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Protocol - 12-Step Group Participation

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Description

The Multidimensional Mutual-Help Activity Scale (MM-HAS) includes 16 interviewer or self-administered items assessing involvement in 12-step mutual help groups, frequency of attendance, and perceived effectiveness. Participants are asked about their attendance in 12-step mutual help groups (in-person and online) and their involvement in various activities related to these groups.

Specific Instructions

The Multidimensional Mutual-Help Activity Scale (MM-HAS) is customized to measure activities specific to 12-step meetings. For a measure that provides questions about involvement that are generalizable across various types of mutual-help organizations (Self-Management and Recovery Training [SMART], Women for Sobriety, etc.) and thus allow for comparison, see the Peer Alternatives for Addiction (PAL).

Protocols may include terms and language that could be triggering to respondents. Investigators are encouraged to have resources in place to help respondents cope with triggers as needed.

Terminology related to substances, substance use, and recovery is fluid. Updates in protocol language may be appropriate based on circumstance. Suggestions for revision have been offered to update answer responses or other components of the questionnaires to account for the constantly changing landscape. These suggestions have not been tested or validated in research studies but may be considered by investigators to enhance relevance.

Availability

This protocol is freely available; permission not required for use.

Protocol

MULTIDIMENSIONAL MUTUAL-HELP ACTIVITY SCALE (MM-HAS) 

[REPEAT MEASURE FOR EACH FELLOWSHIP/SUPPORT GROUP ATTENDED]

Please answer the following questions for [support group].  

Do you currently consider yourself to me a member of [support group]? Select one.  

[ ] Yes  

[ ] No  

In the past 3 months (90 days), did you…   

Yes  

No  

1. Have a sponsor?  

[ ]  

[ ]   

2. Have contact with your sponsor either by phone or in person outside of a [support group] meeting?  

[ ] 

[ ] 

3. Have contact with other [support group] members either by phone or in person outside of a meeting?  

[ ] 

[ ] 

4. Read 12-step literature (big book, step book, “24 hours a day”) outside of a [support group] meeting (e.g., at home)?  

[ ] 

[ ] 

5. “Share” or talk during [support group] meetings?  

[ ] 

[ ] 

6. Help with setting up/running [support group] meetings (e.g., making coffee, setting up chairs)?  

[ ] 

[ ] 


While participating in [support group] in the 3 months (90 days), have you…   

Yes  

No  

7. Completed a written inventory (Step 4)?  

[ ]    

[ ] 

8. Discussed your written inventory with another person (i.e., completed a Step 5)?  

[ ] 

[ ] 

9. Made a list of people you have harmed (Step 8)?  

[ ] 

[ ] 

10. Made direct amends to people you have harmed (Step 9)?  

[ ] 

[ ] 

11. Prayed or meditated when not at a meeting (Step 11)?  

[ ] 

[ ] 

12. Tried to help new/other members at or outside of a meeting (Step 12)?  

[ ] 

[ ] 


13. On a scale from 1 to 10 where 1 = “not at all helpful” and 10 = “extremely helpful,” how helpful is [support group] in your recovery efforts? 

[Enter number between 1 and 10]     

14. On a scale from 1 to 10 where 1 = “do not enjoy at all” and 10 = “enjoy a great deal,” how much do you enjoy attending [support group] meetings?  

[Enter number between 1 and 10]    

15. On a scale from 1 to 10 where 1 = “not at all safe” and 10 = “completely safe,” how safe do you feel when attending [support group] meetings?   

[Enter number between 1 and 10]  

 Scoring: 

Individual items are scored dichotomously as 0 (No) and 1 (Yes). Total score is the sum of items 1, 2, 3, 4, 5, 6, 7, and 12.  

Personnel and Training Required
The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a “don’t know” response is provided. The measure can also be self-administered.
Equipment Needs
The PhenX Working Group acknowledges these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.
Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Lifestage

Adolescent, Adult

Participants

Adolescents and adults aged 14 and over with a history of substance use disorder.

Selection Rationale

The Multidimensional Mutual-Help Activity Scale (MM-HAS) protocol was selected because it provides a comprehensive and multidimensional assessment of 12-step mutual-help group activities, capturing a wide range of experiences and behaviors that are critical to understanding the role of these groups in recovery.

Language

English, Spanish

Standards
StandardNameIDSource
Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

Multidimensional Mutual-Help Activity Scale (MM-HAS)

Source

Kelly, J. F., Urbanoski, K. A., Hoeppner, B. B., & Slaymaker, V. (2011). Facilitating comprehensive assessment of 12-step experiences: A multidimensional measure of mutual-help activity. Alcoholism Treat Quarterly, 29(3), 181–203.
https://doi.org/10.1080/07347324.2011.586280

General References

Humphreys, K., Barreto, N. B., Alessi, S. M., Carroll, K. M., Crits-Christoph, P., Donovan, D. M., Kelly, J. F., Schottenfeld, R. S., Timko, C., & Wagner, T. H. (2020). Impact of 12 step mutual help groups on drug use disorder patients across six clinical trials. Drug and Alcohol Dependence, 215, 108213. https://doi.org/10.1016/j.drugalcdep.2020.108213

Kelly, J. F., Stout, R. L., & Slaymaker, V. (2013). Emerging adults’ treatment outcomes in relation to 12 step mutual-help attendance and active involvement. Drug and Alcohol Dependence, 129(1–2), 151–157.
https://doi.org/10.1016/j.drugalcdep.2012.10.005

Protocol ID

590603

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
Substance Use Recovery
Measure Name

Treatment and Recovery Support Services

Release Date

January 30, 2025

Definition

Psychosocial treatment is psychotherapy, pharmacological treatment is medication, and recovery support services are nonclinical interventions.

Purpose

Recovery may include use of a variety of treatment and recovery support services that people may utilize to mobilize and/or maintain adaptive and salutary recovery-related change. This measure can be used to assess lifetime and past 30-day use of “assisted” (i.e., formal treatment/medications, mutual help organizations/recovery community centers, recovery housing, recovery coaching, etc.) versus “unassisted” resolution pathways.

Keywords

Mutual-help groups, 12-step programs, alcohol use disorder, AUD, recovery, peer support, substance use disorder, SUD, Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Cocaine Anonymous (CA), mutual-help group activity, recovery support services, substance use, addiction

Measure Protocols
Protocol ID Protocol Name
590601 Use of Treatment and Recovery Support Services
590602 Mutual-help Group Involvement and Treatment Attendance
590603 12-Step Group Participation
590604 Future Service Needs - Self-Help Involvement