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Substance use treatments that address both substance use and social\u2010contextual factors are uniquely positioned to address these substance\u2010related problems and produce more sustainable improvements in social functioning than treatment as usual (TAU) or behavioral controls (Control). The aim of this study was to evaluate changes in substance\u2010related problems among Black adults, focusing on the comparative effectiveness between social\u2010contextual treatments and TAU\/Control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Individual\u2010level data synthesis based on secondary analysis of Black adults enrolled in the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All data were collected in the primary studies between 2001 and 2008 at clinics across the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Black adults who reported cocaine and\/or opioid use across nine studies within the NIDA CTN. The sample used herein consisted of individuals from five of these studies who provided data on substance\u2010related problems (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009532; mean age\u2009=\u200939.34; standard deviation\u2009=\u20099.6).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>There were two treatment conditions: Social\u2010contextual (e.g. Motivational Interviewing, Seeking Safety, STAGE 12) and TAU\/Control. Moderated nonlinear factor analysis estimated latent scores for substance\u2010related problems, using subscales from the Addiction Severity Index, while accounting for measurement noninvariance across studies, time and covariates. Linear mixed models estimated latent score differences over time between social\u2010contextual treatments and TAU\/Control during treatment and from the end of treatment through 12\u2010month follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Both treatment groups improved across substance\u2010related problem areas from baseline to the end\u2010of\u2010treatment (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.10 to\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.47), with effects maintained at 12\u2010month follow\u2010up. Although social\u2010contextual treatments did not statistically significantly outperform TAU\/Control from baseline to end\u2010of\u2010treatment, they showed greater effects from end of treatment to 12\u2010month follow\u2010up in family\/social [Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      difference (\u0394\n                      <jats:italic>d<\/jats:italic>\n                      )\u2009=\u2009\u22120.47, 95% confidence interval (CI) = \u22120.57 to \u22120.38], legal (\u0394\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.20, 95% CI = \u22120.31 to \u22120.10) and psychiatric problems (\u0394\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.29, 95% CI = \u22120.38 to \u22120.20) than TAU\/Control. Sensitivity analyses indicated that Seeking Safety and STAGE 12 predominantly drove post\u2010treatment improvements in family\/social problems.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Substance use treatment may yield broader, delayed benefits beyond substance use reduction among Black adults in the United States. Compared with treatment\u2010as\u2010usual, social\u2010contextual treatments can yield more sustainable effects in legal, family and psychiatric areas among Black adults, with interventions such as Seeking Safety and STAGE 12 showing particular benefits in addressing family\u2010related challenges.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70405","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T08:15:30Z","timestamp":1775117730000},"page":"1699-1708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative effectiveness of social\u2010contextual treatments for improving substance\u2010related problems among Black adults: An individual\u2010level data synthesis"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1117-8595","authenticated-orcid":false,"given":"Adriana","family":"Espinosa","sequence":"first","affiliation":[{"name":"Department of Psychology The City College of New York and The Graduate Center, CUNY  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3004-6977","authenticated-orcid":false,"given":"Angela M.","family":"Haeny","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesia M.","family":"Ruglass","sequence":"additional","affiliation":[{"name":"Department of Psychology The City College of New York and The Graduate Center, CUNY  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caravella","family":"McCuistian","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Vena","sequence":"additional","affiliation":[{"name":"The Emmes Company: The Emmes Company, LLC  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Roundtree","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Counseling and Clinical Psychology Teachers College, Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio A.","family":"Morgan\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"RTI International: Research Triangle Institute, International  Research Triangle Park North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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