Project Summary
Despite the high prevalence of substance use disorders (SUDs), including opioid use disorder (OUD), among
people incarcerated in the US, only a small portion receive SUD treatment while incarcerated. One barrier is
limited evidence-based treatment availability in correctional facilities. Concerning OUD, though a growing
number of facilities are screening for OUD and providing medication for OUD (MOUD), supporting these
services across correctional facilities has been limited; adjunctive behavioral counseling to support MOUD
adherence and outcomes is recommended in clinical practice guidelines, but availability may be limited in
correctional facilities. Furthermore, correctional mental health staff report high burnout, which affects the
quality of care delivered. Digital therapeutics for SUDs—which may offer an accessible, low-cost, and low-
burden option for providing treatment—would be helpful in closing the gap between incarcerated individuals
with OUD and other SUD(s) who need treatment and services available in correctional facilities.
The proposed training plan and research project of this K23 application will provide mentored training to
support Dr. Jennifer Loya's pursuit of an independent research career conducting patient-oriented research
with dual expertise in substance use treatment and implementation science. The training goals focus on
gaining knowledge in implementation science methods, learning specific qualitative methods and respective
data analysis, and gaining experiencing in conducting a pilot clinical trial, as well as advancing career
development. Complementing these goals, Dr. Loya will receive mentorship from experts in these areas and
participate in structured didactic and experiential training through formal coursework and trainings/workshops,
attendance at seminars and annual conferences, and direct research activities.
The research plan aims to gain a comprehensive understanding of how an evidence-based digital
therapeutic of cognitive and behavioral skills for substance use—Computer Based Training for Cognitive
Behavioral Therapy (CBT4CBT)—could be effectively implemented as a treatment for incarcerated people with
current OUD/SUD. In Aim 1, attitudes and perceptions of using a digital therapeutic for SUDs and input
regarding barriers to and facilitators for implementing CBT4CBT will be assessed with qualitative individual
interviews among addiction treatment providers in two Connecticut correctional facilities. In Aim 2, with
implementation recommendations from providers incorporated, CBT4CBT will be implemented through a pilot
clinical trial among 50 incarcerated individuals with current OUD (primary), as well as other SUD(s), to examine
its feasibility and acceptability, as well as preliminary efficacy. Results of this project will inform future efforts to
modify and adapt CBT4CBT to enhance implementation and examine its efficacy as a pre-release intervention
to improve substance use outcomes post-release. Completion of the proposed training plan and research
project will optimally position Dr. Loya to pursue a career as an independent patient-oriented researcher.