Paths to improving engagement among racial and ethnic minorities in addiction health services.
Paths to improving engagement among racial and ethnic minorities in addiction health services.
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DOI：
10.1186/s13011-015-0036-z
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发表时间：
2015-10-26
期刊：
影响因子：
--
通讯作者：
D'Aunno T
中科院分区：
文献类型：
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作者：
Guerrero EG;Fenwick K;Kong Y;Grella C;D'Aunno T
种族和少数民族群体的成员最有可能在成瘾治疗方面受到限制和参与不足。关于方案能力和提供全面护理在改善有药物滥用问题的少数群体获得和保留药物方面的作用的研究有限。本研究的目的是检查在何种程度上获得和保留增强时，种族和少数民族接受高容量成瘾健康服务（AHS）计划的照顾，并通过协调与心理健康和接受艾滋病毒检测服务。这项多层次的横断面分析涉及来自108个项目的数据，并与2011年13,478名进入AHS的成年人的客户数据相结合。使用多水平负二项回归模型检验程序容量与进入治疗天数（等待时间）和治疗天数（保留）之间的相互作用和间接关系。与低容量计划和非拉丁裔和非非洲裔美国人的客户相比，在高容量计划中服务的拉丁裔和非洲裔美国人报告了更短的等待时间。非裔美国人在高容量项目中的治疗保留时间也更长。接受艾滋病毒检测和精神卫生服务的项目协调在项目能力和等待时间之间的关系中发挥了间接作用。AHS的计划能力和协调服务可能会减少获得护理的差距。支持低能力的方案，以消除在获得医疗服务的差距的影响进行了讨论。
Members of racial and ethnic minority groups are most likely to experience limited access and poor engagement in addiction treatment. Research has been limited on the role of program capacity and delivery of comprehensive care in improving access and retention among minorities with drug abuse issues. The goal of this study was to examine the extent to which access and retention are enhanced when racial and ethnic minorities receive care from high-capacity addiction health services (AHS) programs and via coordination with mental health and receipt of HIV testing services. This multilevel cross-sectional analysis involved data from 108 programs merged with client data from 2011 for 13,478 adults entering AHS. Multilevel negative binomial regression models were used to test interactions and indirect relationships between program capacity and days to enter treatment (wait time) and days in treatment (retention). Compared to low-capacity programs and non-Latino and non-African American clients, Latinos and African Americans served in high-capacity programs reported shorter wait times to admission, as hypothesized. African Americans also had longer treatment retention in high-capacity programs. Receipt of HIV testing and program coordination of mental health services played an indirect role in the relationship between program capacity and wait time. Program capacity and coordinated services in AHS may reduce disparities in access to care. Implications for supporting low-capacity programs to eliminate the disparity gap in access to care are discussed.