg 2 and Eugene Medina 3 Abstract Background: The continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings. Methods: This study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed. Results: The data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community. Conclusions: The authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions. Additional investigation into ways technology may be useful to enhance treatment access for certain subgroups is needed. Background Nationally, the demand for substance use disorder treat- ment in publicly funded systems far exceeds the available capacity. In 2008, over 20 million people who needed treatment for alcohol or illicit drug abuse or dependence were unable to access this needed service [1]. As a result of this gap between treatment demand and capacity, pro- viders often establish waiting lists. Moreover, the motiva- tion of people in need of substance use disorder treatment often fluctuates, resulting in lack of initiation of treatment and dropouts early in treatment. Motivational Interviewing [2,3] has demonstrated effectiveness in improving engagement and retention in substance use disorder treatment by tailoring interven- tions to each individual client's readiness to change. Nev- ertheless, motivational interviewing relies on individualized, face-to-face interactions that are often neither economically nor geographically sustainable. With similar aims to Motivational Interviewing, Persua- sive Technology combines intentional persuasion prac- * Correspondence: nancy.vandemark@du.edu 1 Graduate School of Social Work, University of Denver, 2148 South High Street, Denver, CO 80208, USA Full list of author information is available at the end of the article