Table 2 STRIDE Assessments

Diagnostic and Screening Measures

Demographics Form

Screen

To gather basic demographic information.

Composite International Diagnostic Interview (CIDI) (Modules A, J, & L)

Screen

To obtain substance use diagnoses. Tests of the reliability of the CIDI-SAM based on DSM-IV diagnoses for cocaine dependence compared to SCID interviews done by trained clinicians, had percent agreement of 82.6%, with kappa = 0.61. With specific criteria for the diagnosis, kappas ranged between 0.68 and 0.55.

Mini International Neuropsychiatric Interview (MINI)

Screen

To identify Axis I psychiatric diagnoses (excluding substance use disorders). In comparison to the Structured Clinical Interview for DSM-IV Disorders (SCID-P), kappa values were good (only one diagnosis < .50), specificities and negative predictive values were .85 or higher across diagnoses, and in general, sensitivity was .70 or higher [113].

Locator Form

Screen, monthly

To obtain contact information for each participant.

Prior and Concomitant Medications

Screen, weekly

To assess prescribed medications taken by the participant.

Self-Administered Comorbidity Questionnaire (SCQ)

Screen

To assess the presence of medical problems, their severity, and whether or not the condition limits functioning. An intraclass correlation coefficient of 0.94 shows good test-retest reliability and is comparable to the Charlson Index intraclass correlation coefficient of 0.92.

Physical Activity Readiness Questionnaire-Revised (PAR-Q)

Screen

To determine whether a person needs to consult with their physician prior to engaging in an exercise program.

Medical History- Self-report Form

Screen

To obtain information that will facilitate the conduct of the physical exam, clinician-rated medical history, and maximal exercise test.

Maximal Exercise Test Screening Questions

Screen

To aid the medical personnel in ensuring that it is safe for the participant to undergo the maximal exercise test

Maximal Exercise Testing

Screen, week 13

To examine cardiorespiratory responses in order to rule out ischemic response to exercise, to identify participants for whom exercise might be hazardous, and to provide data for the exercise prescription.

Physical Exam/Medical History

Screen

To provide clearance for exercise.

Laboratory Tests

Screen

To provide clearance for exercise.

Substance Use and Treatment Assessments

Timeline Followback (TLFB)*

*Primary outcome measure

Screen, 3X/wk for 1^st 3 months, 1X/wk for next 6 months

To quantify days of substance use for calculation of primary outcome (percent days abstinent). The TLFB has been shown to have high test-retest reliability (ICC values ranging from 0.70 to .94, with all p < 0.001), good convergent and discriminate validity, and acceptable agreement between the TLFB and urine drug screens (Yule's Y of 87 or greater for amphetamines and cocaine)[114].

Urine Drug Screen (UDS)

Baseline, 3X/wk for 1^st 3 months, 1X/wk for next 6 months

To test for substance use and to inform TLFB.

Stimulant Craving Questionnaire-Brief (STCQ-Brief)

Baseline, weekly

To assess current craving for stimulants. The CCQ-Brief, from which the STCQ-Brief is adapted, has high internal consistency, with Cronbach's alpha ranging from 0.87 [115] to 0.90 [61]. The instrument also has good construct validity and has shown to correlate well with other craving measures [115].

Stimulant Selective Severity Assessment (SSSA)

Baseline, weekly

To assess signs and symptoms of stimulant abstinence. The Cocaine Selective Severity Assessment, from which the SSSA is adapted, has been shown to have good inter-rater reliability (correlation coefficient = 0.92, p < 0.001) and internal consistency (Cronbach's alpha = 0.80).

Addiction Severity Index-Lite (ASI-Lite)

Baseline, weeks 13, 25, 37

To assess common problems associated with drug use. The CTN version is similar to the ASI-Lite-Veterans Administration (ASI-L-VA) and should have similar psychometric characteristics. Specifically, intraclass correlations between the ASI fifth edition (ASI-5) and ASSI-L-VA are 0.79 for alcohol, 0.79 for drug, 0.85 for legal, 0.46 for family/social, and 0.53 for psychiatric [116].

Fagerstrom Test for Nicotine Dependence (FTND)

Baseline

To assess dependence on nicotine. The FTND has shown acceptable internal consistency (Cronbach's alpha of 0.61) and correlates significantly with other measures of smoking consumption.

Treatment as Usual (TAU) Tracking Form

Baseline, weekly

To assess the participant's treatment for substance abuse within the past week.

Measures of Mood, Sleep and Anhedonia

Quick Inventory of Depressive Symptomatology- Clinician rated version (QIDS-C₁₆)

Baseline, weekly

To assess severity of depression-specific symptoms. The internal consistency coefficient is high (Cronbach's alpha of 0.90)[70]. It also has good concurrent validity, with correlations between the QIDS and the 17-item Hamilton Rating Scale for Depression ranging between .86 and .93. It also has been shown to have good inter-rater reliability with a kappa of .85.

Concise Health Risk Tracking- Self-report (CHRT-SR)

Baseline, weekly

To assess suicidality and related thoughts and behaviors. The CHRT-SR has good internal consistency (Cronbach's alpha of 0.78).

Concise Associated Symptoms Tracking- Self-report (CAST-SR)

Baseline, weekly

To assess symptoms related to suicidal thoughts and behaviors. The internal consistency coefficient for the CAST-SR is good (Cronbach's alpha of 0.77).

Snaith-Hamilton Pleasure Scale (SHAPS)

Baseline, monthly

To measure anhedonia, the inability to experience pleasure. The SHAPS has adequate construct validity, satisfactory test-retest reliability [117], and high internal consistency (Cronbach's alpha of 0.94)[117].

Psychosocial Assessments

Short-Form Health Survey (SF-36)

Baseline, monthly

To assess quality of life and general health. Internal consistency reliability coefficients for the SF-36 are high (all greater than 0.80). Test-retest coefficients range from 0.43 to 0.90 for a 6-month interval and from 0.60 to 0.81 for a 2-week interval. The SF-36 has been shown to correlate moderately well with other health measures.

Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF)

Baseline, monthly

To evaluate general life enjoyment and satisfaction. Test-retest reliability for the Q-LES-Q-SF has been shown to be .86 [118] and internal consistency (Cronbach's alpha) has been shown to range from .86 to .90 [118, 119].

Pain Frequency, Intensity and Burden Scale (P-FIBS)

Baseline, monthly

To evaluate the frequency, intensity, and burden of pain over the past week, as well as usage of pain medication to manage pain.

Cognitive Function Assessments

Wechsler Test of Adult Reading (WTAR)

Baseline

To assess pre-morbid intelligence. The WTAR has been established to be a reliable and valid assessment of pre-morbid intelligence. It has been normed with the Wechsler Adult Intelligence Scale (WAIS-III) and the Wechsler Memory Scale (WMS-III).

MGH Cognitive and Physical Functioning Questionnaire (CPFQ)

Baseline, monthly

To assess physical well-being and cognitive and executive dysfunction. The CPFQ has been shown to have high internal consistency with a Cronbach's alpha of 0.90 and test-retest reliability (0.83, p < 0.001)[120].

Stroop Color and Word Test (Stroop)

Baseline, weeks 13, 37

To measure attention response inhibition.

Physiological Measures

Physiological Measures

Baseline, monthly (height once at baseline, weight weekly)

To measure height, weight, body mass index (BMI), and waist circumference

Exercise Readiness Form

Baseline, each supervised exercise session (3X/wk for 1^st 3 months, 1X/wk for next 6 months)

To measure resting heart rate and blood pressure for those in the exercise condition in order to evaluate safety for exercise.

Retention

Treatment Participation Questionnaire (TPQ)

Baseline, weekly

To assess participant's likelihood of remaining in treatment.