Graduation Year

2026

Document Type

Open Access Senior Thesis

Degree Name

Bachelor of Arts

Department

Psychology

Reader 1

Stacey Wood

Reader 2

Woo Jung Lee

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Abstract

Rates of methamphetamine use disorder (MUD) have risen sharply across the United States, with rural Appalachia experiencing the steepest mortality increases. Contingency management (CM) is among the most effective treatments for stimulant use, yet implementation is constrained by cost, logistics, and clinician shortages. Utilizing digital CM platforms and peer recovery support specialists, who are central to addiction support in rural regions, may reduce these barriers. This thesis proposes a 16-week, three-arm randomized controlled trial (N ≈ 300) comparing: (1) Digital Abstinence CM Only (remote saliva toxicology and monetary vouchers for stimulant-negative tests); (2) Digital + Peer-Goal CM (digital abstinence-based CM plus weekly peer-led goal-based CM across four domains: Social & Community Engagement, Mental Health, Physical Health & Lifestyle, and Daily Functioning & Role Responsibilities); and (3) Peer Support Only (generic peer support and toxicology monitoring without vouchers). Primary outcomes include verified abstinence and treatment engagement; secondary outcomes include motivation to recover and composite psychosocial functioning aligned with the goal-setting domains. It is hypothesized that (1) both CM conditions will outperform Peer Support Only in abstinence rates; (2) the Digital + Peer-Goal CM condition will produce the strongest abstinence, engagement, psychosocial improvements, and the most durable abstinence at six-month follow-up; and (3) higher goal attainment within Digital + Peer-Goal CM will predict greater motivation and sustained abstinence through enhanced self-efficacy and recovery capital. Steeper delay discounting and poorer executive functioning are expected to weaken CM effects across conditions. Findings will inform scalable hybrid CM models for rural stimulant-using populations

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