Procedure

Medicaid recipients meeting the criteria were called by trained research assistants and invited to participate in a research survey about their interest in and evaluation of specific types of services. The survey was administered using a web-based, semi-structured script to guide the interviewer and was audio recorded with the verbal consent of the participant. The researcher gathered basic demographic information, including age, gender, living situation, and method of transportation for attending prescriber appointments. Next, the researcher described 2 treatments in counterbalanced order; in-person CAT (called In-person Wellness Support) or R-CAT (called Remote Wellness Support). In-person CAT was described as a wellness program using environmental supports delivered to the home by the provider on weekly visits and text messages between visits to assist individuals with taking medication and attending medical appointments, coping with stress, anger and sadness, and working toward recovery goals. Remote CAT was described as a wellness program with the same goals. In remote delivery, environmental supports would be mailed to the participants. We explained that in R-CAT, reasons for specific supports, where to place them, and how to use them would be discussed during weekly video visits.

For both treatments, the types of supports participants might receive and their behavioral targets were described in the same manner. The order of presentation of the treatments was randomized to allow us to examine any effects of order on acceptance of treatments. Questions were asked throughout treatment descriptions to ensure understanding on the part of the participant. Following a description of each service, the researcher asked 3 open-ended questions regarding the participant’s general impressions of the treatment, what the respondent liked and what the respondent disliked about the treatment. Following these open-ended questions, participants were asked whether they would accept and participate in the service if it were available that day at no cost. After both services were described and discussed, participants were then asked to state a preference for either 1, both, or neither treatment. Finally, participants were asked to state the extent to which they agreed or disagreed with a series of statements describing characteristics of CAT and R-CAT. Comments were scored on a series of Likert scales from completely disagree to completely agree. Participants were sent a $10 gift card to compensate them for their time participating in the survey. The survey took approximately 15–20 minutes to complete.